Showing posts with label medicaid. Show all posts
Showing posts with label medicaid. Show all posts

Tuesday, March 8, 2011

Baby Boomers, Entitled?


Having arrived at early stage "geezerhood," this cartoon made me smile the other day. Our generation has made waves ever since the end of World War II, because there were so many babies made after the fathers returned from war.

New elementary schools were built to contain us. Then middle schools and high schools burst their seams to accommodate our burgeoning numbers. A draft was instituted to fight a war in a country nobody had ever heard of -- Vietnam -- because there was an ample supply of young Americans. It was easily the most hated and wasteful war (aren't they all?) ever waged. Those of us with a modicum of intelligence found ways to avoid that war altogether.

We protested against authority. We lived through the sixties with abandon and self-indulgence. We rebelled, we wore flowers in our hair (well, some did, not all of us), and our generation was responsible for assassinating John F. Kennedy, his brother Robert, Martin Luther King, and we grew to love murder and violence more than our own mothers' milk it seemed.

We initiated bloated budgets for colleges and universities. We prompted government education financing plans, then we defaulted in record numbers in faux gratitude to a giving welfare state that made it possible for us to be well taught.

We launched industrial waves and bubbles throughout our illustrious careers as baby boomers. We lived way beyond our means. Savings became passe. Easy money and debt financing was the norm of the day. More homes were needed as we grew into young adulthood. but instead of filling those homes with a new and responsible generation of replacement Americans, we filled them instead with "stuff." We forgot the most valuable things aren't things.

We didn't reproduce enough children to keep the grist mill of greed turning and thriving. We self-sabotaged by reducing the numbers of taxpayers who could support us in our old age.

We've now reached a point where the birth rate has dropped off the edge of the table, barely high enough to replace a mother and a father. There just aren't as many people paying into the Social Security Trust Fund as there are people now receiving (or soon to receive) benefits out of the system. The trends for the future do not look promising. In Russia today there are cash incentives for those willing to reproduce more children, because they realize (too late probably) that zero population growth was not a wise fiscal policy after all.

This is one of the hot potato political issues no one wants to take on. Fact is, no one even wants to define whether Social Security is "an entitlement program" or not.

We baby boomers paid good tax money into the system for decades in anticipation of having something there for us when we approached retirement age. The current rules state you are eligible to begin drawing benefits on your 62nd birthday if you paid in enough to the system to qualify. All you need to do is register on line.

Because we're living longer than ever before (thanks to the generosity of our fellow Americans who have funded Medicare through their payroll deductions), we will likely outlive the old actuarial probabilities under which benefits were structured and our "guaranteed" government Social Security checks that can be electronically deposited like magic every month until death will go far beyond what most of us paid in.

I'm at least willing to acknowledge the problem in simple terms, more than most politicians will admit.

Most in my generation will tell you they are "entitled" to receive their government sponsored retirement check, because, dag nabit, we were taxed to qualify for it and, dad burnit by golly, we're entitled to collect it when we reach geezerhood status.

So, if we classify Social Security as an "entitlement" so be it, but truthfully it's not "something for nothing" until our benefits go beyond what we paid in plus interest. At least that's how I do the calculations.

There's a lot of talk about socialism these days. Let me say this about that. If you for one minute think we are not already a socialist country, having adopted the socialist agenda one bite at a time for the last century, then my friend, I have a lovely bridge in Brooklyn I'd like to sell you (dirt cheap, I might add).

Speaking of Medicare and Medicaid (not to mention Obamacare), all these "entitlements" are bought and paid for by a massive government sponsored redistribution of taxes extracted from the pocketbooks of hard-working Americans so the less fortunate among us may be blessed by the largess of the taxpayers. The Centers for Medicare and Medicaid Services (CMS) administers Medicare, the nation's largest health insurance program, which covers nearly 40 million Americans! And Obamacare insures those ranks will grow, attempting to mandate coverage (ruled unconstitutional, but pending a final SCOTUS ruling). Medicare is a Health Insurance Program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant).

I have no idea what Obamacare is really going to cost on top of what Medicare and Medicaid is already costing, but I have a feeling it's going to be a very big number. As I stated, we baby boomers are always making waves whenever we move through the demographic nozzle.

Am I "entitled" to have those generous subsidy programs because I am part of the entitled "landed gentry" of baby boomers? Does the younger generation of Americans owe me anything because of my newly attained "geezerhood" status? Do I deserve to be treated with dignity and respect in my old age because I live in America and I've worked hard and paid my way without complaint? Do my children and grandchildren and unborn great-grandchildren owe me adulation and adoration because I've left the world a better place for them than the one I inherited? Do they owe me one red cent for my existence?

Our parents would have said, "Hell, no!" That's who they were.

And we would say, "Hell, yes!" Especially if we live in Wisconsin and we're part of a public employee union.

