Jeb Bush suggests phasing out Medicare

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http://americablog.com/2015/07/jeb-bush-suggests-phasing-out-medicare.html

Jeb “Apple Watch” Bush told a gathering of conservatives at an Americans for Prosperity event last night that he thinks the country should phase out Medicare, ending the program for those who aren’t already receiving benefits.

Said Bush:

I think a lot of people recognize that we need to make sure we fulfill the commitment to people that have already received the benefits, that are receiving the benefits. But that we need to figure out a way to phase out this program for others and move to a new system that allows them to have something — because they’re not going to have anything.

This puts the supposedly “moderate” Bush to the right of Republicans’ most rabid budget hawks when it comes to the social safety net. When Rep. Paul Ryan proposed a budget that privatized much of the program, Democratic claims that Republicans wanted to “end Medicare” were dubbed the “Lie of the Year” by PolitFact; they weren’t ending the program, they were just radically changing it.

Well, now we know. Republicans want to end Medicare. Not just “as we know it,” but completely.

Bush justified his claim by arguing, as is always argued when Republicans attack Medicare, that the program is on its way to insolvency. That would be true if Bush got his way and we replaced Obamacare with Apple Watches, but as Kevin Drum at Mother Jones pointed out, current projections show Medicare spending reaching about half the proportion of GDP that it was projected to in 2005, falling from 13 percent to 6 percent.

There are a lot of caveats in the numbers. As Drum noted, projecting Medicare costs is a bit more difficult than projecting Social Security costs because there are more variables:

Social Security is basically just arithmetic. We know how many people are going to retire, we know how long they’re going to live, and we know how much we’re going to pay them. Do the math and you know how much the program will cost us. It can change a bit over time, as projections of things like GDP growth or immigration rates change, but that happens at the speed of molasses. There are very few surprises with Social Security.

Medicare has all that, but it also has one more thing: the actual cost of medical care. And that’s little more than an educated guess when you start projecting more than a decade ahead. Will costs skyrocket as expensive new therapies multiply? Or will costs plummet after someone invents self-sustaining nanobots that get injected at birth and keep us healthy forever at virtually no cost? I don’t know. No one knows.

In any case, given the best information we have available, Medicare looks to be in much better shape now than it did ten years ago.

A lot of that has to do with the Affordable Care Act. The law cut Medicare Advantage, the part of Medicare that had been privatized under George Bush and was (unsurprisingly) costing the government more per-plan than the public version of the program. Remember back in 2010 when Republicans were attacking President Obama for cutting Medicare? That was what they meant. And, of course, the Ryan budget being drafted and circulated around that time included bigger cuts to more crucial parts of the program.

Congress also recently repealed the “doc fix,” which will produce additional savings in the program by restructuring its payment mechanism to doctors.

At the end of the day, as MSNBC’s Steve Benen put it, “Before ‘Obamacare’ was passed, Medicare was projected to face a serious fiscal shortfall in 2017. As of yesterday, Medicare trustees now believe the system is fiscally secure through 2030.”

So sure, if Jeb Bush has his way and returns us to the health insurance regime in place while his brother was president, Medicare would all of a sudden look much less viable. But to claim that the program is on the verge of bankruptcy today, warranting its elimination, is simply not true.

What’s more, Bush claims that “people understand” the need to eliminate Medicare. This, too, is false. No matter how many times Republicans say that the public’s on their side, the polling data simply doesn’t support them; roughly eighty percent of seniors say that the program is working well. In that same poll, 76 percent of Republicans agreed that the deficit can be cut to appropriate levels without touching Medicare.

So chalk this up to the latest installment of Jeb Bush couching extreme — even by Republican standards — policies in a soft tone and calling it moderation. He’s planted a flag way out in right field on an issue where there is a clear national consensus against him, and planted it on dubious empirical grounds.

As Benen wrote, “It says something important about Republican politics in 2015 when the most mainstream candidate is also the candidate who wants to scrap Medicare altogether.”