I’d like to think that the selection of Paul Ryan as Mitt Romney’s vice presidential candidate could lead to a substantive, adult debate on Medicare for the general election. I’m pretty sure that’s not going to happen, but I do think it will at least get Medicare on the table, where it belongs.
From my perspective a substantive debate would include at least the following topics:
I’d like to think that the selection of Paul Ryan as Mitt Romney’s vice presidential candidate could lead to a substantive, adult debate on Medicare for the general election. I’m pretty sure that’s not going to happen, but I do think it will at least get Medicare on the table, where it belongs.
From my perspective a substantive debate would include at least the following topics:
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- Current and projected sources and uses of funds for Medicare. It should be made clear that Medicare is not self-financing today, with close to half of funds coming from general revenues
- Whether and to what extent Medicare should be means-tested for people with certain levels of wealth an income
- Medicare’s impact on intergenerational equity, considering that it’s largely the young paying for the care of the old
- How to preserve the benefits of Medicare while making the program more cost effective
- Continue to offer unlimited Medicare coverage during a person’s lifetime, but have the estate pay back the difference between what the person contributed during their working years and what was expended on their care
