The Republican National Convention has been gaveled into order, and an already-hoarse RNC Chair Reince Priebus has begun the proceedings. The first day will include the roll call to formally nominate Mitt Romney and Paul Ryan for President and Vice President. What may have been an uncomfortable floor fight over the seating of delegates appears to have been averted, with a deal between Mitt Romney and the Texas delegation (LATE UPDATE: or perhaps not).
Also, in a couple hours’ time, the RNC will formally adopt the party platform. Republicans aren’t really interested in having anyone read that platform, but it offers plenty of clues into the policy trends of one of the major parties in America. We’ve heard about the abortion plank, calling for a ban on the procedure with no exceptions. There are planks that support African nations that persecute members of the LGBT community, planks supporting the establishment of a commission to study the return of the US to the gold standard, planks that draw a red line on Iran’s nuclear program at a weapon “capability” instead of a weapon itself, even planks recommitting to a forceful prosecution of pornography.
But perhaps the most important plank in the platform, considering the prominence of the nation’s fiscal debate, is the plank on Medicare, which spells out quite directly the GOP plan for the future of the program.
The text details the privatization policy that GOP lawmakers have supported for years, and that Mitt Romney and Paul Ryan are selling as necessary to “save” Medicare. But in an unusual twist, it addresses the specific aspect of the proposal that makes it a departure from what Americans know as “Medicare.”
“The first step is to move the two programs [Medicare and Medicaid] away from their current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model,” the draft platform reads. “While retaining the option of traditional Medicare in competition with private plans, we call for a transition to a premium-support model for Medicare, with an income-adjusted contribution toward a health plan of the enrollee’s choice. This model will include private health insurance plans that provide catastrophic protection, to ensure the continuation of doctor-patient relationships.”
The platform will also reportedly support increasing the Medicare eligibility age.
Fact-checking organizations who have mistakenly called the proposition that Republicans would “end Medicare as we know it” a lie must pay attention to that paragraph. Simply put, Republicans want to, well, end Medicare as we know it, from a defined benefit, a government-run insurance program for all seniors, which pays medical bills like any other insurance program, to a defined contribution, where seniors instead get a coupon to purchase their own insurance on the private market but the contribution likely won’t keep up with rising costs and premiums. The menu of options may include a government-run alternative, but it too would be a defined contribution rather than a defined benefit.
Republicans call the defined benefit plan unsustainable. But private competition, which is the method that they prefer for lowering costs, has never worked to do so in any test you can muster. Medicare is far better at containing costs on health care in the United States than private insurance. Every advanced country in the world, with their more coherent and less fragmented health care system, has lower costs than this country. The only thing a premium support plan would do is to offload those higher costs onto individuals as the higher costs exceed the “defined contribution.” In the name of keeping providers fat and happy with higher reimbursements, Republicans would throw seniors into the vicissitudes of the marketplace, which has not worked for individuals.
Let’s not overlook the part of that language that supports the block-granting of Medicaid, which would make massive cuts, shoulder costs onto beneficiaries, and lower the enrollment of the program.
The final platform language will not be made public until after the vote, a sign that Republicans don’t really want anyone to know about it. But these are basically the programs for Medicare that Mitt Romney and Paul Ryan have supported.