Likewise, although a case can be made for reducing the Medicare benefits of higher-income beneficiaries, as a practical matter their savings are almost as vulnerable to rising healthcare costs as are the more modest savings of middle-income retirees. "Means-testing" Medicare also runs the risk of transforming it into a program for the "less fortunate," which can undermine its political support.
In short, Medicare isn't the problem. The underlying problem is the sky-rocketing costs of health care. Because Medicare's administrative costs are a fraction of those of private health insurance, Medicare might be part of the solution. Medicare for all, or even a public option for Medicare, would give the program enough clout to demand health providers move from a fee-for-service system to one that paid instead for healthy outcomes.
With healthcare costs under better control, retirees wouldn't be paying a large and growing portion of their incomes for healthcare -- which would alleviate pressure on Social Security. I'm still not convinced a "chained CPI" is necessary, though. A preferable alternative would be to raise the ceiling on the portion of income subject to Social Security taxes (now $113,600).
Besides, Social Security and Medicare are the most popular programs ever devised by the federal government, which is why Republicans hate them so much. If average Americans have trusted the Democratic Party to do one thing it has been to guard these programs from the depredations of the GOP.
Putting these two programs "on the table" is also tantamount to accepting the most insidious and dishonest of all Republican claims: That for too long most Americans have been living beyond their means; that we are rapidly approaching a day of reckoning when we can no longer afford these generous "entitlements;" and that prudence and responsibility dictate that we must now begin to live within our means and cut back these projected expenditures, particularly if we are to have any money left to invest in the young and the disadvantaged.
The truth is the opposite: That for three decades the means of most Americans have been stagnant even though the overall economy has more than doubled in size; that because almost all the gains from growth have gone to the top, most Americans haven't been able to save enough for retirement or the rising costs of healthcare; and that because of this, Social Security and Medicare are barely adequate as is.
Paul Ryan's House Republican budget takes on Medicare, but leaves Social Security alone. Why should Democrats lead the charge on either?
The Republicans are already slashing help for the young and the disadvantaged. Democrats shouldn't succumb to the lie that the elderly and young are in competition for a portion of a shrinking pie, when in fact the pie is larger than ever. It's just that those who have the largest and fastest-growing portions refuse to share it.
We are the richest nation in the history of the world -- richer now than we've ever been. But an increasing share of that wealth is held by a smaller and smaller share of the population, who have, in effect, bribed legislators to reduce their taxes and provide loopholes so they pay even less.
The budget deficit "crisis" has been manufactured by them to distract our attention from this overriding fact, and to pit the rest of us against each other for a smaller and smaller share of what remains. Democrats should not conspire.
Needy children should be getting far more help, better pre-school care, better nutrition. Seniors need better healthcare coverage and more Social Security. All Americans need better schools and improved infrastructure.
The richest nation in the history of the world should be able to respond to the legitimate needs of all its citizens.
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