57.1: Medicare
Saving Medicare for Future Generations. Other Information:
The Republican Party is committed to saving Medicare and Medicaid. Unless the programs’ fiscal ship is righted, the individuals
hurt the first and the worst will be those who depend on them the most. We will save Medicare by modernizing it, by empowering
its participants, and by putting it on a secure financial footing. This will be an enormous undertaking, and it should be
a non-partisan one. We welcome to the effort all who sincerely want to ensure the future for our seniors and the poor. Republicans
are determined to achieve that goal with a candid and honest presentation of the problem and its solutions to the American
people. Despite the enormous differences between Medicare and Medicaid, the two programs share the same fiscal outlook: their
current courses cannot be sustained. Medicare has grown from more than 20 million enrolled in 1970 to more than 47 million
enrolled today, with a projected total of 80 million in 2030. Medicaid counted almost 30 million enrollees in 1990, has about
54 million now, and under Obamacare would include an additional 11 million. Medicare spent more than $520 billion in 2010
and has close to $37 trillion in unfunded obligations, while total Medicaid spending will more than double by 2019. In many
States, Medicaid’s mandates and inflexible bureaucracy have become a budgetary black hole, growing faster than most other
budget lines and devouring funding for many other essential governmental functions. The problem goes beyond finances. Poor
quality healthcare is the most expensive type of care because it prolongs affliction and leads to ever more complications.
Even expensive prevention is preferable to more costly treatment later on. When approximately 80 percent of healthcare costs
are related to lifestyle -smoking, obesity, substance abuse-far greater emphasis has to be put upon personal responsibility
for health maintenance. Our goal for both Medicare and Medicaid must be to assure that every participant receives the amount
of care they need at the time they need it, whether for an expectant mother and her baby or for someone in the last moments
of life. Absent reforms, these two programs are headed for bankruptcy that will endanger care for seniors and the poor. The
first step is to move the two programs away from their current unsustainable defined-benefit entitlement model to a fiscally
sound defined-contribution model. This is the only way to limit costs and restore consumer choice for patients and introduce
competition; for in healthcare, as in any other sector of the economy, genuine competition is the best guarantee of better
care at lower cost. It is also the best guard against the fraud and abuse that have plagued Medicare in its isolation from
free market forces, which in turn costs the taxpayers billions of dollars every year. We can do this without making any changes
for those 55 and older. While retaining the option of traditional Medicare in competition with private plans, we call for
a transition to a premium-support model for Medicare, with an income-adjusted contribution toward a health plan of the enrollee’s
choice. This model will include private health insurance plans that provide catastrophic protection, to ensure the continuation
of doctor-patient relationships. Without disadvantaging retirees or those nearing retirement, the age eligibility for Medicare
must be made more realistic in terms of today’s longer life span
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