Politicos are spinning the results of a recent special election in New York's 26th congressional district. Democrats claim Kathy Hochul's victory in what has been a reliably Republican district demonstrates voters' rejection of the House Republicans' plan to overhaul Medicare. Republicans argue a tea party candidate split their vote.
But no matter how one explains these results, Medicare's future will clearly be a wedge issue in 2012 elections. A recent Associated Press poll shows most Americans do not believe that Medicare reform is required in order to balance the federal budget. The poll further indicated that nearly three in four Americans see Medicare as a vital part of their retirement security.
Left on its current trajectory, however, Medicare is headed toward insolvency even as it consumes an ever-larger slice of federal revenues and the gross domestic product. This is not opinion; this is the most recent fiscal analysis of Medicare's trustees, who project that Medicare's hospital insurance funds will be depleted in 2024.
Perhaps the electoral focus on Medicare's future will sufficiently illuminate the magnitude and the importance of the relevant issues such that serious proposals to make Medicare both solvent and affordable get traction. We fear, however, that in our sound bite political culture, serious competing Medicare reform proposals will be subject to scaremongering rather than consideration.
To gain electoral advantage, partisans will obviously focus on the differences between competing Medicare reform proposals. We would, however, hope that as competing proposals move forward that we will see common themes, even if they propose divergent means.
The most important theme to highlight would be that our 21st-century demography of an aging workforce and declining birthrates makes the current model of transfers from workers to retirees unsustainable.
Additionally, policymakers must emphasize that Medicare benefits require dedicated sources of funding. That may sound obvious, but much of our current problem with Medicare comes from the decision to provide a prescription drug benefit without identifying a funding source.
Finally, Medicare funding needs to be capped at some reasonable percentage of GDP. Precisely how it is that quality basic care would be provided within a capped system would then become the focus for most of the policy debate. All parties will agree on the need to reduce waste and fraud. President Obama's plan calls for limits on allowed procedures and reimbursements within Medicare's single-payer system. Rep. Paul Ryan, R- Wisc., calls for limits on premium expenditures within a system of competitive insurance. We would welcome serious discussion of risk-adjusted benefits and means testing as well.
Americans deserve some health insurance security in their old age. The prognosis for Medicare's future, unfortunately, is that it will be both too expensive and insolvent when most Americans retire. Medicare, as currently constituted, is inherently insecure. If lawmakers will embrace demographic reality, identify dedicated sources of funding and cap expenditures, we believe they could find innovative means to provide genuine health insurance security to America's elderly that is both solvent and affordable.
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