The pro-Medicare case for Medicare reform

Ezra Klein’s recent column is titled “The pro-Social Security case for Social Security reform.” It includes the following paragraph:

Too often, however, the folks most resistant to reforming Social Security are also those most committed to its mission. Many of the program’s defenders are so concerned that conservatives will slash benefits — now or down the road — that they are afraid to open the pension plan to any reforms at all. I think they’re wrong. This country is better than that. A political party that tries to tell ordinary Americans their retirements are too secure and too long will quickly learn its lesson when the election rolls around. Poll after poll shows the vast unpopularity of cutting Social Security benefits, and Republicans can read those surveys as easily as Democrats can. A politician may as well burn a flag on the Capitol’s lawn.

Change “Social Security” to “Medicare” and the logic is the same. Yet every time someone suggests changes to either program it isn’t long before someone else trashes it in the name of protecting it from benefits cuts. It’s not necessarily an incorrect argument, not always. But if one is serious about preserving either program it can’t be an argument always and forever about every possible reform. If it is, it is essentially an argument for no reform. And no reform itself guarantees benefits cuts (see Don’s graphs).

Fundamentally, we can’t afford to continue Medicare or Social Security as we know them. Something must be done. By default and necessity, something will be done. Do you want to bet that it won’t involve some cuts to benefits if we wait until the crisis is upon us? Those who wish to preserve some minimal degree of economic security in retirement should begin to embrace some element of change. The sooner they do so the better.

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