May 2, 2005
Robert Reich asks why Bush is still flogging his plan to reform Social Security. After all, most Americans don’t want change, Republicans know it’s a vote-loser, and even the most right-wing voters hate it.
Writing in USA Today, Reich suggests that Social Security is simply a placeholder:
As long as it remains on the domestic agenda, it blocks consideration of the real domestic crisis President Bush doesn’t want to touch: the health care system.
Consider the symptoms. Medicare, the government’s health care program for the elderly, is heading toward bankruptcy faster than Social Security. Its future unfunded liabilities are seven times larger. Social Security is projected to be in financial trouble in four decades; Medicare, within 10 years.
Medicaid, the government’s health care program for the poor, is also in trouble. Its costs are rising so fast the White House and congressional Republicans want to whack it by $10 billion over the next five years. But governors don’t want Medicaid cut. States pick up half its cost. If the feds bow out, states will have to make up the difference.
And never mind the 44 million Americans without health insurance, or the employees who do have health insurance but are struggling with soaring costs. Reich thinks it’s possible to solve both of those problems:
One step is to use the government’s bargaining clout to cut the prices medical providers and suppliers charge. Through Medicare and Medicaid, the U.S. government is the biggest health purchaser in the world. It has the heft to get pharmaceutical companies to agree to far lower drug prices. The same bargaining power could be used to bring down prices of other health care supplies and services.
Another step is to offer every American the chance to buy basic health insurance for the family at say, a few hundred dollars a year. The low cost would be possible because so many Americans would be in the same plan, generating vast economies of scale. In such a uniform system, transacting with a doctor or hospital of your choice would be as easy as using an ATM.
With so many Americans (and American employers—Republicans please note) feeling the pain, this would be a politically smart time to tackle healthcare. But it won’t happen, because it means a more active role for government—something Bush is pathologically opposed to.
So Social Security it is, while healthcare quietly implodes.
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