Wednesday, April 22, 2015

Thanks, LBJ, for (Sort of) Ruining Healthcare for the Rest of Us

Voter disconnect: Yes, Medicare is government-operated healthcare.

Lyndon Johnson is to be praised for taking his ability to work with Congress and guiding through bills like the one that established Medicare before Democrats lost the South for good.

It's only speculation, of course, that Johnson could have succeeded in passing universal single-payer for all. But deciding not to and settling for protecting seniors -- the single most impoverished group at the time -- had the effect of locking in Medicare and locking out single-payer for the rest of us.

It's also likely that he couldn't have foreseen some of the cultural and economic changes, like the loss of defined-benefit pensions, that would add to the stress of growing old in America.

But these changes came, and here we are. Now, the single block with the greatest need for healthcare has it -- seniors -- and they quite naturally fear that giving the same benefits to younger people will come at their expense. Whether that's true or not, there are reasons to believe it. From a Thomas B. Edsall op-ed:
[...] The combination of longer lives and unreliable pension benefits increases retirees’ dependence “on transfers from the working population for living expenses, including large consumption of medical care,” Eggleston and Fuchs note.
Adding to the financial pressures on the elderly, Munnell et al. found that in the 27 years from 1983 to 2010, health care costs under Medicare Part B rose from 6.8 percent of the average 1983 Social Security benefit to 17.0 percent of the 2010 benefit. The decline in interest rates since 2008 has reduced the rate of return on retirement savings, another factor leading to anxiety among seniors.
The Kaiser Family Foundation has data (see chart 2) that shows how even with Medicare, out-of-pocket health costs are larger for over-65 households – both in dollar terms and as a percentage of income – than for younger households.
In other words, the data suggest that the elderly are right to be worried.
Here's how I think it scans: The elderly won't support expanding healthcare to the young for fear of reducing their own benefits. This may also apply to expanding Social Security. And the young won't support -- or pay for -- expanding healthcare for themselves because they think they're healthy and don't need it. As for Social Security, enough young people doubt they'll ever see it, so why should they support expanding it?

Now, I'm not saying Obamacare won't win over the nation -- even its seniors -- eventually. The latest tracking poll from the Kaiser Family Foundation shows Obamacare finally achieving a plurality of positive support. But I fear that it'll be a cold day in hell before enough support -- from voters, like seniors, who can influence politicians -- to morph into the single-payer kind of government program favored by the rest of the civilized world.

LBJ pulled the trigger. I'm glad he did, but I'm afraid it hasn't accrued to our advantage.

The I've-got-mine-you-can't-take-it generation?

Mind you, I'm on Medicare and am happy with it. I just want everyone to have it, too.

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