Medicare vouchers' quick death
House Budget Committee Chairman Paul Ryan (R-Wis.) touts his 2012 federal budget in early April. Credit: AP
It didn't take a long beatdown for Republicans in the House of Representatives to wise up on Medicare. They got an earful from angry voters over the past few weeks, saw the light, and abandoned their plan to end the program as we know it and replace it with vouchers. Chalk one up for the public.
The GOP proposal, crafted by Rep. Paul Ryan (R-Wis.) and approved last month by the House as part of a deficit-reduction plan, would do little to control medical costs. It would have shifted the financial burden for insuring the elderly from the federal government to individual seniors. That would shrink federal budget deficits, but it would leave seniors in the lurch. Even with a federal subsidy to help buy private insurance, many would likely be unable to afford it.
Voters were quick to see that, so the proposal quickly became political poison for Republicans. What that could mean next November is playing out now in suburban Buffalo. In a special May 24 congressional election in an overwhelmingly Republican district, a longshot Democratic candidate is surging in the polls after a barrage of attacks against the Ryan plan.
Rep. Dave Camp (R-Mich.), chairman of the House Ways and Means Committee, where legislation to implement the Ryan plan would have to originate, has seen enough. He said this week that strong opposition has made it pointless to continue down that road. It is.
The reason Medicare exists is that private insurance companies don't want to cover people who are old and sick. It would be tough for any company that did to make a profit. So Washington shouldn't abandon its guarantee of coverage for the elderly.
Something has to be done to restrain runaway medical costs, contain Medicare spending and rein in federal budget deficits. But the Ryan plan was a flawed and futile attempt to find a magic bullet to slay the dragon. Unfortunately there is none.
Chipping away at the problem with a variety of admittedly unglamorous moves is more likely to work. Things like using Medicare's buying power to bargain aggressively with pharmaceutical companies for lower prices -- a commonsense approach currently prohibited by law. Another is paying doctors and hospitals for a full course of treatment rather than for each procedure they perform. Allowing nurse practitioners leeway to independently provide routine treatment would also help. So would using research to determine the best treatments, which may not always be the newest or most expensive procedures.
We also have to get serious about reducing what we spend on end-of-life care for the terminally ill. That doesn't mean denying anyone treatment. The proposal irrationally vilified as "death panels" would simply have authorized Medicare to pay doctors to talk with patients about what's important to them when that time arrives. Given an informed choice, many would opt for care that makes them pain-free and able to talk with loved ones rather than procedures to keep them merely breathing as long as medically possible.
The trick is to make sure medical care is available without bankrupting the federal government or the elderly.
