As advocates, the MOAA lobbying team is paid to watch out for the interests of military and veteran beneficiaries. From that standpoint, we do our utmost to recognize the nation’s special obligation to do right by those who have accepted the extraordinary demands and sacrifices inherent in a 20- to 30-year career in uniform.
By and large, I believe Congress is making a good faith effort to do that in the ongoing thrash in Congress over national health reform.
But as a taxpayer, I have growing concerns on several fronts.
First, we face a harsh reality that, unless Congress acts relatively soon, Medicare will go broke in the very near future because of the coming wave of baby boomer retirements. In fact, many of those boomers will be retiring sooner than they planned to because the economic crunch of the past year has left lots of folks in their early-to-mid 60s downsized, bought out, and with less continued employment prospects than they had expected.
Second, unless current law is changed, Medicare and TRICARE payments will be cut by 21% this coming January — a disaster that would cause thousands more doctors to stop seeing elderly and military patients. Fixing that alone will cost about half a trillion dollars over the next 10 years. Where, exactly is that money going to come from (keep reading)?
Third, every legislator’s concern is to protect seniors from any cuts. But we’re living in some kind of dreamland if we think we can add new expensive benefits (such as increasing doctor payments or subsidizing care for all of America’s poor) without either bankrupting the country or making some hard decisions on cutbacks for somebody somewhere or raising a healthy chunk of new taxes on somebody.
All of the various bills would address the doctor payment fix somehow, but none of them in a particularly rational way.
The Senate bills would provide a one-year “patch” to prevent the doc payment cut just for 2010. That’s so they can claim that it’s “budget neutral”. What they don’t say is that that approach creates an even bigger ticking time bomb in the form of a 25+% payment cut that would have to happen in January 2011. (That’s what we’ve done every year for the last several years, and each successive year’s cut has ballooned from 5% to 10% to 21%. That budget rock just gets bigger and bigger, and the slope we’re pushing it up gets steeper and steeper…and that exercise just cannot go on much longer.)
The House bills would provide a longer-term formula fix and still claim to be deficit neutral. How? By simply not counting the cost of the doc payment fix in the equation! Talk about head-in-the-sand budgeting/economics…that’s no different than a college kid going wild with a credit card and pretending there’ll never be a bill to pay.
Like all other Americans, I want to fix Medicare for the long term. But we’re dreaming if we think we can just keep everyone where they are, add new benefits, and keep kicking the budgetary time bomb another year in the face of huge and unprecedented deficits.
The job ahead is to find the least objectionable cuts to make. Pretending that we can hold everyone harmless, not raise taxes, and pay for massive new programs and benefits as well is denying budgetary reality.
That’s how we got into this mess, and continuing to do the same thing isn’t a viable way out of it.
Do I have the answers? I could only wish.
But I know when the budgetary emperor has no clothes…and when it’s time to stop thinking we can do everything for everybody even though we’ve already maxed out multiple national credit cards.
