Florida would be the ideal setting for a debate that remains unscheduled. Namely, what to do about health care, entitlement spending, and the demographic imbalances?
Not that there would be any resolution. But it would be better than the superficial campaign responses from both candidates.
The Romney campaign, at times, runs on a platform that is against cuts to current seniors on Social Security and Medicare but at the same time promises to change the program in dramatic ways for younger works.
And the Obama campaign stresses that it will protect the current Social Security and Medicare despite the fact that these two programs cannot stay the same. There are not enough young people to pay the bills (the demographic problem).
But in terms of politics, Florida politics, there is this: Nearly 90 percent of seniors are satisfied with Medicare the way it is. Kaiser Health News reported that the poll, commissioned by Allsup, an Illinois-based, Social Security disability claims representation company, found that 60 percent say they are concerned about any changes.
Rebecca Ray, a representative from Allsup told Kaiser, “They like the current version. They like the version they’re receiving now.”
So both sides promise a program that’s a lot like the one now. Republicans say it will stay the same for seniors (even though there proposals would change the program now, simply repealing the Affordable Care Act would cost seniors immediately) and Democrats say the program must be preserved.
But both Republicans and Democrats know deep down that major changes are in store.
The reason has nothing to do with politics, it’s about life expectancy. This is a global issue – so it really should be a topic in Monday’s last debate – because in the U.S., the United Kingdom, France, Germany, Canada, Japan, the trend of living longer is increasing. Today one in 10 people, globally, are over 60 years old. Forty years from now that number will double to one in five. At that point people over 60 will outnumber children. (Indian country is a bit younger, but we are growing older quickly, too.)
When older people outnumber children, let alone workers, there is simply no way possible for a society to provide all the benefits promised in Medicare and Social Security. At least without major changes.
Older people will probably have to work longer. Social Security, for example, could be adapted by increasing the number of years people work. This is important because you need more workers to pay for current retirees. (Unlike the image of a retirement bank: Social Security is a pay-as-you-go program. People working today pay for their relatives who are now retired. We are not, at least in this program, saving for our future.)
Ryan repeated this fiction a few days ago on the campaign trail. In Florida the Republican vice presidential nominee talks about his mother, according to The Hill newspaper, saying “she paid her payroll taxes all those years, based upon the promise that the government would keep its promise to her. So that she could retire, she could move here in the winter — it is a little cold where I come from in the winter … she’s retired and she deserves to have this promise kept for her.”
Ryan knows better. This is what Social Security says about its operations. “So we could image that at any given time there might be, say, 40 million people receiving benefits at the back end of the pipeline; and as long as we had 40 million people paying taxes in the front end of the pipe, the program could be sustained forever.”
That’s why the number of workers – the demographics matter – because it keeps this pipeline balanced. “In this context,” Social Security says, “it would be most accurate to describe Social Security as a transfer payment—transferring income from the generation of workers to the generation of retirees—with the promise that when current workers retire, there will be another generation of workers behind them who will be the source of their Social Security retirement payments.”
Medicare is that same idea, only more so. What wrecks the stability of Medicare and Medicaid to be sustainable is the actual cost of care. That’s why Obama spent so much time on the Affordable Care Act, or ObamaCare, because it represents a step (a small one at that) to actually lowering health care costs and according to the Congressional Budget Office extends the solvency of the program by at least eight years.
Because of seniors, the two candidates both talk a lot about Medicare (although not in a debate setting) but Medicaid is left out of the discussion. This entitlement program is far more significant to the Indian health system. In some regions of the country, Medicaid funds more services than does the Indian Health Service.
Even though many seniors express reservations with the Romney approach to these entitlement programs, polling suggests that they may vote for the Republican ticket anyway. A poll last month by The Washington Post showed seniors saying that Romney would do a better job on Medicare. This holds in Florida, Ohio and Wisconsin.
“What’s striking is that the poll also finds very big majorities of seniors in all three states support leaving Medicare as it is, while small minorities support changing it so government provides fixed amounts to spend on insurance,” the Post says.
Perhaps voters are no better than candidates outlining what they really want as an election result. It’s a lot like the Tea Party sign, “keep your government hands off my Medicare.” That’s another debate topic to schedule.
In the meantime, on January 1, the Social Security, Medicare and Medicaid programs will all get a little more funding. The payroll tax is going up. The pipeline gets extra cash.
Mark Trahant is a writer, speaker and Twitter poet. He is a member of the Shoshone-Bannock Tribes and lives in Fort Hall, Idaho. He has been writing about Indian Country for more than three decades. His e-mail is: firstname.lastname@example.org.