Mitt Romney is down South, trying to win votes in the Alabama and Mississippi Republican primaries. So, I will respond as a Southerner to Romney's announcement that he won't be enrolling in Medicare, because he's worth $150-to-$200 million and doesn't need it: Well, bless his heart.
Once again, I reminded of Will Allen Dromgoole's poem, "The Bridge Builder," in which an old man crosses a river only to start building a bridge across it. (A "bridge over troubled water," if you will.) Asked by a traveler why he's building a bridge over a river he's already crossed, the old man speaks of one who will pass that way after him. "I am building this bridge for him," he explains.
As I said of Romney's billionaire backer Ken Griffin, Romney sound like the kind of guy who would cross that bridge, and then either blow it up or build a toll booth on it.
Romney's ideological evolution towards becoming the Republican nominee includes a move to embrace Paul Ryan's Medicare plan. Just to review, Ryan's original plan would have fundamentally changed the nature of Medicare, from a guaranteed public benefit to a subsidized private benefit.
Ryan's original plan replaced guaranteed coverage with "premium support." seniors would turned out into the private health insurance market with a "fixed amount" of "premium support," that would increase with inflation — not the cost of health care, which increases at a much faster rate. The effect is to (a) into the private health insurance market and (b) shift growing health care costs so seniors. According to the CBO, by 2030 a 65-year-old cold be liable for up to 68% of her health care costs. The plan also raised age at which seniors would become eligible for Medicare.
Romney's current Medicare plan, differs from Ryan's original plan in that it include a private plan but makes it optional, and preserves traditional Medicare "for those who want it." This is akin to the difference between a bullet to the brain and "death by a thousand cuts." It sounds much better, but end result is the same. Health insurers would simple cherry pick healthier seniors, just like they already cherry pick the youngest, healthiest and richest. Traditional Medicare would sicker seniors who are more expensive to cover. The costs would undermine traditional Medicare. Conservatives could then use this engineered failure to take what's left of Medicare as we know it out behind the barn, to finish the job.
Slightly different means lead to pretty much the same end for Medicare. The program would have the same name, but would be otherwise unrecognizable. Ultimately, the shift to a subsidized, privatized program called Medicare wouldn't even lower health care costs. Medicare as we know it may not be perfect, but it saves a ton compared to private health insurance. Sure, Medicare spending increased 400% from 1969 10 2009, but private insurance premiums increase more than 700% in the same period. Data from Medicare Advantage, which lets recipients get care through the private sector, costs taxpayers 13% more than Medicare as we know it.
The saving grace for conservatives is that their changes to Medicare would make it much harder to track how much more seniors end up paying for their health care. Success, here, resembles the catastrophic success of "welfare reform." Success means reducing the number of people getting help, rather than reducing the number of people needing help.
This is another case of the candidate of the 1 percent trying to relate to the other 99 percent (in the south, this apparently means dropping his g's, as well as dropping gratuitous references to grits into his speeches) and failing miserably. Romney's wealth places him among the richest 0.001 percent of Americans, so it's no surprise that he doesn't need Medicare.
Romney's decision not to enroll Medicare can be seen "walking his talk," but it sets him apart from most seniors. Nearly all seniors are automatically enrolled in Medicare Part A, which covers hospital care, but they can choose not to use it. But 95% choose to enroll in Medicare Part B, which covers physician services, once they're eligible. Romney's plans for Medicare are also out of step with the majority of Americans who are opposed to cuts to Medicare.
Romney certainly doesn't need Medicare. He can use his wealth to buy top-of-the-line health insurance and health care. But had he chosen to enroll anyway, it might have demonstrated, to seniors and Americans who opposed Medicare cuts a commitment to Medicare as we know it.
Instead, Romney's message that he just doesn't need Medicare, combined with an agenda that alters it beyond recognition, is really that he's just "not that concerned" with people who do need Medicare.
