Kevin Drum’s Medicare reform plan strikes me as well worth considering, and most certainly creative. At first blush, I suspect that its ultimate effect would be essentially the same as most proposals for means-testing Medicare. And, as Will Wilkinson points out, it would most certainly set off “a game of regulatory whack-a-mole.” Still, trusts and estates are already a “game of regulatory whack-a-mole,” so I’m not at all certain Drum’s proposal does much worse than marginally exacerbate an existing problem. It is also, I think, vastly more politically feasible than most proposals for cutting Medicare’s costs.
Alas, “more politically feasible” does not mean remotely the same thing as just “politically feasible.”
It’s not crazy, but an obvious problem is that we can’t expect the dead to do much in the way of economizing.
Will’s idea seems a lot more intuitive to me: “Don’t give the elderly rich any government money for health care. Let them pay for it, because they’re rich!”Report
Oh, I definitely agree and if I had my druthers straight-up means testing of Medicare would be the way to go. But I suspect Drum’s solution is more politically feasible, and the downsides to it aren’t that big.Report
Politically feasible in a very watered-down fashion, that is. If you want to get this past the farmer and small business lobby, expect exemptions and deductions like they exist for the estate tax, and the resulting take won’t be very significant, nor will many people be affected in their health care choices. Every little helps, of course, but this idea would have to be part of a more comprehensive reform.Report
The dead can’t do much in the way of economizing, but this is a good point: “What’s more, that Medicare bill, with its continuously increasing grand total, would give people a pretty good sense of just how much medical care they’re really getting.”
For a good number of folks, passing something on to their chillun’s is something of a major factor. Sitting there watching the 1 million to socked away slowly get virtually eaten away will provide an incentive to be engaged in economizing your health care to a measurable and significant degree, I’d wager.Report
“It is also, I think, vastly more politically feasible than most proposals for cutting Medicare’s costs.”
Who’s we, kemosabe?
The Ryan plan is plenty feasible enough politically (taking a wide enough view of the Ryan plan), if people who supposedly support limited government such as yourself can actually be bothered to do it.
After that, there’s the issue that fiscal restraint is not just a matter of Medicare. Medicare might be the biggest fish in the tank, but it’s not the only one.Report