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Wednesday, August 15, 2012

Medicare as a Metaphor

Congressman Paul Ryan's choice as Romney's vice-presidential pick quickly ignited Medicare as a metaphor for American social policy. In other words, Medicare has morphed from a government insurance program, primarily for senior citizens, into a social concept. Do we want to take care of our nation's middle class, poor, disabled, children and veterans, or not? Medicare symbolizes all of the above.

Ryan's VP pick has unequivocally opened this long simmering national debate. His self named "plan" to reduce the nation's deficit by cutting spending (without raising revenue) was just another dusty Congressional document until Ryan's pick by Romney launched the "Ryan Plan" into the national spotlight. 

Now, there's a real risk that a Romney-Ryan administration will change progressive social policies like Medicare, Social Security, Medicaid, Veteran's benefits, Planned Parenthood, Head Start, student loans and so forth.

Does the Ryan Plan really propose to cut these and other important programs? Obviously, I'm not sure because I certainly haven't read the document. But, changing Medicare is a central component of the Ryan Plan. What he proposes is for Medicare to morph into a voucher system. It's terrible public policy. But, a Voucher system is a cash cow for private insurance companies that will sell confusing products.

It's unclear if the Vouchers will include the Medicare Part D drug benefit. It's unclear how the Voucher products will cover physician specialty care. It's just unclear about how much money a Voucher program will cut or cost.

A Medicare Voucher system is a metaphor for all the social safety net programs, passed by Congress with rigorous public vetting over the past 80 years, since the FDR singing of the Social Security law.

Because the Ryan Voucher proposal is flawed, all other proposals in his plan are tainted. It's just like your mother said, "Watch the company you keep'.  If Medicare is cut, so, it probably goes, for all the other social safety net programs. 

What's most alarming about the Medicare Metaphor is the complete lack of data to support regressive social policies. Instead of cutting social programs, our nation should be focused on improving our nation's quality of life. For example, our nation's infant mortality rate is 34th in the world, where Singapore and Iceland are among the best. (Infant mortality is often used as an indicator of the level of health in a country.) 

Our nation's educational outcomes are outpaced by other countries in reading, science and math. 

In fact, US life expectancy is 38th in the world, while Japan is first.

Meanwhile, the US tax rates are lower than most highly developed. countries.

Polls indicate presidential candidate Romney didn't get the political "bump" he hoped for from his selection of Paul Ryan as a running mate.  The lackluster roll out of his VP pick has the probably unintended consequence of putting Romney's vision for the nation's future into the spotlight.  If Romney's vision for the future includes imposing the "Ryan Budget" on us, then, at least, his choice created a clear understanding of why he should not become our President.  

Medicare is a metaphor for the concept of caring.  

Romney flubbed up on the Ryan roll out. He wasn't prepared for questions about how the Ryan Budget impacts the struggling middle class.  My suggestion is for Romney-Ryan to completely rethink their political strategy and embrace both Medicare the program and the metaphor it represents about a nation of caring people.



Blogger Jacques said...

If the voucher program being proposed is anything like the Medicare Plan D for drugs, it will be a disaster.

The reason I am saying this is because the drug Plan D started at $6/month for every company and the plans were identical. Now the plans cost from $30-60/month and have many options, like no deductible, no co-pays, no doughnut hole, ... To get the cheapest plan, I have to go to the Medicare website every November and see which is the cheapest for each of us, given our drug mix. Every year, a new company comes up with a plan cheaper that all the others, sometimes by a factor of two to three. Than plan is never the lowest the next year and another one is. In four years, I have changed plans three times. And sometimes, the best one for me is not the best one for my wife. The companies are hoping that you do not do your homework and that you stick with the same one for another year, without realizing that the price has changed. It is a mess but, still manageable for a drug plan since I have to contact only one pharmacy with my new plan information.

If I had to go through this exercise every year for my Medicare and supplemental plan, I would go crazy, picking the cheapest one every year, and as comes January, I would have to contact all our doctors, clinics, hospitals, with our new plan information, not to mention the problems resulting with illnesses that overlap multiple plans. This would be a nightmare.

10:27 AM  

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