Does Medicare Have A Future? Do the Democrats Care?

Every sentient American knows that Medicare is a fiscal disaster, and that the program must either be reformed or terminated. The Medicare Trustees recently released a report that indicated Medicare is five years closer to bankruptcy than it seemed a year ago. But, as Yuval Levin points out, the news is actually much worse than that:

[T]he real shocker in this year’s report is a letter that the chief actuary of Medicare attached to the very end of the report, basically saying that things are much worse than the trustees suggest. The letter (which starts on page 265 of the document and pretty much makes the prior 264 pages moot) first says that the trustees were compelled to adopt some near-term assumptions that are highly implausible….
Then it says that Obamacare, because it calls for across-the-board cuts in Medicare funding but does not put in place the market mechanisms for encouraging greater productivity in health care, spells disaster for Medicare providers, and therefore for Medicare recipients….

For these reasons, the financial projections shown in this report for Medicare do not represent a reasonable expectation for actual program operations in either the short range (as a result of the unsustainable reductions in physician payment rates) or the long range (because of the strong likelihood that the statutory reductions in price updates for most categories of Medicare provider services will not be viable).

In other words, Medicare as we know it is on the fast lane to ruin.

Medicare, in its present form, is doomed. The Democrats certainly know this. A reader writes:

It’s a feature, not a bug. The PLAN is to create an unstoppable crisis in the delivery of entitlement health care. After “engorging the beast” with Obamacare entitlements on top of the now untouchable Medicare entitlements, and after wrecking the private insurance market through Obamacare….it will be either chaos and dis-entitlement or a single payer monopsony to capture all health care provision–and, it goes without saying, higher taxes, and not just on the “rich.” It will be the Canadianization of private insurance and health care in America–effectively, government health care in substance irrespective of the form.

I think that is right. The Democrats intend to use the collapse of Medicare as part of the overall destruction of our health care system, so that the only apparent alternative is socialized medicine. That, plus they think that demagoguing the issue will help them in 2012 as it has in prior elections.
But it is hard for the Democrats to articulate their real policy with regard to Medicare. For political reasons, they have to pretend that the program in its present form is viable, even though they know perfectly well that it isn’t. This is, I think, the central reason why the Democrats cannot come up with a budget. Any honest budget would have to either 1) cut Medicare spending, or 2) raise taxes on all taxpayers by an astonishing amount, or 3) project horrific deficits, forever. The Democrats prefer not to face this reality, but rather to pin their electoral prospects on an appeal to the ignorant.
This is why Kent Conrad, Chairman of the Senate Budget Committee, ignored the law that requires his committee to produce a budget by April 15. He has now announced that a scheduled markup of a budget bill has been deferred indefinitely. Today, ranking member Jeff Sessions said:

I appreciate that Senator Conrad has recognized the serious concerns that I, my Republican colleagues, and millions of Americans have over the decision of the Democrat-led Senate to not pass a budget in the last 750 days, to not present a budget at all this year, and to not even allow the budget process to go forward. However, today’s announcement does not ease my concern nor, I would imagine, the concern now felt by people throughout this country. It seems Senate Democrats are desperately trying to avoid having to present a budget to the American people. They know that the big spenders in their caucus prevent them from bringing forward a credible plan that both their party and the country can support.
… Today’s announcement is just another excuse for delay–delay with no end in sight.
Nothing can change the fact that as long as Democrats retain the majority in the Senate–the majority they asked the American people to confer upon them–it is their responsibility, as required by statute, to publicly present their budget to the American people. … Once produced, the budget must be available for amendment, debate, and floor action as provided by law. …
Sooner or later every Senator will have to stand and be counted.

Perhaps. But if the Democrats can put the day of reckoning off until after November 2012, they will.

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