I was in the optician’s office the other day, waiting for a new lens to be put in my glasses. I was feeling a bit sorry for myself as I struggled to read a magazine without glasses. Then, a fellow came in pushing an elderly lady in a wheelchair. I try not to be nosy, but it was hard not to overhear them.
She had just been to the ophthalmologist, and had been told she needed to have cataract surgery. It became clear that she lives alone without any family close by. The gentleman who brought her in goes to the same church as her, and has been helping her for years, transporting her to appointments and helping her with financial matters. The cataract diagnosis had obviously had upset her, and she struggled to hold back tears as she tried to work out whether or not she should have this surgery at 90 years of age. Her friend from church tried to console her. When she asked what she would owe for the visit to the ophthalmologist as well as this minor repair to her glasses, he had encouraging words. The doctor visit was covered by Medicare and the optician probably wouldn’t charge to fix her glasses.
Folks like this lady can sometimes struggle through what are supposed to be their golden years. Things promise to get even worse for her successors if the plan to privatize Medicare is enacted. Under Rep. Paul Ryan's proposal, seniors and others on Medicare would begin receiving a set amount of money, starting in 2022, to offset the cost of buying a private insurance plan. This plan to replace the federal government's Medicare plan sounds good in theory. Ryan says that applying what he calls "free-market principles" to the insurance market is the best way to control costs.
But, will it really work out that way? The independent Congressional Budget Office (CBO) says otherwise. CBO’s review of Ryan’s program estimates seniors would end up paying almost twice as much out of their own pockets — or more than $12,510 a year. Altogether, the total cost of health care would be higher. That is why a number of studies show that voucher programs like the one Rep. Ryan is proposing will not reduce health care costs.
Why is that? It turns out that buying health insurance is different from picking out a car or groceries. You and I can figure out which auto will be best for us by comparing different models and using resources like Consumer Reports. We can choose whether we want to buy the name brand box of corn flakes or the generic store brand. But, how many of us can figure out which is the best health care plan for us, given the myriad factors like deductibles, exclusions from coverage, lifetime caps, etc., etc.?
Rep, Ryan says he wants seniors to be covered by a plan that is similar to that currently in effect for federal employees. But, here’s an interesting fact. Under the Federal Employees Health Benefits Program, costs have risen over 64% over the last five years, far faster than health care costs generally and faster than Medicare costs have increased. Of course, under Rep. Ryan’s plan, the federal government will only be paying a fixed amount to each senior for health care, meaning that our seniors will bear the brunt of higher health care costs.
Now, maybe, you and I can educate ourselves so that we can make an intelligent choice among health care providers. But, is this a burden we want to impose on frail seniors like the lady in my optician’s office? Is it morally right to make her have to figure out which health insurance option is best for her? Is it right to make her bear a steadily increasing share of health expenses as we switch from a program with a good track record of containing costs to one that has let costs rise much faster?
We will all need to make sacrifices to balance our federal and state budgets. Rep. Ryan’s plan mostly imposes the sacrifices on the elderly and less fortunate, those least able to bear it. I think we should couple some cuts to these programs with some revenue increases. These should include a repeal of the Bush tax cuts on the rich. We should also close some loopholes in the individual and corporate tax codes that allow those with the brightest lawyers and accountants to avoid paying taxes. Those who have benefitted the most in our society should contribute their fair share. Just throwing the elderly under the bus is the wrong solution to our budget problems.
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