The Real Entitlement Problem is Medicare

David Brooks (NY Times columnist) as published in the Salt Lake Tribune (http://www.sltrib.com/sltrib/opinion/54736233-82/medicare-romney-spendin…):

The biggest threat to national dynamism is spending money on the wrong things. If you go back and look at the federal budgets during the mid-20th century, you see that they spent money on the future — on programs like NASA, infrastructure projects, child welfare, research and technology. Today, we spend most of our money on the present — on tax loopholes and health care for people over 65.

A study by Jessica Perez and others at the group Third Way lays out the basic facts. In 1962, 14 cents of every federal dollar not going to interest payments were spent on entitlement programs. Today, 47 percent of every dollar is spent on entitlements. By 2030, 61 cents of every noninterest dollar will be spent on entitlements.

Entitlement spending is crowding out spending on investments in our children and on infrastructure. This spending is threatening national bankruptcy. It’s increasing so quickly that there is no tax increase imaginable that could conceivably cover it. And, these days, the real entitlement problem is Medicare.

My comment:

Mr. Brooks used his column today to point to the seriousness of the federal budget woes, and compare the two presidential candidates on how they have approached this problem. But the talking point I want to emphasize is that “the real entitlement problem is Medicare”. People need to stop talking about Medicare in the absence of understanding or acknowledging that we can not have ‘Medicare as we know it’. What can not happen will not happen. We cannot afford the spending track we are on with Medicare (and for that matter, Medicaid, CHIP, and other government funded health care). Something fundamental must change about the way we do health care business, because the current path we are taking is impossible. The Affordable Care Act is not a change in how we do health care business. Taking money from Medicare in order to create a new health care spending category is not a solution, particularly because that spending enlarges the role of the private health insurance business model, which is the most inefficient way to spend health care dollars ever invented. I see no way to give either presidential candidate a pass on this issue. They are both equally wrong in their approach (and it is the same) to health system problems. You can not begin ‘reform’ efforts by expanding corporate welfare and expect to make any progress.

In the long run, whoever wins this next presidential election will not solve this problem. We, the American people, must solve this problem. I suggest that we push Congress to pass legislation that allows states to tackle comprehensive health system reform. And then, let’s each work at the state level for higher quality care more efficiently financed, which will be done by reducing corporate welfare (tax moneys given to corporate interests in the pharmaceutical, insurance, hospital, medical device, and other industries).

Dr. Joe Jarvis