Keep benefits intact
When Medicare was created, it amounted to a promise that whatever health care retired individuals need will be covered at public expense. That promise must be honored, even if it means raising taxes or reducing spending in other areas. As things stand, elderly persons are paying more than ever for out-of-pocket medical expenses that are not covered by Medicare. Minor adjustments can be made to reduce the program's cost, and aggressive measures should be taken to reduce fraudulent claims. But it is immoral and unthinkable to reduce medical benefits or deprive elderly persons of the freedom to choose their own physicians.
What Should be Done?
Keep the current structure of Medicare intact. Only minor modifications are needed. Take new measures to detect fraudulent and excessive claims, from individuals as well as health care providers. Ensure that full Medicare benefits are provided to upper-income retirees, just like everyone else who pays into the system. No one should be forced to pay more for out-of-pocket health care costs. Oppose changes that may lead physicians to cut corners on medical care provided to retirees. Make sure physicians in HMOs who treat Medicare patients don't stint on care to keep costs down. Redefine coverage so Medicare covers a full array of preventive measures, such as screening for breast and prostate cancer, which should lead to savings in the long run.
Arguments For This Approach
Medicare is not in dire straits. All that's necessary are minor adjustments, and more agressive measures to detect fraudulent claims. Medicare is a right and a promise. Everyone who has paid into Medicare, regardless of their income, deserves to have their health care costs covered in retirement as a public expense. Providing for individuals who can no longer provide for themselves is one of the fundamental responsibilities of government. As a society, we respond to the needs of elderly persons because we recognize in them a vulnerability that most of us will eventually share. Older Americans need the benefits provided by Medicare. Even though many have only modest incomes, retirees are paying a lot in out-of-pocket medical expenses. Retirees need Medicare benefits more than ever since they are living longer and the cost of health care is often staggeringly high.
Arguments Against This Approach
Medicare needs a lot more than just minor adjustments. Unless benefits are reduced, taxes raised, or program costs cut, this program cannot be sustained for more than a few years. Medicare could go broke as early as 2010. Retirees are the only group in America with universal health insurance. Why should America's elderly get Cadillac coverage while 40 million Americans have no health insurance at all? While an increasing percentage of working-age Americans use HMOs, which have a proven record as cost-cutters, most Medicare recipients get expensive fee-for-service care. Unless limits are placed on Medicare coverage, new medical procedures and a growing number of retirees will drive the costs of this program even higher. It's not right to cut corners on other public obligations to cover the cost of health care for elderly Americans.
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