As the orchestrated health care reform mayhem of the town halls continues into its third week, one notable aspect is that the preponderance of protesters come from the over-65 demographic, which is of course, the very same group that already benefits from a national, socialized health care system....Medicare.
James Kwak at Baseline Scenario comments further:
What are the underlying reasons why seniors are more likely to oppose “reform?” The first – leaving aside the self-contradicting notion that health care reform will mean a government takeover of Medicare – is probably fear that Medicare will be negatively affected. Now, there is a grain of a partial truth to this fear. Several of the proposals on the table include paying for health care reform (meaning, paying for the subsidies that poor people will need if we’re going to mandate universal coverage) in part by reducing growth in Medicare spending. One proposal is the Independent Medicare Advisory Committee, which would look for ways to increase efficiency in Medicare, which could include lower reimbursements for procedures that were deemed to be not providing benefits commensurate with their costs.
Kwak then touches on one of the fundamental conundrums that fiscally conservative Medicare recipients have to grapple with, namely that
concern about health care costs rises with age. Now this makes sense; even with Medicare, seniors’ out-of-pocket medical expenses are considerably higher than those of younger people, for the simple reason that on average they consume more medical care. But there’s no good way to reduce seniors’ out-of-pocket spending without at the same time reducing Medicare spending because, broadly speaking, those two types of spending are buying the same thing – health care. You can’t have a system where Medicare spends more and more yet seniors spend less and less out of pocket (short of simply reducing seniors’ relative contribution to their health care costs, which would only make the fiscal problem worse).
It’s simply contradictory to oppose reductions in the growth rate of Medicare spending while favoring reductions in your out-of-pocket spending.
No answers here, but another aspect to an interesting problem with the healt care debate, namely that support is lowest among the group that already benefits from and has the greatest need for a national plan. At the same time, they worry about cost control, just so long as it doesn't affect them!
