Sunday, June 24, 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: Handing out gift cards like candy at CareerSource

Editorial: Handing out gift cards like candy at CareerSource

It’s hard to pick the biggest outrage in the financial and ethical swamp that has swallowed Tampa Bay’s two primary job placement agencies, CareerSource Pinellas and CareerSource Tampa Bay. Is it the boiler room atmosphere where CareerSource recruite...
Published: 06/21/18
Updated: 06/22/18

Family separation crisis is not over

The family-separation crisis that President Donald Trump created is not over. The executive order Trump signed Wednesday purporting to end the routine tearing of children from their undocumented parents stands on uncertain legal ground. U.S. border a...
Published: 06/21/18
Updated: 06/22/18
Editorial: State help needed to staff hotlines with veterans helping veterans

Editorial: State help needed to staff hotlines with veterans helping veterans

Veterans can help veterans deal with trauma resulting from military service in a way no one else can. That’s the theory behind a special hotline set up in the Tampa Bay area that proponents are hoping to take statewide.The expansion would cost some $...
Published: 06/21/18
Updated: 06/22/18
Editorial: With Supreme Court ruling, Florida should collect sales tax from online retailers

Editorial: With Supreme Court ruling, Florida should collect sales tax from online retailers

It turns out the U.S. Supreme Court has a better grasp of the economic realities of the 21st century than Congress or the Florida Legislature. The court ruled Thursday that states can require online retailers to collect sales taxes even if the retail...
Published: 06/21/18
Updated: 06/22/18
Editorial: Congress should ban splitting kids, parents

Editorial: Congress should ban splitting kids, parents

The shocking scenes of immigrant children crying after being taken from their parents at the border exposed a new level of cruelty by the Trump administration, and though the president reversed course Wednesday, Congress needs to end the shameful pra...
Published: 06/21/18
Sessions kickstarts action on marijuana

Sessions kickstarts action on marijuana

Good job, Jeff Sessions! It seems the attorney general’s misguided attempts to revive the unpopular and unjust federal war on marijuana may be having the exact opposite effect — prompting a new bipartisan effort in Congress to allow states to legaliz...
Published: 06/18/18
Updated: 06/21/18
Editorial: A court victory for protecting Florida’s environment

Editorial: A court victory for protecting Florida’s environment

A Tallahassee judge has affirmed the overwhelming intent of Florida voters by ruling that state lawmakers have failed to comply with a constitutional amendment that is supposed to provide a specific pot of money to buy and preserve endangered lands. ...
Published: 06/18/18
Updated: 06/20/18
Editorial: Trump should stop taking children away from parents at the border

Editorial: Trump should stop taking children away from parents at the border

Innocent children should not be used as political pawns. That is exactly what the Trump administration is doing by cruelly prying young children away from their parents as these desperate families cross the Mexican border in search of a safer, better...
Published: 06/17/18
Updated: 06/19/18

Editorial: ATF should get tougher on gun dealers who violate the law

Gun dealers who break the law by turning a blind eye to federal licensing rules are as dangerous to society as people who have no right to a possess a firearm in the first place. Yet a recent report shows that the federal agency responsible for polic...
Published: 06/17/18
Updated: 06/18/18
Editorial: Encouraging private citizens to step up on transit

Editorial: Encouraging private citizens to step up on transit

The new grass-roots effort to put a transportation package before Hillsborough County voters in November faces a tough slog. Voters rejected a similar effort in 2010, and another in 2016 by elected officials never made it from the gate. But the lates...
Published: 06/15/18