Perspectives on the (Impending) Medicare Cr...

Mending America's fiscal issues will be an immensely complicated feat. Still, with the proper policies and political considerations, our fiscal woes can be rectified. In this edition of Facing Up's blog carnival, we are taking Medicare to task.

As you may know, Medicare is only piece of America's overall fiscal debacle -- albeit an extremely important piece. A number of trends are leading us toward a serious crisis. While Medicare has been a successful program since its inception in 1965, changes within the social and political landscape are creating unforeseen challenges. Facing Up provides a brief, yet accurate, summation:

"Put these…trends together—a huge wave of retirees, spiraling health care costs, and the abandonment of health care benefits by employers—and it’s easy to see why we’re headed for one of two unfortunate results. Either we’re going to lose Medicare as it becomes too expensive to maintain, or we’re going to keep Medicare but bust the federal budget through unsupportable debt."

Either way, the results are grim. With a budget that is already blown, the latter option is less than optimal. And losing Medicare -- a program that assists the vast majority of America's elderly population is a horrific prospect. So, what can we do? Public Agenda and Facing Up to the Nation's finances have compiled some ideas for consideration (please note that these are not Public Agenda/Facing Up's opinions; rather, they are widely held community perspectives on how we can address Medicare's impending crisis). While I won't delve into the pros and cons of each perspective, you can find them when you explore each perspective in greater detail.

Perspective 1: Maintain Our Current Commitment to the Elderly

Some individuals feel that Medicare is a promise that simply cannot be broken. This means that retired individuals will need to be covered at public expense. Facing Up provides a summary of this position:

"That promise must be honored, even if it means raising taxes or reducing spending in other areas…Minor adjustments can be made to reduce the program's cost, and aggressive measures should be taken to reduce fraudulent claims. But it is immoral and unthinkable to reduce medical benefits for the nation’s seniors."

Perspective 2: Make Medicare Affordable by Focusing on Those Who Need it the Most

Those individuals who subscribe to perspective two are more focused on determining who needs coverage. This is to say that these individuals would like to see a more pointed determination of who is entitled to Medicare benefits:

"Unless we revisit what Medicare promised, the program will drive up either our taxes or our national debt so much it will cripple the nation. Before the baby boomers retire, we need to pare down benefits to make them more affordable. Even more importantly, we need to change the system so that affluent retirees pay more of their own health care costs. In this way, we can maintain benefits for those who need them the most."

Perspective 3: Make Health Care in Retirement a Matter of Personal Choice, not a Shared Responsibility

And those who subscribe to option three are more focused on re-centering responsibility. This plan focuses on individuals taking primary responsibility for their healthcare. Under this theoretical model, citizens would have required and voluntary individual medical savings accounts through which they would take individualized control over the future of their medical care:

"We would be better off if Medicare were no longer a public program for older Americans. Instead, it should be replaced by a combination of required and voluntary individual medical savings accounts. This approach would make health care in old age more a matter of personal responsibility, rather than a government or social responsibility. This would encourage people to take care of themselves, while relying on market forces to bring costs down."

No matter where you stand, one thing is for certain. We must act now if we want to secure a sustainable future. Medicare is amendable, but the necessary dialog must take hold immediately.