Medicare’s Dim Horizon

by Stephen Spruiell

The Center for Public Integrity is publishing a series of articles this week on wasteful spending in the Medicare program. Politicians talk a big game about saving Medicare by eliminating wasteful spending, but they never follow through. That’s because, as the Center explains, much of the waste in Medicare results from the overuse of medical services and the prescription of unnecessary treatments — the essential byproducts, in other words, of a third-party, fee-for-service insurance system. Fixing the system is going to require a thorough rethinking of how best to provide this benefit to seniors and people with disabilities — and few politicians are up to the task.

The first installment in the series doesn’t break any new ground, but it does provide a clear, concise explication of how we got here and what our choices are going to be. It points out, in a fair-minded way, the shortcomings of the approaches to cost control taken by the authors of the recently passed Affordable Care Act. And it promises, in future installments, “a vivid picture of some of the questionable spending that occurs in the Medicare program.” Something to keep on your radar.

While we’re on the subject: A few weeks back, the editors noted both the desperation with which some liberals were distorting Republican proposals on entitlement spending and also the frivolity of the counter-proposals emanating from such personages as Charlie Crist, who, without offering specifics, made a cliché of himself by offering to save the system by cutting down on “waste and fraud.” The editors wrote:

It seems like just months ago (actually, it was) that Democrats were accusing Republicans of opportunistically trying to scare seniors by highlighting the $500 billion in Medicare cuts contained in the Obama-Reid-Pelosi health-care bill. Republican supporters of entitlement reform, in particular, were labeled hypocrites, and some even deserved it. But there is a big difference between making cuts to entitlement programs to ensure their long-term solvency and appropriating $500 billion from an already-bankrupt program to fund a new entitlement.

That’s true. But there’s another big difference, which John McCormack explains here: The $500 billion that the Democrats’ health-care bill would take from Medicare to fund new subsidies for able-bodied adults would come from benefit cuts affecting seniors today. By contrast, the kind of reforms that Republicans are putting on the table would be phased in so that current and near-retirees wouldn’t be affected. That’s an important political difference, but it’s an important moral difference, too: It speaks to the the need to give people time to adjust their long-term plans to the proposed policy changes. Those who possess clear sight with regard to the worsening state of Medicare are already making those adjustments, I hope.

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