My generation is an embarrassment compared to the "Greatest Generation" of my parents. They saved the world from Nazism and fascism. They fought bravely and sacrificed much as the children of the Great Depression. When there was nowhere else for the world to turn for help, American G.I.s invaded Europe on D-Day to put down the persistent oppression of Hitler and other dictators of their day. Fearlessly, they answered the call. Their wives and children remained behind to work three shifts day and night in factories to build the implements of war. The government offered debt then, "war bonds," to finance the war, but the bonds were bought by Americans. When the war was over they came home, rebuilt their lives on the knowledge that freedom would be vouched safe for their children who could live an existence without the threat of the loss of freedom in this land.

And my generation? What of us? What will be our claim to greatness? That we recklessly spent our inheritance? That we ran up unsustainable deficits and debt that will never if ever be repaid? That we lived as though there were no tomorrow, and never a day of reckoning? That we lived in homes we did not build with our own hands, ate from the abundance of harvests we neither sowed nor nurtured, that we drank from wells we never drilled, that we drove chariots filled with refined crude oil we purchased from the house of Saud and other dictators who despised us with borrowed money from the Chinese when our own resources laid untapped beneath our feet because we were determined to generate wind, solar and other "green energy" resources to fight a fictitious political global warming boogieman?

Let me answer all those questions this way: When Adam and Eve were cast out of the Garden of Eden, they left without a Social Security card clutched tightly in their fists and without demanding their entitlements from a government sponsored retirement safety net complete with the finest medical care delivery system the world has ever known.

Naked and penniless came I into the world, and I'm likely to leave the same way. Everything in between is just detail, most of which will be unheralded by those my generation leaves behind. Too pessimistic, you say?

My faith resides in much more certain outcomes beyond all the entitlement programs to which I feel anything but entitled. The sooner my generation awakens to that reality, the sooner we'll be able to grapple with the task before us. We need to stop being spoiled brats whining about what we think we are entitled to receive but never will because we have taxed ourselves into oblivion without an extrication plan.

We are guilty of generational theft. We live on borrowed light, borrowed money and borrowed time. . .

My generation is entitled to reap the whirlwind of our poor choices. And we will. May God have mercy upon us, and may we never receive that to which we are entitled.

Friday, January 21, 2011

"Symbolic" House Vote Repeals Obamacare


It was newsworthy last week only if you don't tune in to the mainstream media.  They didn't give it much play.  But the newly-elected Republican-dominant U.S. House of Representatives resoundingly voted anyway by a margin of 245-189 to repeal the most costly entitlement program in nation's history.  They don't call this body "The People's House" for no reason!

It's no secret I was opposed to it from the moment it was announced, but more than being opposed to it, I was opposed to HOW it was done.  It is that aspect of the ongoing debate that interests me most today.

There was opposition to Social Security when it first was introduced and enacted into law.  But there was no vote within a year to repeal it.  That was also the case when Medicare was first introduced, along with Medicaid.  None of those programs faced this kind of perpetual anger and frustration from the public, united in their dislike in majority numbers. 

How it was done

The difference in my mind is that unlike Obamacare, the other entitlement programs listed did not pass on a one vote margin bought and paid for in the middle of the night on Christmas Eve in the Senate.  Further, one year after its passage Obamacare has managed to inflame half the states in the nation who have gone to court to challenge its constitutionality.  None of those other programs were struck down within a year of their passage as "unconstitutional" by a federal court.

Handout or empty hand?

We have all been partaking at the trough of government entitlement programs for a long time, and the majority of Americans now like them.  The difference with Obamacare, in my humble opinion, is that it represented a bridge too far in the minds of Americans.  Rather than welcome a handout when the economy had punished so many so severely recently, they pushed back knowing it was not a hand up, only an empty hand promising unsustainable debt and deficits.

Most economists and others who have studied its provisions (I have not) now conclude there is little of anything representing cost savings in the measures enacted.  It went too far, and fewer and fewer have indicated they really want more government intruding into their lives and their choices, especially when it is being paid for with more foreign debt.

Maybe more than symbolic

There is some indication, however, the vote may actually be more than symbolic.  Often, split government produces real progress.  A measure proposed by the White House to a divided Congress thought to be DOA is often debated fairly, both sides expressing their views and a helpful and useful conclusion reached.  Those were the days when a Ronald Reagan could persuade a Tip O'Neill that tax cuts in a bad economy might just be a good idea to present to a Democratic Congress.  It's happened before, why not again? 

The useful reality about debate and a straight up or down vote on proposed measures is that such actions put people on the record, forcing them to declare themselves, compelling them to take a stand for their constituents, and revealing whether or not they give a hang about what their bosses, the people, think and believe.  That's why this vote to repeal is maybe more than symbolic, even though everyone knows it's not a big enough margin of victory to be veto proof and Harry Reid won't let it see the light of day in the Senate, thus dooming it to "symbolic" status.  But only for now, perhaps.

