One of the few silver linings of Joe Biden winning the presidency is this: Republican elected officials will no longer feel duty-bound to defend absurd policy positions so as not to find themselves in conflict with Donald Trump.
Trump espoused many excellent policy positions, including tax cuts, deregulation, domestic energy production, support for Israel and much else. My purpose here is not to indict Trump on his policy positions.
But on some issues he revealed himself to be more of a Ross Perot-style populist than a Ronald Reagan-style conservative. And this was especially true on the issue of entitlements.
Whether he sensed it was a political necessity or he sincerely saw himself as sticking up for old and sick people, Trump made it clear during his 2016 campaign: He had no interest in touching Social Security, Medicare and Medicaid.
This is the safe position most American politicians prefer to embrace. Seniors vote, and when you mess with Social Security and Medicare, there’s every reason to believe they’ll vote for someone other than you.
This is why, no matter how serious a fiscal crisis these entitlement programs become, it’s almost impossible to find an American politician of either party who will say what needs to happen.
Instead, they’ll wax eloquently about how Social Security, Medicare and Medicaid are “sacred trusts” between the government and its people, and that nothing and no one must ever be allowed to change the slightest pen stroke of the current structure of these programs.
But if we don’t change them, the country will collapse fiscally.
In 2021, the federal government will spend $2.5 trillion just on payments to beneficiaries of Social Security, Medicare and Medicaid. That’s nearly 70 percent of all federal outlays. That number is growing quickly.
In 2018, the trustees of the Social Security Trust Fund told Congress that, on its current trajectory, the program will become insolvent no later than 2034.
Medicare already costs $900 billion a year, and that’s with fewer than 60 million enrollees. By 2030, it is expected to have 79 million enrollees. The Medicare Trust Fund is on a trajectory to run out of money in 2026.
Medicaid costs the federal government “only” about $400 billion a year, but its recent expansion under Obamacare will set Medicaid on the same suicidal trajectory as its entitlement siblings.
We can’t continue this. And there are things we can do. Some of them are so simple that they would probably not be all that controversial.
One is simple means-testing. People with assets of several million dollars at the time they retire do not need monthly checks of a few thousand dollars from the government. That would be a simple and reasonable way to control the growth of the program.
A more controversial, but also more effective idea, is to replace the federal guarantee of benefits with market-based investment products. This would not deliver positive results to everyone, but it would to most people, and those who need help would be far less numerous than who we’re helping now – which is everyone, regardless of whether they need it or not.
Medicare and Medicaid should be completely restructured. Instead of the government defining the benefit packages and paying the medical bills, the government could simply provide premium support for the elderly and the poor to purchase coverage in the private insurance market.
The government could also provide tax credits to large corporations to cover retiree health insurance, which would help allay the cost to employers but also eliminate the need for many to rely on the government for their health care bills to be paid.
These are just a few ideas. There are many others worth consideration. But if we don’t fundamentally restructure these programs, they will lead to the fiscal ruin of this country.
If Republicans stand for anything, they are supposed to stand for limited government. There was a time when Ronald Reagan would declare, “Government is too big and spends too much,” and not a Republican from sea to shining sea would disagree with him.
If the Republican Party stands by now and allows these mutating social programs to bankrupt the nation – refusing to say anything for fear of angry seniors and critical journalists – then it will demonstrate that it never really believed Reagan’s words.
The American experiment has always been based largely on the idea that we are people who can take care of ourselves and that we only need our government to do a few basic things while leaving us to otherwise meet our own needs and run our own lives. The explosive growth of entitlement programs are a direct assault on that ideal.
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