Medicare, front and center

Ryan re-energized the debate; now it’s time for everyone to show their plans

The end of Medicare as we know it.” In the dwindling weeks between now and the Nov. 6 election, expect those words to be repeated on the campaign trail and in the news media just as often, if not more so, than the all-too-familiar call to “repeal and replace” the Patient Protection and Affordable Care Act.

The selection this month of Rep. Paul Ryan (R-Wis.), chairman of the powerful House Budget Committee, as Mitt Romney’s running mate immediately reintroduced the phrase back into the national political echo chamber. The choice of Ryan also guarantees that healthcare will remain center-stage in the policy debate, involving not only the presidential/vice presidential contest but races all the way down the ballot in the battle for control of Congress.

The “end of Medicare” reference, of course, is one of the charges against Ryan’s most aggressive plan to overhaul the program from standard fee-for-service to a “premium support,” or voucher, model. Such a change would mean seniors would be paid a fixed amount of Medicare dollars that they would then use to comparison-shop for a private insurance policy.

There can be no argument that such a plan would spell the end of Medicare as we’ve always known it. Even another idea floated by Ryan and Sen. Ron Wyden (D-Ore.) last year offering seniors added choices would require restructuring of the program. The real question is whether Medicare as we know it is a healthy program that we know will be there for the next generation and beyond.

Everyone agrees the current system is unsustainable. Analysis shows a “solution” such as Ryan’s might make Medicare more affordable for the treasury, but at the same time equally less affordable for seniors. One of raps against the plan is that the vouchers can’t possibly keep up with healthcare inflation if the proposed budget is to be honored, resulting in an out-of-pocket increase of $6,500 per beneficiary, according to the Congressional Budget Office. And that cost would continue to grow.

So, for many seniors, that could mean the end of a secure retirement as they might have known it.

Romney, set to officially accept the Republican presidential nomination next week at the GOP soiree in Tampa, Fla., was quick in his attempt to deflect the initial tsunami of criticism for his running mate’s ideas, saying that he would have his own plan for Medicare, and that Ryan’s plans aren’t necessarily his plans. But we have yet to see the nuts and bolts of such a plan. Last week, he offered some ideas that might pass as a framework, but for detail, the only substantive proposals we have are courtesy of Congressman Ryan.

To be fair, when it comes to Medicare, we’ve yet to see a comprehensive plan from the Obama administration either. The White House can take some credit for extending the life expectancy of the program through provisions of the ACA, but it’s no long-term fix. By contrast, Ryan’s vision is there for all to take in. Based on opinion polls, the public doesn’t like what they see, especially those sure-to-turn-out-at-thepolls seniors. Romney, meanwhile, continues to vow that part of the solution to Medicare’s ills is the repeal of Obamacare. Again, we say, if unplugging the reform law is part of the answer, we’d love to hear more. Where’s the plan?

The nation needs to have a civil, balanced discussion about our fiscal future. The direction of Medicare, Medicaid and Social Security are core issues, along with bipartisan solutions for their solvency. The question: Can we expect to see such changes enacted anytime soon?

If so, that would mean the end of politics as we know it. Assistant Managing

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