Medicare – the Elephant in the Room

I called for the end of Medicare/Medicaid.  Mr. Tennessee Paul though questioned this bold ideology over at AmericanMissive.com to which I will respond.

Quite ideological. I could agree that these entitlements are a drag on the economy and ideally should eventually be done away with. But you can’t simply cancel these systems. It isn’t feasible. While I am not a fan of these systems, they are in fact obligations that this country has promised. An outright cancel is akin to default on a debt. And while I do subscribe to the notion that the Government is not the savior of mankind, it is the duty of the government to provide the environment for commerce. Besides, if the government were to simply up and dump these three entitlements, it would not solve the current issues within the health care system. The issues being affordability of care and insurance.

- Tennessee Paul

Yes, ideological.  But I think this misses the point.  Medicare/Medicaid is in fact insolvent.  They cannot be paid for quite simply.  I realized I used the word cancel Medicare which applies something dramatic.  But I wouldn’t be the technocrat doing the canceling.  I’m sure it would be canceled in a slower planned and organized way.  However, it may be akin to default on debt as Tennessee Paul suggests.  A ugly word, default, and an ugly thought but not out of the realm of possibility.

The financial structure of the U.S. government currently has two nominal firewalls. The first, between Treasury debt and unfunded liabilities, is provided by the trust funds of Social Security, Medicare, and other, smaller federal insurance programs. These give investors the illusion that the shaky fiscal status of social insurance has no direct effect on the government’s formal debt. But according to the latest intermediate projections of the trustees, the Hospital Insurance (HI-Medicare Part A) trust fund will be out of money in 2017, whereas the Social Security (OASDI) trust funds will be empty by 2037. Although other parts of Medicare are already funded from general revenues, when HI and OASDI need to dip into general revenues, the first firewall is gone. If investors respond by requiring a risk premium on Treasuries, the unwinding could move very fast, much like the sudden collapse of the Soviet Union. Politicians will be unable to react.
-Why Default on U.S. Treasuries is Likely
Jeffrey Rogers Hummel

Further, Tennessee Paul states that Medicare and Medicaid being dumped wouldn’t solve the health care crisis [CORRECTION: TP used the term "current issues" not crisis].  To which I respond, “What health care crisis?” [To which I should have responded, "What are the issues?"] There is no crisis yet the crisis will come when Medicare/Medicaid collapse.  The crisis to me is the impending economic, social and political chaos that will come when the world economy follows the U.S. economy into the abyss while the last bastions of freedom are surround by egoists and tyranny.

The solutions I have read, put forth by many conservative pundits are directed at creating just such an environment to facilitate more economically feasible solutions for health care reform.

- Tennessee Paul

I agree with Tennessee Paul there are many conservative pundits calling for better solutions out there.  The problem is the Republican party isn’t proposing them.  I know Tennessee Paul thinks I’m being to harsh on politicians.  But I think it’s time to be harsh.  It’s getting late in the game politicians feet need to be held to the fire.  It’s up to us the voters to do this.  So even more then the politicians we the American people need to come down on our respective parties and demand change.  The more we dilly-dally around the issues and fail to address those things which are pressing on our society, culture, and lives the greater risk we are in of losing it all.  Perhaps, Paul doesn’t have the same fears I have but I think things are going to get MUCH worse before they get better.

As for Tennessee Paul’s point about doing away with Medicare/Medicaid not being the end all solution I agree.  There needs to be deregulation and a decoupling of employer provided health care in concert with the cancel/phase out/end of Medicare.   These two points I know Tennessee Paul agrees with but a deregulation and a decoupling of employer health care but these are still to me meaningless without true reform of the system.  Medicare still places way to large a constraint on the U.S. health care system.  It is the elephant in the room and it’s growing way to fast.  And it’s not being debated, solutions aren’t being proposed and I still believe there has yet to be proposals from either sides towards true reform.