New York Times - Business Day
Originally published August 24, 2012
Older adults are understandably anxious about the political sniping over the future financing of Medicare. That is precisely the intention of the presidential campaigns.
Yet the cross-fire over who will cut Medicare by how much sidesteps a critical issue about the future of our medical care: If we must ration our care to hold down costs in the future, how can we do it in a fair, efficient and transparent way?
Mitt Romney’s campaign was brazenly misleading in its charge that the president’s health plan would cut medical services to older adults by reducing Medicare spending by $716 billion. The president’s savings will come mostly from smaller payments to managed care companies, which provide the same services as Medicare at a higher cost, and from slower growth in reimbursement rates to health care providers.
But the response of President Obama’s campaign also aimed to stoke voters’ fears. It stressed — rightly — that the plan to curb Medicare costs proposed last year by Representative Paul D. Ryan, Mr. Romney’s vice-presidential running mate, would add thousands of dollars to older Americans’ out-of-pocket expenditures. Yet it ignored Mr. Ryan’s recent efforts to soften the plan.
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Rationing is inevitable in a world with finite resources. We do it in this country, too, and it is still one of the least fair and most inefficient rationing systems in the world. You get care if you have the money to pay for it; if not, you probably won’t.
The wealthiest 30 percent of the population accounts for nearly 89 percent of health care expenditures, according to a government study. Tens of millions of Americans — those whose employers don’t provide health insurance, who are too poor to pay for it themselves and yet are too rich to use Medicaid — get the least health care of all.
