Nation needs a reality check
Published 12:01 am Tuesday, July 19, 2011
It’s true that rigid ideology is one of the chief barriers to major deficit reduction. Republicans are opposed to tax increases, Democrats to cuts in entitlement programs. On those positions, each side seems about as flexible as Tim Eyman is on red-light cameras.
But it’s also us, the electorate. Politicians, after all, usually respond to the demands of those who voted them into office — and can vote them out. Turns out voters aren’t all that flexible either.
Take Medicare, the mother of all entitlement programs. An Associated Press-GfK poll conducted in May showed that 54 percent of Americans think the budget can be balanced without cuts to the federal health insurance program for seniors and younger folks with disabilities. That poll was taken in the wake of a budget bill passed by House Republicans that would change Medicare from an open-ended entitlement to a defined-contribution benefit, with recipients using limited government funding to buy private insurance.
Keep your grubby hands off my benefits, Americans said.
Serious proposals from Democrats have fared no better. A plan to have Medicare pay for voluntary end-of-life counseling was derided by Sarah Palin and others as the institution of “death panels.” Even though such hyperbole was widely discredited, the idea was dropped from last year’s health-care bill.
This is why meaningful deficit reduction is so hard. It requires very hard decisions, like finding ways to spend significantly less on health care — including expensive care that buys a few more months, weeks or days at the end of life. CBS’s “60 Minutes” reported that in 2009, Medicare payments just for doctor and hospital bills in the last two months of life totaled $55 billion.
Absent change, Medicare is in a death spiral, with spending projected to increase from $519 billion in 2010 to $929 billion in 2020, even with reductions mandated by Obamacare. Blame an aging population and longer life expectancy, along with higher health care costs fueled by increasing use of services and new, costly technologies.
Meanwhile, many Americans seem convinced — incorrectly — that they’ll only take out of the system what they’ve paid into it. Payroll taxes (37 percent) and beneficiary premiums (13 percent) pay for just half of Medicare. Forty-three percent comes from that rising sea of red ink categorized as “general revenues.”
Medicare may need reform more urgently than other programs, but it’s emblematic of America’s refusal so far to face reality. We still have time to dictate our own solutions, but the hourglass is getting awfully bottom-heavy.
Leadership will take political courage, even a willingness by politicians to sacrifice their own re-election in pursuit of the greater good.
Like we said, it’s hard.
