Tuesday, July 29, 2014

Outlook Impoved, say Medicare Trustees

The annual Medicare Trustees Report came out yesterday, and the official line is good news.  You can see that from Googling the news reports.

Not surprisingly, administration spokesmen have claimed that the Affordable Care Act is partially responsible for this. Maybe.  After all, the ACA is supposed to raid Medicare of something like $700 billion over ten years to pay for the ACA.  Or maybe the answer is Medicare Advantage, which encourages large deductibles and limits the front-end "free stuff" aspects of conventional Medicare.

What has happened is that Medicare costs have moderated in recent years, although they are expected to start to climb significantly by 2020.  But the result is that, according to my analysis at usgovernmentspending.com, Medicare costs will reach 4 percent of GDP by 2023 -- instead of in 2020 as forecast in last year's report.  Long term, at the end of the century, Medicare is forecast to approach 7 percent of GDP.

Think of it.  By the end of the century the American people will be forking out 7 percent of every dollar just for the government share of senior healthcare, and that doesn't include Medicaid expenditures for the low-income elderly.

Something, as they say, will have to give.  And way before the end of the century.

In a way, it's nice that the government takes care of our retirement income and health care.  It relieves us seniors of the big worries of our declining years.  Feel a pain, head for the doctor.  But I worry about the young 'uns.  Is is really fair or just to saddle them with such enormous burdens?

If you raise the question with a liberal they will ask you whether you want grandma starving in the street.  Good point, liberal.

But, as the Brits are finding out, if you tighten up on welfare eligibility, more of the poor go out and get a job.  In other words, marginal economics works, even with welfare.  If you change the rules a bit, people will change their behavior a bit.  Maybe we could try that with Medicare, especially as old people are the richest kind in America.  What a concept: make seniors more individually responsible for their health care.

John Hawkins, in a typical "5 Obvious Principles of Human Nature That Baffle Liberals," points out the central principle of responsible individualism.
[I]t’s bad for people to have someone else making the decisions about their kids’ education, their retirement, and their health care[.]
That's because the person that has other people make the big decisions about their life is, de facto if not de jure, a slave.

Hawkins also mentions a corollary of this truth: "it’s even worse that the government officials that take those decisions away from people are usually given a free pass when they screw-up."

Yeah.  Why is that?  Oh all right, we know why.  The whole point of government power (as opposed to market power) is that you don't get called on your mistakes.  If you can get called on your mistakes then you don't have power, you just have responsibility.

The whole point of responsible individualism is to reduce the amount of power and domination in the world and increase the amount of responsible individual acts in the world.

So here's a question.  Under what conditions would seniors like me demand of the government: take it away?  Take Medicare away and let me get my own health care in my old age. Hey, I'll even kick in a little for the aged poor.

Don't hold your breath.

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