Paul Ryan claims to oppose dependency on the federal government. So let’s ask some questions:
Is a senior citizen who cannot afford health care “independent”?
Is a senior citizen who is without income “independent”?
No. Before these programs, senior citizens who did not have these things became dependent upon their families or charity to provide health care and sustenance. Before Medicare, only 51% of senior citizens had health insurance. Senior poverty has gone from 30% in 1959 to 8.9% in 2009 — largely because of Medicare and improved Social Security benefits.
Those senior citizens are more independent now, not less.
And it is not “government charity” that made it so. It is a much different concept: Social insurance. Folks pay into the system, and then they get something out of it when they retire. They’ve earned it by the time they collect benefits. You can call it an “entitlement” — as if it were a rich uncle’s windfall inheritance, or a title of nobility — but in fact it’s an earned benefit. It’s reciprocity, not charity, that’s at work here.
And we do it together, through the government, because that’s how you get everyone covered; that’s how you make it secure. And it has been that way for a long time now.
The problems of Medicare are twofold: One is that there’s a demographic bubble, with a large and aging population about to collect benefits; and the other is simply the rising prices in health care (cf pg 8-11), which pressures Medicare is subject to as much as the private market. That, by the way, is the source of the $500 billion in future Medicare savings that the Affordable Care Act contemplates, and which Ryan’s very plan anticipates as well. Medicare needs cost controls — we miss you Don Berwick — not to be gutted and turned into something weaker and less effective.
Dependency is what these programs prevent. That’s the reason why they exist, and the reason why they’re popular.