Fiscal Cliff 'Grand Bargain' May Be Anything But
Mary Sanchez

They say that Social Security is the third rail of American politics: Touch it and you die.

That dictum extends to Medicare and even Medicaid as well. I'd like to take this opportunity to remind President Obama and members of both parties in Congress of why that is.

If you are an ordinary American worker, you might be unlucky enough to learn a new buzzword of the health care industry: memory care. It refers to the health care assistance some older people need to do basic things like take the correct pills on the right day, get bathed and dressed safely, and remember whether they already ate lunch.

This care is incredibly expensive -- several thousand dollars a month in a live-in facility. If your mother or father needed memory care, how would you pay? With costly private long-term care insurance? Savings? Would you or your spouse cut back work hours or leave the workforce to provide the care? Or should Medicare and Medicaid pick up some or all of the cost?

The AARP estimates that two-thirds of people over the age of 65 will need long-term care of some sort. Median costs in the U.S. for an assisted living apartment are $3,300 a month, usually paid for with private funds. Nursing homes are more expensive, with a median annual rate of $81,000, costs that can be covered by Medicare or Medicaid.

It's not surprising that talk of "entitlement reform" and "grand bargains" and "hard choices" coming out Washington make voters nervous.

We're supposedly hurtling toward a "fiscal cliff" in January, when drastic federal budget sequesters will kick in unless the president and Congress can avert them with a budget agreement that enacts some combination of tax increases and spending cuts.

What should be cut? Both Obama and members of Congress have suggested that $400 billion could be cut from Medicare. Another idea getting a lot play is to raise the Medicare eligibility age from 65 to 67.

This may sound good to some, but it will amount to robbing Peter to pay Paul. A Kaiser Family Foundation study estimated that doing so would mean "increased state and private-sector costs would be twice as large as the net federal savings."

If put in place by 2014, Kaiser estimated $5.7 billion in net federal savings, but $11.4 billion in higher health care costs to individuals, employers and states. Hardly a grand bargain.

Besides, how many 66-year-olds are employed with the full benefits of healthcare? Or can rely on pension plans with healthcare coverage intact?

This is top-down thinking. Anybody in Washington who contemplates this clearly fails to see how such budgeting plays out in real homes across America.

Republican Gov. John R. Kasich of Ohio framed it well recently in speaking with reporters during the Republican Governors Association meeting, noting how decisions on the deficit reduction from Washington befall states.

"I'm just saying that if you're going to affect us, you'd better realize there's a bottom line that affects flesh and blood and real people," Kasich said.

Polls show that Americans, across party lines, overwhelmingly reject drastic cuts to either Medicare or Medicaid. Why? Because these aren't welfare programs for "moochers," as many on the right suggest. They are social insurance.

According to a February 2012 report from the Center on Budget and Policy Priorities, more than 90 percent of entitlement and mandatory program dollars go those who are elderly, seriously disabled or members of working households.

Without these social insurance programs, which all working Americans contribute to with payroll taxes, how many famillies would be able to cope with the challenges of illness and old age? In an age when both spouses in most families must work, where is there time and where are there surplus resources to assume these responsibilities on their own?

Most Americans want affordable, dignified care to be there for their elders -- not to mention for themselves when the time comes. Not a handout or a "gift," as Mitt Romney might put it, but rather a system that taxes all and cares for all.

The costs of Medicare and Medicaid are growing at an alarming rate, but only because the costs of medical care generally are growing. Yet Congress has failed to enact commonsense measures to control that growth -- such as using Medicare's market power to negotiate cheaper drug prices.

Medicare and Medicaid are very popular programs. If we're lucky, Congress and the president might not have to learn the hard way just why that is.

 

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Fiscal Cliff 'Grand Bargain' May Be Anything But | Politics

 

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