[StBernard] Saving Medicare

[Westley Annis]

Friends - 

Kudos to Congressman Paul Ryan for having the courage to insist Washington
policymakers focus on the real challenges facing our country, as opposed to
giving the same speeches filled with the same talking points. That kind of
courage is so rare in politics, no wonder the American public has stopped
listening. 

You can, and people have, quibble with the details all you want, but Paul is
the only one in Congress who consistently presents serious ideas that would
guarantee Medicare continues to be there for our children while also not
bankrupting our country.  The President, in his fourth year, continues to
promise us his entitlement reform plan is coming - kind of like Lucy
promising Charlie Brown she won't move the football this time.

This week I called Paul to thank him for his courage.  We served in Congress
together, traveled to Israel together, and I count myself as one of his
fans.  After reducing the budget here in Louisiana by billions of dollars, I
told him I know you get very few calls thanking you for cutting spending.
Since I'm a governor, I think he was just relieved I wasn't calling to ask
for an earmark. 

Paul's proposal changes the way Medicare operates, installing what is known
as a "premium support" plan that would provide federal dollars to defray
most of the cost of an insurance plan covering a defined set of benefits.
There are many important questions to answer in how you implement a premium
support plan for Medicare: e.g., Does the government-run fee-for-service
plan continue to be offered everywhere and to all, forever? How are premiums
for this plan calculated? How much flexibility do you allow plans to offer
different benefits? How do you calculate the premium subsidy?  

But, make no mistake, there are basically two options for Medicare - we can
take serious action now to save the program or face drastic choices as the
Baby Boomers continue to retire.  We know we are not going to dramatically
reduce promised benefits and cannot continue to borrow trillions of dollars
from our children (China is just the middle man collecting the interest).  

The Left's solution is simple - raise payroll taxes; they have never met a
problem that can't be solved by spending more of our money.

Premium support allows beneficiaries to share the savings as Medicare plans
compete to provide them health care services more efficiently.  Choice and
competition will save billions by reducing the rampant fraud and abuse in
the current Medicare system that make hundred dollar hammers and toilet
seats at the Pentagon seem quaint.  But even more importantly, premium
support provides an alternative to the current centralized command and
control system, where as Len Nichols noted years ago, the government tries
to set 10,000 prices in 3,000 counties.  (You can guess how often it gets it
right!)  

I don't know about you, but I don't want unelected bureaucrats or members of
Congress deciding what treatment my parents get - as Sen. John Breaux said
years ago, he didn't go to medical school so Senators shouldn't be making
medical decisions.  Doctors and their patients, not the politicians, should
be making these decisions.  

This is not just a question of fiscal responsibility, but a question of
liberty - whether we will accept the Left's view that the government knows
best how to run our lives or the conservative view that we should empower
the American people to direct their lives for themselves.     

The Left will call this idea of a "premium support" model dangerous and will
accuse Republicans of all kinds of awful, evil anti-elderly behavior, but we
know this model works, because it is already how Members of Congress and
federal employees get their health care coverage.  If the system Paul
proposes is so bad, let's make Congressmen give up their premium support
health care coverage - though that might be a good idea for other reasons!  

I was the executive director of a congressionally-created commission back in
the 1990s that garnered significant bipartisan support for premium support,
including endorsements from the AMA, Democratic Leadership Council, Wall
Street Journal, Mayo Clinic, etc.  We got majority, but not the required
supermajority, support on the commission - some speculated because of the
Clinton White House's distraction with the Lewinsky scandal.  President
Clinton later whined he was denied the opportunity to be a great president
due to the lack of major challenges on his watch.  Imagine his legacy if he
had, in the spirit of Nixon going to China or even his own eventual
capitulation to welfare reform, joined the charge to fix Medicare. 

Governor Scott Walker - another good guy from Wisconsin - inspired the
following thought:  We need leaders willing to think and act not for the
next poll or the next election, but for the next generation. At least Paul
and others like him are making sure President Obama cannot continue to
ignore the job he was elected to do.

-Bobby