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Republican New Year’s Resolution: Dismantle Medicare

Written by Nancy Altman

The New Year is a time of resolutions.  Consistent with that tradition, the Republican New Year’s Resolution is clear: Dismantle Medicare, ending Medicare as we know it. What’s most scary is that with Republican majorities in both the U.S. House of Representatives and the Senate, they have the power to make good on their intention to destroy Medicare.

To be sure, you are not likely to hear the Republican leadership talk about gutting Medicare.  Instead, they euphemistically talk about “saving” Medicare. Simply put, they are “saving” the government money by cutting Medicare spending and forcing older adults and people with disabilities to spend more out of their own pockets for their care–if they can even afford the medical care they need. Let there be no doubt that, in the view of the Republican politicians, Medicare (and Social Security, for that matter) need not continue to guarantee people’s health and retirement security.

The truth is that Medicare doesn’t need “saving.” As the wealthiest nation in the world, the United States can afford a greatly expanded Medicare that offers far more coverage and covers far more people than it does today. In 1965, when Medicare was enacted, the nation’s Gross Domestic Product was, in real terms, a quarter of what it is today ($4.1 trillion in 1965 versus $16.7 trillion today.)

Expanding Medicare is the way to provide high quality, cost effective access to care for everyone in the U.S.  Because we rely on for-profit insurers, the United States is unable to rein in health care costs or to drive the system changes that we need to improve our quality of care. Other countries have, essentially, Medicare for All, and pay a fraction of what we pay, frequently with better health outcomes.   We spend three times more per capita than Japan on health care, for example, and live, on average, around five fewer years!

Ryan and the Republican leadership’s Medicare plan will only drive up costs and undermine quality further. They want to return the country to pre-Medicare days, allowing insurers the freedom to offer inadequate coverage or no coverage at all. “Free choice” in their world simply means freedom to fall into medical bankruptcy or to forego needed care. Medicare was enacted because commercial insurers were unwilling to offer older adults good coverage at an affordable price.

The Republican plan will simply empower commercial insurers by giving people a voucher to help cover the cost of their commercial insurance. At the same time, it will disempower older adults and people with disabilities who will not be able to buy reliable cost-effective coverage they can count on. To make matters worse, the Republican plan proposes to raise the age of Medicare eligibility to 67; and, though it would permit people to use their vouchers to buy Medicare, the program will, foreseeably, wither on the vine, as a result of a vicious circle: Medicare will be available only to the oldest and least healthy part of the population, and so will become more and more expensive, covering people with the greatest health care needs, while commercial insurers cherry pick the healthy.  Even fewer healthier people will opt for Medicare, and the price will go up even more.

Rather than giving all Americans the option of cost effective coverage through a robust federal Medicare program, people in Medicare today and their children and grandchildren increasingly will, under the Republican plan, be forced into a commercial insurance plan that they cannot rely on to meet their health care needs.

We need to expand Medicare, not end it, if we care about the lives of people in the U.S. If the Republicans end Medicare, we are destined to have an unsustainable health care system that increasingly rations care based on people’s ability to pay. Medical bankruptcies will rise. And, life expectancies in the U.S. will continue to be shorter than in other countries.

To stop the Republicans, I urge everyone who is old or hopes to be old someday to make your own Medicare resolution for 2017. Tell your elected leaders: Hands off Medicare except to expand it.

Sign this petition and ask your friends to join you. Mobilize and make your voices heard. Then, as a resolution for 2018, we can all resolve to elect leaders who listen to us and have the good sense to expand, not destroy, Medicare.

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