The policy and political playing field on social insurance programs and safety net issues has for decades been one of defense, protecting programs like Social Security and Medicare which have been the pillars of the American social compact going back to the 1930s and 1960s respectively. The budgetary and ideological threats to each are not new. In each case they go back to the passage of the original legislation, with the aim being first to abolish them outright and then later to create new programs under similar branding which place the risk on individuals as opposed to creating security by socializing risk.
That is the key to what Paul Ryan, in yet a new phraseology, calls his "premium support" model for phasing out Medicare. What is key to understand with all these plans, whatever their names, is this: The amount of money the country will spend on health care for baby boomers is relatively fixed in toto - whether it's out of people's pockets, through single payer government programs like Medicare or 'premium support' hybrids. There are good ways and bad ways to 'bend the cost curve' - the jargon for reducing overall inflation in medical costs the country pays, regardless of which party is doing the paying. You can create genuine efficiencies which Obamacare seems to have had some success in doing or you can simply find ways to give less care to those who don't have a lot of money.
The key in all these plans, with all the bewildering bundle of jargon, flimflam and subterfuge, is who carries the risk: society as a whole or individuals. The Medicare model puts everyone in the same boat. The Paul Ryan model puts the risk on individuals. That is the foundational prism through which to see all of these debates whether they're about Medicare, Social Security or to a lesser degree about Obamacare. It is all about who carries the risk.
With that in mind, in addition to our on-going reporting on Capitol Hill I am hoping to launch a group of on-going series this year on the larger questions of retirement security, which goes beyond protecting Social Security and Medicare to expanding each. It also includes the too-little discussed issue of private pensions, which have dwindled almost to nothing in recent decades. Many of those which do exist for current or near retirees are woefully underfunded because the companies in question looted their pension funds or in other cases the industries on which they depended simply ceased to exist.
This is all part of a common set of problems and a common story. On first blush we look at retirement security, Social Security, Medicare and pensions as issues for old people, retirees. But this is a very incomplete view. Funds which get pulled into paying for retirement or mounting medical bills for parents don't get spent on college educations for kids. Children having to support aged parents divert money from buying homes or education for their own children. The intergenerational impact of these programs and an effective retirement in general is greatly underestimated.
These are issues I'm hoping to focus on this year with series on a couple of these issues, similar to the one we did on wealth inequality in 2015.
More to come.