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Ever since I was in Congress there was a group of people that wanted some form of universal healthcare. It would include one healthcare provider through the federal government, which they frequently refer to as “Medicare for all.”
However, there is a huge difference between Medicare which is for the elderly and disabled in contrast to Medicaid which is for the indigent and their children. Working Americans contribute by paying into Medicare, while Medicaid is paid by the federal government. Essentially healthcare for Medicaid individuals is free. You simply cannot combine the two systems into a form of universal healthcare.
Let us remember, no one could say that Americans do not have a form of healthcare, even if it is extremely costly. The correct statement is not all Americans actually have paid for healthcare or are paying for healthcare insurance coverage.
Medicaid needs serious reform. Hospitals must provide healthcare to the sick or injured. Those folks without insurance struggle to pay out of pocket. If they fail to do so their credit worthiness is destroyed. If deemed indigent, Medicaid takes care of all the costs. This puts a strain on many hospitals.
The number of indigent folks and their children has grown exponentially due at least in part to the millions who illegally entered America via porous borders. They have arrived in America poor and without health insurance immediately falling into the Medicaid category. The American people pay for their healthcare. This results in a significant cost shift affecting the healthcare insurance cost for millions of middle-class Americans.
In 1990 there were 22.9 million folks in America receiving Medicaid. Today that number has swollen to nearly 76 million people. Thus, 20% of Americans have
healthcare provided by the federal government for others to pay for. It mirrors one of the prime causes of the fall of the Roman Empire: providing services to their growing population was a major cause of the empire’s collapse.
What the Democratic Socialists of America (DSA) refuse to acknowledge is that both Social Security which provides income for senior citizens and Medicare which provides healthcare for senior citizens and those with disabilities have been paid for by those receiving the benefits.
I started working, like many Americans, at age 16. I cleaned the toilets, mopped the floors, and washed the pots and pans at Waterbury Hospital. Like most Americans, after nearly 50 years of contributing to the system those funds, if used or invested properly, would amount to a sizable chunk of change.
Medicare and Social Security are entitlements that working Americans contribute to in this manner:
Federal Insurance Contribution Act (FICA)
Social Security: Employees pay 6.2% of their gross wages, and employers match this with an additional 6.2%, for a combined 12.4%. These funds are channeled into the Social Security Administration. The tax applies up to a specific annual earnings cap, which is set at $184,500.
Medicare: Employees pay 1.45% and employers match it with 1.45%, totaling 2.9% on all earnings. High-income earners may pay an additional 0.9% Medicare tax.
Self-employed workers: Individuals who work for themselves pay both the employer and employee portions, resulting in a 12.4% Social Security contribution and a 2.9% Medicare contribution.
Former President Franklin Roosevelt was not giving us a freebie. It was an investment. The contributions were pooled into a trust fund. The problem is that we have raided this fund in lieu of raising taxes or reducing spending. We have done so to such a degree that the funds could actually run out if our “do nothing Congress” continues to, well, do nothing.
Our labor force participation rate is at abysmal lows, reducing the number of people contributing to Social Security and Medicare as America ages. Our large increase in population, however, has been a positive factor, producing more workers.
Over the decades, when the Medicare Trust or Social Security Trust has produced a surplus the U.S. Treasury borrows from it, which was not what it was meant to do when established.
Former President Lyndon Johnson was the first to borrow from our Social Security Trust. He used it to help fund the Vietnam War. President Bill Clinton actually used the surplus to help balance the budget.
What the DSA members refuse to tell the public is that putting all people under Medicare is not only a disservice to Roosevelt, Democrats and Republicans of the 20th Century, but it could destroy Medicare as we know it today. Plus, this would be a major injustice to the millions of seniors and soon to be seniors who paid into Medicare with their hard-earned labor for decades.
Healthcare reminds me of the drug crisis of the 1980s. We focus so much on the crimes involved in trafficking and selling drugs that we did not recognize that to stop the drug crisis we merely had to halt or at least reduce the demand for illegal drugs.
The lesson we can draw is this: It is age, accidents (not a major part) and unhealthy people that are causing the cost of healthcare to dramatically increase. That is why we need to have Medicare strengthened, not weakened or diluted with those who never paid into the system.
Exercise, diet, preventive care, and personal responsibility are ways we can dramatically reduce these costs.
Pre-existing illnesses, genetic disorders, and catastrophic illnesses must be addressed with government assistance, but they should not be grouped in with Medicare. It would drive healthcare insurance premiums up for those who can pay.
If the members of the DSA are suggesting that we tax our way into paying for Medicaid, well, that too would require “someone” to pay the bill. There are no free lunches.
Congress has deficit spending already – meaning our government is not taking in enough in taxes to pay its current bills. Medicaid is growing out of control. We need to reform it and then attack a root cause of our healthcare troubles: unhealthy lifestyles.
I say facetiously that it may be cheaper to pay people to stay healthy than to stay on our current course of an unsustainable Medicaid problem and sky high costs for healthcare insurance.
Gary Franks served three terms as a congressman from Connecticut’s 5th District. He was the first Black conservative elected to Congress and first Black Republican elected to the House in nearly 60 years. Host: Podcast “We Speak Frankly” www.garyfranksphilanthropy.org