2020 federal dossier: Entitlements

This is the eighth part of a multi-part series taking a deeper dive into various important topics in the 2020 election. On the 100-point scale I am using to grade candidates, entitlements are worth 13 points. And in case you are wondering, I don’t get along with the “it’s our money that we’re only getting back” crowd – to me, Medicaid, Medicare, and Social Security are entitlements. Here’s where I will see what the candidates have to say.

It’s become an annual rite of sorts – it seems like every year we hear the news that Social Security and Medicare are projected to take in less than they give out years sooner than projected. We’re assured they’re not going to go bankrupt but there may come a point where they won’t be able to meet the promised benefits. (That always seems to be just about the time I am eligible to collect.)

The fix is relatively simple, they say: ratchet up the retirement age, begin means testing, or place more income inside the reach of the Social Security tax (which caps someplace in the low six figures.) On the other hand, we have a President who earnestly believed a booming economy would solve the problem. All I know is that something will be done in the next few years because doing nothing will be its own action, with consequences.

Unfortunately, this is a subject that is indeed treated like a third rail in that no one wants to touch it, despite the fact all have been asked for their thoughts on the subjects. Perhaps because he’s eligible for these programs, the only lengthy response so far among the Republicans is from James DeMartino, and he focuses mostly on Obamacare, which has also become an entitlement (although that’s in a large degree due to its significant reliance on Medicaid to insure the working poor.)

“As a nation we require a robust healthcare system; doctors, nurses, medical facilities, equipment and pharmaceuticals that are truly affordable to individuals and small business,” writes the DeMartino campaign. “Small businesses have struggled due to the cost of insurance and individuals have suffered financially due to exorbitant premiums and deductibles. We need insurance companies to provide effective coverage and competitive pricing. Government bureaucracy cannot control healthcare, medical decisions must be made by medical professionals. Individuals and their doctors should be in control of their own care.  Individuals should be able to select the coverage they need and know what they are paying for with itemized bills.”

I’m going to foreshadow my thoughts on the next part regarding the role of government here by stating some unpopular opinions.

The problem with the DeMartino approach isn’t the end goal, but the approach. As I see it, there is an implication by James that we need a federal solution to a problem they created when in fact health insurance is one of those commodities best handled at a state level. The needs of Florida and its high retiree population are vastly different than a state like Maryland which trends younger.

It should have been a priority in the previous Congress to rip out Obamacare by the roots, but instead our side fumbled it away. I’ve heard the argument that most of the program was rendered moot by Congress removing the tax penalty (putting it outside the boundaries of NFIB v. Sebelius) but nothing would have sent the message more clearly than a straight repeal. We also kicked the other entitlement cans down the road thanks to a lack of emphasis on a fix from the top.

Seeing how gutless Congress is on these subjects, and having a long memory of the reception a modest proposal on Social Security received (remember George W. Bush wishing to privatize a fraction of it?) it’s frankly disappointing to see no new ideas from the field. Again foreshadowing, I’m not sure the GOP portion of the Congressional field wishes to rightsize government. It’s more the approach of making government perhaps run more efficiently but not trying to restore a more Constitutional approach.

After I posted this originally I found Lee Murphy‘s 2018 website in the internet archives, so I think I can add this pearl of wisdom to the discussion:

“The government needs to get out of the health insurance business once and for all. Competition should drive the market for health insurance, not mandates from the federal government. I believe that individuals are best equipped to make health insurance decisions for their families.”

I like that, so far. But there’s more.

“The citizens of this country should be offered a competitive choice for health insurance plans. I support legislation allowing families to buy health insurance across state lines. It would drive down the cost of health insurance, making it more affordable and more accessible. If you live in Delaware and a better plan is available in Nebraska, you should be able to buy it.”

That’s been a standard GOP line for awhile, but there’s a lot of merit to it – and it’s a start to what needs to be a lengthy adult discussion.

I’m going to share my thoughts on the candidates and how they seem to perceive the role of government in my next, penultimate part.

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