Brian Beutler points out another tell in Speaker Boehner’s speech last night. He aggressively supports means-testing Medicare. That’s included in the Ryan Plan — even in the newly private insurance version of ‘Medicare’ Ryan endorses. But Boehner seems to be saying that regardless of whether you preserve the current system or not, benefits should be means-tested.
Now means-testing has always been a tough sell but also a proposal that cuts across normal ideological divisions. Advocates will often say ‘how is it that the public should pay Medicare premiums for Bill Gates or Warren Buffet?’ And who can disagree with that? But that’s basically a dodge. Because cutting back on subsidies for the ultra-rich or even the super-rich doesn’t really save you any money. Remember, higher taxes on the ultra-rich can get you a lot of new money. But cutting their Medicare benefits doesn’t because medical care doesn’t cost more for them than for the average Joe — at least what Medicare covers.
To really move the needle you need to cut benefits way way down the economic scale — maybe not for seniors who are barely scraping by. But certainly for what we might call the comfortable elderly. People who are living benefit check to benefit check but with some savings to enjoy some of the comforts of life in retirement. That’s what means-testing really means. Making those folks pay a much bigger slice of their health care costs.
Historically, progressives have opposed this not only because it cuts back benefits for people who need them but because over time it makes Medicare into something more like poor relief — or like Medicaid, which operates on principle something like a means-tested program. That, the argument goes, weakens political support for the program over time and makes the quality of the program itself deteriorate because it’s not something the broad mass of the public is invested in.