I'm hoping what will happen is Obamacare will die a death of a thousand cuts.  This vote last week extends the debate; opens it up for the first time, really.  Voters will increasingly use the information they glean from successive votes to gauge whether or not they need to do further reassessments about whom they will choose to represent their wishes.  In that sense it may go beyond "symbolic."

SCOTUS will weigh in

I'm wondering what impact this vote will have on the eventual judgment to be rendered by the Supreme Court, where Obamacare will ultimately be adjudicated.  Knowing the Constitution trumps all the laws of the land, will the expressed will of the people stand?  I'm wondering if the SCOTUS also realizes they are subject to the people.  I hope they still are.

Predictably, the administration poo-pooed the whole exercise last week.  Nancy Pelosi openly ridiculed a reporter last year who asked her if she was concerned about its constitutionality, with "Are you serious?"  Well, now we know the people are serious, and so was at least one federal court judge in Virginia.  If this repeal vote was merely "symbolic," then someone forgot to inform the White House about how seriously the new members of Congress have taken their oath to reflect the people's will when they got to Washington.  They heard the message from the voters, loud and clear.  That's why the vote had to be taken -- it's the primary reason they were sent there.

Real health care reform will happen when Obamacare is reversed.  Congressman Jim Matheson (D-UT) said it best:  "It reforms too little and costs too much."  He voted against it last year because he knew he would have no chance for re-election if he had done otherwise, and remains practically the lone man standing among the so-called "Blue Dog" Democrats in Congress who went along with Obamacare.  However, last week he reversed course and voted against repeal.  Go figure.

Why the sustained anger?

So maybe, just maybe, it is more than "symbolic."  There was more than Obamacare factoring into the historic tidal wave that washed ashore last November in Washington.  The voters felt disenfranchised and they were angry at not having their wishes realized.  For me and the vast majority, it started with TARP that opened the floodgates for rampant ($862 billion) stimulus spending failing to stimulate as promised, and a $1.3 trillion price tag on health care reform.  The deficit climbed rapidly to over $1 trillion, then the red ink flowed to overflowing with bailouts for "Government Motors" and Chrysler.

So Americans reacted justifiably -- we tossed out nearly everybody we could and began again, as America does every two years.  It's why this country is so viable.  Even when we make mistakes in judgment the founders gave us the reassurance we could begin afresh every two years.  We've all had to make readjustments in our lives these last two years.  We've cut back, we're learning how to save again, we're reducing debt, and we're somehow surviving in spite of it.  And now we demand the same of our federal government.  Some say individual households don't operate the same way as government.  That's true, because the government can print money.  We can't.  We can send representatives to Washington, however, who will do as we do and stop the presses.

Watch for more fiscal responsibility and big reductions in spending.  Those who refuse will be voted out.  That's the way politics works.  The Piper will be paid.

Chipping away now at Obamacare, and if Americans increasingly can stand by their convictions that it won't produce anything but grief if left to another generation to pay for it, then a large enough majority in both houses of Congress and maybe the White House in 2012 can finally bury it so deeply it cannot resurrect.

Federalism must be re-enthroned

The analysts I have read have been uniformly critical about the measure doing nothing to solve the upward tilt of the cost curve associated with health care, references to "bending the curve" in the years ahead notwithstanding.  Obamacare doesn't address the escalating costs associated with malpractice lawsuits.  The states were given virtually no latitude to develop their own solutions, since health care, like education, is administered at the local level.  Utah was already well underway in its efforts.  Federalism (giving states the right to be self-determining) has all but died in the wake of Obamacare.

Finally, one would hope the individual mandate in the law, forcing Americans to buy health insurance or face fines, must certainly be declared unconstitutional in the end.  This is still America, the land of the free.

But rather than let the moniker "the party of NO" stick, Republicans would be well advised to form committees, hold hearings, and work to craft real solutions lacking in Obamacare.  Keep the parts (if there are any) that might work, and scrap the rest.  We do have a health care crisis.  The costs are out of control, the incentives are skewed in the wrong direction, and Medicare and Medicaid are already too much to bear in a bankrupt nation borrowing to sustain an "even keel" level of care.  What do I mean by "incentives" being skewed?  Physicians and health care providers are reimbursed for a never-ending cycle of life-sustaining expenditures for seniors that extend life but sometimes with the tradeoff for quality of life compromises in the name of advancing medical science.  Aged grandparents and great-grandparents become little more than lab rats for government funded research.  Is that too harsh for you?  That's what we've got now.

Re-enthroning states' rights linked with free market competition among carriers would be a huge first step.  Given choices, let consumers be in charge of their care.  Intermountain Health Care is well on the way to showing the path to the rest of the nation.  The federal government needs to stand down and get out of health care reform and education.

The House last week finally heard and acted based upon the will of the electorate.  Yes, it may be "symbolic" as a repeal vote this year, but if the trend continues look for the electorate to take back the other chamber and the White House before the real damage is done when Obamacare kicks into high gear in 2014.  The question remains, will the angst survive another two years?

Power still resides in the majority that can choose to defund or repeal.  This "symbolic" vote was the first step.