- The Washington Times - Thursday, June 2, 2011

ANALYSIS/OPINION:

In light of the results of the special election in upstate New York, where Democrats scored an upset victory by accusing Republicans of wanting to “end Medicare,” the GOP is being urged to abandon the effort spearheaded by House Budget Committee Chairman Paul Ryan to reform this most giant entitlement program. Lyndon B. Johnson once ran an ad accusing Barry Goldwater of wanting to blow up the world. In this election, Democrats followed up with an equally subtle pitch showing grandma being pushed over a cliff. What liberals won’t do in pursuit of the Great Society.

It would be a mistake if the GOP abandoned this critical effort. Even if nothing will move before 2012, it is important that the issue be discussed as a prelude to a serious reform effort after 2012. Remember that President George W. Bush tried to introduce Social Security reform in 2005 without a proper foundation. He got nowhere. And though it may not matter in the hothouse of national politics or in the minds of national pundits who chuckle about Republican overreach, it is the right thing to do and is key to fixing our trillion-dollar deficits and restoring our economic future.

A more muscular GOP response to liberal desperation is required if Medicare reform is ever to get serious consideration.

First, the GOP should emphasize that this is not an effort to change Medicare, but rather to save and strengthen it. The status quo cannot continue. The current program, born in that wonderful year of 1965, is unsustainable by any yardstick. A brief review of the just-released latest report by the Medicare trustee panel demonstrates this. Because the board is dominated by Obama appointees, their projections assume that Obamacare will actually reduce health costs (go figure) and they also assume that cuts in reimbursement rates for physicians will actually be implemented by Congress. (They won’t.) Despite these unrealistic assumptions, the trustees paint a gloomy picture of the Hospital Trust Fund (Medicare Part A), which is scheduled to be exhausted five years sooner than last year’s projections.

The trustees also note, albeit in opaque bureaucratese, that the solvency of the entire Medicare program is in serious question for the long term and urge major, though unspecified, reforms. Prominent Democrats, including House Minority Leader Nancy Pelosi and even President Obama, also seem to acknowledge this, though they never quite get around to specifying what they would do to solve the problem. Sadly, the president appears prepared to maintain this Buddha-like position for his entire re-election campaign.

Second, Republicans must stress that it was Mr. Obama and the Democrats who took $500 billion out of the program to start Obamacare - yet another unfunded entitlement. If the solvency for Medicare has worsened just in the past year, Mr. Obama’s bad economy surely is part of the reason. The other part is the unconscionable looting of the program in order to fund a new entitlement that places even more financial obligations on an overextended federal government.

Finally, Republicans should note that the only real policy alternative to Mr. Ryan’s plan for greater reliance on private insurance is rationing. That clearly is where Obama Democrats are headed, as evidenced by the establishment of the Independent Payment Advisory Board as a key part of Obamacare. If you are old enough to remember Jimmy Carter’s gas lines, wait until you have to take a number before you can see a doctor. If the program is not reformed, government will pick winners and losers, allocate a fixed dollar amount for care for the entire Medicare population, decide which services it will cover and which it won’t and for how much. Medical advances will slow, and more doctors will refuse to treat Medicare patients. The current fee-for-service model will continue in theory, but the fees will pay for fewer services, and the services provided will be sporadic and not readily available. Price controls can lead to no other outcome.

Democrats are relying on fear of the unknown to scare seniors. Expanded choice sounds great in theory, but trying to analyze a dozen different private health care plans with different benefits and lots of fine print is not an edifying prospect to the average retiree. To address this concern, any program reform must ensure that plan costs and benefits are clear and understandable. Seniors are not as helpless as liberals believe. They deal with apartment leases, reverse-mortgage contracts, life insurance payouts, and trust and estate documents. Why should health care be any different, especially if the alternative is rationing and continued national fiscal chaos?

Liberals believe the modern world is too complex for mere individuals - especially seniors - to deal with. Wise men in Mr. Obama’s Washington know best. Conservatives believe that given proper information, individuals can best provide for themselves and that Washington almost always makes problems worse, not better.

It sounds like a good debate to have in the next few years.

Frank Donatelli is chairman of GOPAC.

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