The Washington Post
July 17, 2003
… Medicare’s universality. Many Democrats and some Republicans consider this to be Medicare’s central attraction. It is a program, they say, that gives the same benefits to everybody, rich or poor, and therefore receives universal political support. To preserve this universality, many are fighting against a provision in the House bill, for example, that calls for people with incomes above $60,000 to pay a larger share of their drug bills. They object on the grounds that nobody should be treated differently.
This kind of thinking helps to illustrate what has gone so deeply wrong with the bill, a piece of legislation that seems to be oblivious to its long-term consequences. In practice, the refusal to countenance any means-testing will set in motion a vast transfer of wealth, from the pockets of America’s poorer children — who will eventually be working adults — to America’s wealthier elderly. The desire to maintain political support for Medicare is understandable, but the zealous opposition to any reform that would provide fewer benefits for the rich is profoundly misplaced. It guarantees the swindling of a generation that cannot vote in order to benefit a wealthy constituency that can.
Comment: The editorial staff of The Washington Post supports destroying Medicare as a program of social insurance. Introducing means testing would result in a mass exodus of affluent beneficiaries into the private sector. The traditional Medicare program then would undergo de facto conversion into a welfare-type Medicaid program, but with even fewer benefits, not to mention the inevitability of deficient funding.
The editors support means testing as a method of preventing “a vast transfer of wealth from the pockets of America’s poorer children.” But an equitable system of progressive funding is much more readily assured through the tax system rather than through a fragmented system of differential qualification for benefits. Measures as simple as exempting from the Medicare tax wages that are necessary to meet basic needs would go a long way toward establishing equity.
We cannot afford to abandon the concept of social insurance. In fact, we need to expand it to include all of us.