Medicare — Even Reaching The Sane Conservatives Will Be Tough


Posted by Bob Lord

There are sane, rational conservatives out there. There really are. 

But on a data-driven issue like Medicare, even they're hard to reach. There's just too much misinformation floating around. Once those on the right (or left) hear or see information that fits their worldview from a source that seems reliable, it's very hard to dissuade them. 

I just experienced this with a conservative friend of mine. He explained to me how our unfunded medicare obligation was "86 Trillion" and that we couldn't possibly sustain Medicare unless we "reformed it." I didn't believe the total unfunded obligation was $86 Trillion, but it made no sense to challenge that "fact," unless I was armed with first-hand data, and even then the discussion likely would not have been productive. Instead, I asked a simple question: "Upon how long a period is the unfunded obligation based?" He didn't know.

This friend of mine is really smart and very well read. If you ranked people by sheer brain power, he's easily in the top 5%, and probably much higher. But it turns out he was badly misinformed.

When I next had the chance, I looked up the unfunded Medicare obligation, and I found this article, which quotes the latest trustees' report as placing the unfunded Medicare obligation estimate at $38.6 Trillion. It's not hard to guess what happened. Somewhere between the Medicare trustees report and my friend's ears or eyes, 38.6 turned into 86. The three and the decimal point were lost somewhere along the way. 

I also learned that the estimate covers a period spanning 75 years. Since the age for Medicare eligibility is 65 years, the estimate is based in part on the cost of Medicare for people who are not yet born. 

Once you know that the estimate is 38.6 Trillion rather than 86 Trillion and that it covers a period of 75 years, the task of sustaining Medicare without drastic cuts in coverage for those who most depend on it moves from "impossible," as my friend believed, to challenging. I hope to write more on this subject in the coming weeks, but here are just a few items to consider. First, the military budget is incredibly bloated compared to that of other countries. We could cut that budget by hundreds of Billions per year. Over a 75 year period, those cuts would translate into Trillions in savings that could be used to sustain Medicare. Second, the Medicare trustees' estimates are based on actuarial projections that are at best guesswork. For example, according to the trustees' report, people who reach age 65 soon will be expected to live, on average, almost to age 90. Recent data, however, suggests that life expectancies may be declining. Yes, there have been and likely will continue to be great medical advances. But the American diet is far less healthy than it once was and may very well get worse, and Americans are becoming more and more sedentary. If the life expectancty estimates in the trustees' report turn out to be too rosy, even by just a few years, that undunded Medicare obligation decreases substantially. 

So, the sky really isn't falling on the Medicare front. We really don't need to slash benefits for 65-year old janitors because executives are living a bit longer. Getting conservatives on the street to understand this will be a monumental challenge, however. If my exceedingly intelligent, sane conservative friend is dead certain of the misinformation he's received on Medicare, just think where the less intelligent, less sane conservatives are. And with Republican obstructionists in Congress playing to those less intelligent, less sane conservatives, getting them to budge from their positions will be a daunting task indeed.