Very important NYT article today on Republicans’ failure to identify any specific spending cuts despite using the deficit as a political tool. Indeed, as I wrote after the first 15th district debate, none of the candidates have put forward a serious plan to deal with the deficit, since none of them even mention Medicare/Medicaid.
Credit where it’s due, Jake Towne’s plan to cut defense spending by disciplining missions is highly laudable and would definitely do the most of all three plans, but it is still inadequate for closing the long-term gap.
So before the next debate, I hope reporters and moderators will familiarize themselves with this David Leonhardt column and ask the candidates what they propose to do about Medicare cost-control instead of asking what to do about the deficit:
The huge budget deficits that the country faces in coming decades are, above all, because of Medicare. The program will have to cover growing numbers of baby boomers while health costs are likely to keep going up.
It won’t be possible to pay the bill by cutting other programs. They’re not big enough. Making big cuts to everything but Medicare and Social Security — shrinking the military and other programs to their smallest share of the economy since World War II — might save $200 billion a year by 2035. But by then, annual Medicare spending is projected to grow by more than $1 trillion.
So any deficit strategy needs to focus on Medicare.
In the new issue of the journal Health Affairs, two doctors, both former Medicare officials, have laid out a plan to do so. It would give expensive new treatments three years to prove that they worked better than cheaper treatments, or their reimbursement rates would be cut to that of the cheaper treatments.
I understand that the idea will strike some people as — gasp — rationing. More modest ideas were shouted down during the debate over health reform. But I’d urge anyone who does not like the doctors’ plan to think a bit about how Medicare should be changed. The status quo isn’t really an option.
We are now in a political campaign in which everyone seems to talk about cutting spending without offering many ideas for how to cut spending. When the campaign ends, all that talk won’t balance the budget. Neither will cutting waste, fraud, abuse and foreign aid. Nor will ending the war in Afghanistan and the Bush tax cuts for the rich.
Policies like those can help shrink the deficit, yes. Raising taxes and tweaking Social Security can help even more. But you probably can’t call yourself a fiscal conservative unless you are willing to support changes — that is, cuts — to Medicare.
By contrast, the most serious Republican proposal that’s been put forward is Paul Ryan’s plan, which would turn Medicare into a voucher program, and then allow the value of the vouchers to fall behind health care inflation. Of course it’s true that simply ceasing to pay for Medicare would solve the budget problem, but have fun building support for that approach with old people – especially as seniors make up an increasingly large part of the Republican political coalition.
The next few years are going to see a lot of very important decisions made in this area, so it would be great if moderators used the debates to get the candidates on the record with this stuff, rather than wasting everyone’s time with inane trivia.