The Washington PostDemocracy Dies in Darkness

Paul Ryan to change Medicare for boomers over 55? Good.

During the 2012 campaign, Republicans promised not to change Medicare for anyone 55 or older. Now their budget chief, Rep. Paul Ryan (Wis.), is saying he might violate that pledge. The Hill reports that Republican centrists — apparently there still are a few — “erupted” when they heard that Ryan’s next budget proposal could include structural changes for boomers as old as 58.

If Ryan follows through, Democrats would no doubt brutalize him for it. But promising current and soon-to-be seniors — who vote in droves — that they would not be expected to participate in righting the program set to bust the federal budget was bare election-year cowardice, fiscally unwise and deeply unfair. Even if Ryan’s next budget proposal is inadequate for other reasons, if he believes that Medicare reform is necessary, he should have the backbone to apply it to the boomers.

State spending is already tilted heavily toward the elderly. All levels of government spend $26,355 a year per senior and only $11,822 per child. Politifact reports that, “In the overall federal budget, nearly 4 in 10 dollars go to the elderly and disabled, a percentage that has nearly quadrupled in 50 years.” That imbalance is only getting worse. In successive rounds of budget cuts, including the sequester that just started kicking in, Congress has slashed the discretionary budget, which is most everything but entitlement spending on the elderly. Even without the tea party’s discretionary cutting, a projected unsustainable rise health-care costs combined with the retirement of the boomers means unreformed Medicare will continue to demand more and more of the budget.

The country’s projected long-term debt challenge is not a result of excessive spending on PBS, foreign aid or food stamps. A large number of baby boomers in line to claim ever-more expensive health-care benefits is the driver. At best, doing nothing about that for 10 years while droves of boomers retire and claim decades more in benefits would unnecessarily divert resources from other important government functions. At worst, doing so would result in loads more debt simply to put off reform.

A typical response is that boomers have paid into the system their whole lives, so they deserve traditional Medicare. Except younger Americans will pay at least as much in Medicare taxes as their parents have — why are they any less deserving? Besides, if benefits were tied to the amount paid in, Medicare would be drastically less generous. The Urban Institute calculates that new retirees in the current system will draw benefits worth three times the amount they paid in. Politicians would have to gut the program to get anywhere close to violating the notion that seniors should at least get out what they put in.

But weren’t boomers promised — and aren’t they relying on — a generous Medicare program? Often lost in the debate is the fact that neither Ryan nor President Obama wants to reduce spending per senior from today’s levels. They both at least want the value of benefits to grow with inflation, and a big part of the argument is how much faster than inflation per-senior spending should be allowed to increase. Even in reformed Medicare, the country would be devoting a huge and increasing chunk of its wealth toward keeping its commitment to provide decent health care to its elderly.

Consider, meanwhile, what the GOP’s pledge promised to young Americans. They would have to finance an unreformed, pay-for-service Medicare system for hordes of boomers, the ballooning cost of which would make it harder to continue investing in infrastructure, education, research and defense. Then, to pay for it, they would retire into an attenuated Medicare program that their parents’ leaders didn’t have the courage to impose on anyone old enough to bother voting on the issue. Now try lecturing us on fairness.