Saturday, April 21, 2018
Opinion

We need to learn Medicare's real cost

Medicare may be the most sacred government program in the United States — even 76 percent of tea party supporters oppose cuts to it, a McClatchy-Marist poll found in November. Given its central role in our fiscal challenges, it makes sense to examine why this program is so popular. • There are two key factors. • First, retired Americans receive high-quality care but have virtually no idea what their Medicare benefits cost. The George W. Bush administration required Medicare to begin providing such information, but it is presented in a way that makes it hard to understand and is read only by people who request it. (The Medicare website even cautions that the "files are large so printing them is not recommended.") While not every retiree takes the time to study the cost, almost all rely on the benefits. • Second, every working American has Medicare taxes deducted from each paycheck and has been told that the money is paid into a trust fund for his or her future benefits. It's not surprising that Americans feel proprietary about Medicare ­— they believe that they have spent their working lives paying for their future benefits.

But those Medicare taxes, and interest on the program's small trust fund, cover just 38 percent of the annual cost of the program's benefits. Premiums paid by beneficiaries cover an additional 12 percent, but fully half of the program's $549 billion cost last year was funded by federal income taxes on working Americans.

Put another way, Medicare is a transfer of wealth from younger to older Americans.

As long as the baby boomers were working and paying taxes, their large numbers made this transfer to their parents and grandparents affordable. But the boomers began to retire last year. In its 2011 annual report on the nation's financial position — compiled in conjunction with the Office of Management and Budget — the U.S. Treasury described the federal government's finances as unsustainable. Treasury Secretary Timothy Geithner, in testimony to Congress this year, cited the ballooning cost of the transfer inherent in Medicare as a key driver.

The net present value of the transfer — the amount that would have to be set aside today to fund Medicare's future intergenerational promises — has grown to at least $25 trillion, as calculated by the Government Accountability Office. This number is buried in footnotes of the annual Treasury-OMB report and is so large (almost twice the $14 trillion value of all public U.S. companies) that it defies comprehension. It's not surprising that Americans can't relate the alarming cost of this transfer to their own lives.

But recent work by the Urban Institute calculates the amount of the transfer to an average retiree. An American man retiring in 2011 could expect to receive Medicare benefits worth $170,000 (in 2011 dollars). If he had worked from age 22 at the average U.S. wage each year, he would have paid Medicare taxes (plus interest) worth $60,000 (also in 2011 dollars). So the average male worker retiring in 2011 will receive benefits worth almost three times what he paid in. And the transfer to that retiree will be $110,000 from younger Americans, perhaps including his grandchildren.

If that average worker had a wife who didn't work, she would receive $188,000 worth of benefits, despite having paid nothing in. So the couple's benefits are six times what was paid in, or a $298,000 transfer from younger generations.

A bill introduced in the House last year by Reps. Jim Cooper, D-Tenn., and Paul Ryan, R-Wis., would require the federal government to provide all adult Americans with an annual, personalized calculation of these numbers. As with the annual letter showing what we have each paid into and can expect to get out of Social Security (to save postage, these are no longer sent out but are made available online), this would alert each of us to the amount of benefits we are expecting from younger Americans.

Would Americans be as satisfied with Medicare if we were reminded each year about the hundreds of thousands of dollars that our retirement will cost our grandchildren?

The good news is that this problem is fixable. Other countries spend far less on health care and have better health outcomes. Reform of our health care system would dramatically reduce the cost of future Medicare benefits and reduce the tax burden on future generations. But Americans are angry with their elected leaders, and they lack the information critical to understanding the need for change.

Our toxic politics are not helped by our government's dubious accounting standards and poor disclosure. We deserve better information and an honest discussion of our choices.

Bryan R. Lawrence is founder of Oakcliff Capital, a New York-based investment partnership.

© 2012 Washington Post

Comments
Editorial: New Cuba president is chance for new start

Editorial: New Cuba president is chance for new start

For all the symbolism, Raul Castro’s handoff of the Cuban presidency this week amounts to less than meets the eye even if his handpicked successor, the Communist Party functionary Miguel Diaz-Canel Bermudez, is the first person not named Castro to le...
Updated: 11 hours ago

Editorial: A missed chance for open primary elections

The Florida Constitution Revision Commission did a lot of things wrong this week by combining unrelated or unpalatable provisions into single amendments that will appear on the November ballot. It also wasted an opportunity to do one thing right. The...
Updated: 11 hours ago
Editorial: When they visit Nature’s Classroom, kids are right where they belong

Editorial: When they visit Nature’s Classroom, kids are right where they belong

The Hillsborough school district planted a fruitful seed with the opening of Nature’s Classroom five decades ago on the cypress-lined banks of the Hillsborough River northeast of Tampa. • The lessons taught there to some 17,000 sixth graders each yea...
Published: 04/20/18

Editorial: Equality pays off on Southwest Flight 1380

The passengers of Southwest Flight 1380 can be thankful that, 33 years ago, the U.S. Navy took the lead on equal opportunity.Capt. Tammie Jo Shults was piloting the flight from New York to Dallas on Tuesday when an engine exploded, blowing out a wind...
Updated: 11 hours ago
Editorial: Why single-member districts would be bad for Hillsborough commission

Editorial: Why single-member districts would be bad for Hillsborough commission

Anyone looking to make Hillsborough County government bigger, costlier, more dysfunctional and less of a regional force should love the idea that Commissioner Sandy Murman rolled out this week. She proposes enlarging the seven-member board to nine, e...
Published: 04/19/18
Updated: 04/20/18
Editorial: Improving foster care in Hillsborough

Editorial: Improving foster care in Hillsborough

A new foster care provider in Hillsborough County is poised to take over operations in May, only months after its predecessor was fired for what was alleged to be a pattern of failing to supervise at-risk children in its care. Many of the case manage...
Published: 04/18/18

Another voice: Back to postal reform

President Donald Trump is angry at Amazon for, in his tweeted words, "costing the United States Post Office massive amounts of money for being their Delivery Boy." Yet in more recent days, Trump has at least channeled his feelings in what could prove...
Published: 04/17/18
Updated: 04/18/18
Editorial: Congress should protect independence of special counsel

Editorial: Congress should protect independence of special counsel

A bipartisan Senate bill clarifying that only the attorney general or a high-ranking designee could remove a special prosecutor would send an important message amid President Donald Trump’s attacks on the investigation into Russia’s inter...
Published: 04/16/18
Updated: 04/17/18
Editorial: Don’t fall for Constitution Revision Commission’s tricks

Editorial: Don’t fall for Constitution Revision Commission’s tricks

The Florida Constitution Revision Commission has wasted months as a politically motivated scam masquerading as a high-minded effort to ask voters to improve the state’s fundamental document. The commission on Monday added amendments to the Nove...
Published: 04/16/18
Editorial: Redner’s court win on medical marijuana sends message

Editorial: Redner’s court win on medical marijuana sends message

Florida regulators have done far too little to make voter-approved medical marijuana widely available for patients suffering from chronic illnesses. A circuit court judge in Tallahassee ruled last week there is a price for that obstruction, finding t...
Published: 04/15/18
Updated: 04/16/18