Medicare on the Table

This site is not about politics, but I couldn’t help myself…

Paula Span wrote Medicare on the Table for The New York Times and contrasted the significant differences between the budget proposals of Representative Paul Ryan, representing Republicans, and President Barack Obama’s. She then asked readers for their ideas too, so I added my two cents (actually my Top 10). If you have other ideas, I hope you’ll add them as well – either in the comments below or by following the link above to Span’s article.

Here’s a summary:

Ryan’s proposal would replace Medicare with vouchers for private health insurance for anyone now under age 55.

Obama condemned that approach because, if vouchers don’t buy enough insurance, you’d be on your own. Obama’s own program would tax the wealthy and reign in cost with programs such as using the purchasing power of Medicare to lower prices of prescription drugs.

The debate will continue in Washington for weeks, but what do you think?

Here’s my Top 10 ideas:

  1. People live longer today, thanks to breakthroughs in science and technology. So acknowledge that trend by raising the Medicare eligibility age slightly from 65 to 67 now, 68 in 2013, 69 in 2015 and 70 in 2017. Use the same logic with Social Security.
  2. Raise, or totally eliminate, the FICA salary cap so wealthy individuals who have benefited from our economic system the most pay the most in return. Use that same logic to reform income and corporate taxes too.
  3. Eliminate incentives in the tax code that artificially influence behavior, including mortgage interest deductions on one hand and corporate tax incentives on the other. This would help give startups and small and medium size businesses a level playing field to multinational corporations.
  4. Invest in R&D and technologies that lower health care costs, and focus much of it on Home Healthcare as a lower cost alternative to nursing homes and assisted living.
  5. Accelerate FDA approval of generic drugs to encourage competition to develop more quickly.
  6. Prohibit consumer advertising of prescription drugs and medical procedures. Such ads in medical journals should be enough.
  7. Raise the penalties for fraud to the point where they actually deter behavior and aren’t just a “cost of doing business” and increase enforcement.
  8. Reform “tort-reform” to allow legitimate law suits but with reasonable caps on awards. Don’t allow industry to set those limits without at least equal balance from consumers.
  9. Overturn the Supreme Court’s Citizens United decision and institute Campaign Finance Reform to help prevent unfair influence of the political process by wealthy corporations and individuals.
  10. And no matter what, do NOT privatize Medicare or tie healthcare to Wall Street.

OK. Now it’s your turn.