Within the broad debate that health care reform has become, Medicare holds its own spot as a controversial topic. While both parties agree that Medicare needs to be restructured, just how this should be done and what would be more beneficial to the economy is a matter of high contention. Republican views on Medicare strongly revolve around providing seniors with more options. They believe seniors should be offered the same insurance plan that Congress is, including the option of Medical Savings Accounts. The administrative complexities must be reduced within Medicare, they argue, so that providers will be able to financially continue for patients. The Republican Party argues that Medicare should be designed to give older Americans choices, rather than as a one-size-fits-all institution. One of the primary goals of Republican Medicare reform plans is to create a system that will create incentive for the private sector to develop new drugs. Republicans realize that those that depend on Medicare the most are those that have put the most into the system, and strive to see the system reformed before their health is jeopardized by its inefficiencies.
Republicans recognize that people are living longer today than ever before, and therefore believe in finding ways to reduce the age range on Medicare. However, this does not mean that they hope to leave those that are retired or about to retire without healthcare. Instead, they wish to find solutions that will allow Medicare to account for both of these issues, such as a defined-contribution model. Participants would choose between the existing Medicare program or a subsidy to help buy private insurance. The platform that proposes this idea states, ”This is the only way to limit costs and restore consumer choice for patients and introduce competition; for in healthcare, as in any other sector of the economy, genuine competition is the best guarantee of better care at lower cost.”
Medicare Is Unsustainable
One of the biggest reasons that Republicans believe in drastic Medicare reform is that the system, in its current state, is unsustainable. Medicare has grown from more than 20 million enrolled in 1970 to more than 47 million enrolled today, with a projected total of 80 million in 2030. Medicaid counted almost 30 million enrollees in 1990, has about 54 million now, and under Obamacare would include an additional 11 million. Medicare spent more than $520 billion in 2010 and has close to $37 trillion in unfunded obligations, and total Medicaid spending will more than double by 2019. In many states, Medicaid’s mandates and inflexible bureaucracy have are growing faster than most other budget lines and are devouring funding that could be used for many other essential governmental functions.
Cheap Healthcare vs. Preventative Treatment
The problem with sustainability goes far beyond financial availability and over enrollment. Many believe that the real issue lies in the type and quality of care being provided to patients. Poor quality healthcare is the most expensive type of healthcare. In the end, it lengthens the amount of time people are in need of professional care, and leads to future problems. Even expensive preventative treatment is better than cheap care at the present time that will lead to more costly treatment later on.
Personal Responsibility For Health
Approximately 80 percent of healthcare costs are related to poor lifestyle. This includes problems such as smoking, obesity, and substance abuse. Republicans believe that this means greater emphasis needs to be placed on personal responsibility for health maintenance. While the goal for Medicare needs to be that every participant receives the amount of care they need at the time that they need it, preventative measures need to be taken to ensure that less people need extensive care. This includes creating measures to reduce the number of people that need to use Medicare to pay for health issues that were preventable.
Republicans believe that the first step towards Medicare reform needs to be to move the program away from its current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model. This is the only way to limit costs and restore consumer choice for patients. It is also the only way to introduce competition. Our economy is built on the principle that genuine competition is the best guarantee of better care at lower cost, and there is no reason that healthcare should be an exception. This defined-contribution model is also the best guard against the fraud and abuse that have plagued Medicare in its isolation from free market forces. This fraud and abuse has been costing the taxpayers billions of dollars every year since the program’s inception.
Despite Democratic arguments that Republican reforms would be detrimental to those who rely most heavily on Medicare, Republicans believe that they can implement these reforms without making any changes for those 55 and older. While retaining the option of traditional Medicare in competition with private plans, Republicans call for a transition to a premium-support model for Medicare, with an income-adjusted contribution toward a health plan of the enrollee’s choice. This model will include private health insurance plans that provide catastrophic protection, to ensure the continuation of doctor-patient relationships. This will make age eligibility for Medicare more realistic in terms of today’s longer lifespan without disadvantaging retirees or those nearing retirement.
This model also calls for converting Medicaid into a state block-grant program, which would save the federal government billions of dollars and give the states the power to control both the number of people eligible for Medicaid and the benefits they would receive. “Putting the patient at the center of policy decisions will increase choice and reduce costs while ensuring that services provide what Americans actually want,” the platform states.
Ben Carson on Medicare
Ben Carson has a view on Medicare that is unique among many in his party. Rather than entirely reforming the program, Carson would like to abolish it altogether. Instead of Medicare, he would like to see a system of cradle-to-grave savings accounts implemented. These accounts would be funded with $2,000 a year in government contributions. Surprisingly, this suggestion does not seem to have damaged Carson’s ratings much, and he has not faced the same intense scrutiny that many candidates face when proposing changes to the Medicare program. This is particularly surprising considering that the Republican platform states that the party is “is committed to saving Medicare and Medicaid,” and Carson is currently high within the GOP polls. “I have suggested that we provide the ability for anyone to have a health savings account from the day they are born until the day they die,” Carson stated during a speech at Cedarville University on September 22, 2015. “We’ll pay for it with the same dollars that we pay for traditional health care with. When people are able to see how much more freedom they will have, and how much more flexibility they will have, and how much more choice they would have, I think it’s going to be a no-brainer.”
The Democratic Party has largely ignored Carson’s plans, choosing not to speak out against them. Instead, they have focused on lashing out against other candidates, such as Bush and Rubio, who have simply criticized Medicare but proposed less drastic or no solution to the issue.
Donald Trump on Medicare
Donald Trump is adamantly against cutting back on Medicare costs. Instead, he believes the best option for Americans is to grow the economy so that it is large enough to sustain Medicare and similar programs. However, he did not provide a clear plan as to how he would do this. However, Trump has also stated that it would be possible for Medicare to be replaced with other programs, such as Health Savings Accounts. When asked about the idea by George Stephanopoulos on “This Week,” Trump stated, ”You’re going to have to look at that, but I’ll tell you what, the Health Savings Accounts, I’ve been talking about it also. I think it’s a very good idea and it’s an idea whose probably time has come.” He went on to explain, “I don’t know if you have been watching lately over the last couple of weeks — people’s premiums, George, are going up 35, 45, 55 percent. Their deductibles are so high nobody’s ever going to get to use it.” Savings accounts, in contrast, Trump stated, are “a very down-the-middle idea. It works. It’s something that’s proven.” This statement is somewhat ironic, as Trump previously criticized this idea when it was proposed by Ben Carson. However, he has recently changed his views and began supporting Carson’s idea.
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