Politics & Policy

Don’t Punish Seniors for Health-Care Reform

Denying care options to retirees is necessarily a part of the Democrats plan.

In addition to being fiscally unsustainable, the health-care-reform plan emerging from Democrats in Congress raises disturbing questions for our nation’s seniors. If President Obama pushes through proposed “reforms,” seniors could very well face rationed care as the result of a raid on the coffers of a Medicare program that’s already nearly bankrupt.

One particular provision in the Democratic bill has seniors worried, and rightly so. A new “Center for Health Outcomes Research and Evaluation” could ration access to medicines and treatments based on the government’s assessment of the value of a human life and the “cost-effectiveness” of treatment.

This became abundantly clear when Senator Mike Enzi (R., Wyo.) introduced an amendment designed to ensure that the new center could not put a value on life-saving treatment by using “quality of life” and “cost-effectiveness” measures “for the denial of Medicare benefits to patients against their wishes.” Because Democrats rejected the amendment in a party-line vote, the proposed new entity would be able to impose restrictions on access to treatment, as is common in European countries with socialized medicine. Elderly, disabled, and medically dependent patients would be at greatest risk of being denied necessary care.

One reason for the rationing of care is to use “savings” from Medicare to pay for a radical, risky, and enormously expensive proposal for government-run health care. Except that it doesn’t: These short-term “savings” are a drop in the bucket compared to the massive expenditures required by the bill.

We should be fixing the Medicare system rather than using it to fund a government takeover of health care. If the proposed cuts in care were used to restore the fiscal soundness of Medicare, then those Medicare cuts would at least have some understandable rationale. It has long been recognized that the Medicare deficit — the future unfunded liability of projected Medicare spending — is a fiscal issue that dwarfs all others in magnitude, including the projected Social Security deficit. Spending on Medicare and Medicaid has significantly outpaced inflation over the years, and now accounts for 23 percent of the federal budget. Medicare’s unfunded liability stretching into the future is a mind-bending $89 trillion.

A new analysis by my staff at the Joint Economic Committee shows that, if the administration’s proposed cuts in Medicare were used to fund that program’s deficit instead of a government-run health-care system, Medicare’s long-term deficit would be reduced by 15 percent and it would put off insolvency by two years. The proposed scheme of using these “savings” to fill the massive hole in the budget created by government-run health care is like paying off credit-card purchases that you couldn’t afford in the first place from an overdrawn checking account. It just won’t work.

In a recent speech to the American Medical Association, President Obama himself acknowledged that Medicare’s looming unfunded liability will “swamp our federal and state budgets and impose a vicious choice of either unprecedented tax hikes, overwhelming deficits, or drastic cuts in our federal and state budgets.” Indeed, during the 2008 presidential campaign, candidate Obama criticized the idea of using money saved from making cuts in Medicare “to pay for an ill-conceived health-care plan, even as Medicare already faces a looming shortfall.”

It seems that the politics of health care — and the fact that the president’s reform plan is fiscally unsustainable — have led him to drastically change his views on the matter.

The denial of care options to retirees is not a paranoid fantasy of opponents of reform. President Obama contends that our society spends too much on medical care — and promises that his reforms will correct that imbalance. Scaling back Medicare, which the president acknowledges as one of the major sources of the budget deficit, will necessitate denying options to retirees. This happens already in the United Kingdom, where older citizens are denied certain treatments as a matter of policy, because government bureaucrats have calculated that an extra year of life, adjusted for “quality,” is not worth the cost of the treatment. Given the language in the Democrats’ current health-care bill, the U.S. now faces the truly frightening prospect of the government dictating end-of-life decisions.

We can achieve incremental change in our health-care system without a government takeover. The fact is, using Medicare as a piggy bank which can be raided to fill the deepening deficits that will result from such a takeover — and calling that reform — is wrong, economically and morally. A reform of our health-care system is needed, but not one that puts us into bankruptcy and rations care to our seniors.

– Sam Brownback is a U.S. senator from Kansas and the ranking Republican on the Joint Economic Committee.

EDITOR’S NOTE: This article has been amended since its initial posting.

Members of the National Review editorial and operational teams are included under the umbrella “NR Staff.”

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