Take this not as an endorsement. Rather, I’m merely presenting the text, verbatim, as something of a public service.
At its Republican National Convention, the GOP published its official platform, the first two tenets of which are “Saving Medicare for future generations,” and “Strengthening Medicaid in the states.”
For clarity’s sake, here is the text:
Saving Medicare for Future Generations
The Republican Party is committed to saving Medicare and Medicaid. Unless the programs’ fiscal ship is righted, the individuals hurt the first and the worst will be those who depend on them the most. We will save Medicare by modernizing it, by empowering its participants, and by putting it on a secure financial footing. This will be an enormous undertaking, and it should be a non-partisan one. We welcome to the effort all who sincerely want to ensure the future for our seniors and the poor. Republicans are determined to achieve that goal with a candid and honest presentation of the problem and its solutions to the American people.
Despite the enormous differences between Medicare and Medicaid, the two programs share the same fiscal outlook: their current courses cannot be sustained. Medicare has grown from more than 20 million enrolled in 1970 to more than 47 million enrolled today, with a projected total of 80 million in 2030. Medicaid counted almost 30 million enrollees in 1990, has about 54 million now, and under Obamacare would include an additional 11 million. Medicare spent more than $520 billion in 2010 and has close to $37 trillion in unfunded obligations, while total Medicaid spending will more than double by 2019. In many States, Medicaid’s mandates and inflexible bureaucracy have become a budgetary black hole, growing faster than most other budget lines and devouring funding for many other essential governmental functions.
The problem goes beyond finances. Poor quality healthcare is the most expensive type of care because it prolongs affliction and leads to ever more complications. Even expensive prevention is preferable to more costly treatment later on. When approximately 80 percent of healthcare costs are related to lifestyle -smoking, obesity, substance abuse-far greater emphasis has to be put upon personal responsibility for health maintenance. Our goal for both Medicare and Medicaid must be to assure that every participant receives the amount of care they need at the time they need it, whether for an expectant mother and her baby or for someone in the last moments of life. Absent reforms, these two programs are headed for bankruptcy that will endanger care for seniors and the poor.
The first step is to move the two programs away from their current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model. This is the only way to limit costs and restore consumer choice for patients and introduce competition; for in healthcare, as in any other sector of the economy, genuine competition is the best guarantee of better care at lower cost. It is also the best guard against the fraud and abuse that have plagued Medicare in its isolation from free market forces, which in turn costs the taxpayers billions of dollars every year. We can do this without making any changes for those 55 and older. While retaining the option of traditional Medicare in competition with private plans, we call for a transition to a premium-support model for Medicare, with an income-adjusted contribution toward a health plan of the enrollee’s choice. This model will include private health insurance plans that provide catastrophic protection, to ensure the continuation of doctor-patient relationships. Without disadvantaging retirees or those nearing retirement, the age eligibility for Medicare must be made more realistic in terms of today’s longer life span.
Strengthening Medicaid in the States
Medicaid, as the dominant payer in the health market in regards to long-term care, births, and individuals with mental illness, is the next frontier of welfare reform. It is simply too big and too flawed to be managed in its current condition from Washington. Republican Governors have taken the lead in proposing a host of regulatory changes that could make the program more flexible, innovative, and accountable. There should be alternatives to hospitalization for chronic health problems. Patients could be rewarded for participating in disease prevention activities. Excessive mandates on coverage should be eliminated. Patients with long-term care needs might fare better in a separately designed program.
As those and other specific proposals show, Republican Governors and State legislatures are ready to do the hard work of modernizing Medicaid for the twenty-first century. We propose to let them do all that and more by block-granting the program to the States, providing the States with the flexibility to design programs that meet the needs of their low income citizens. Such reforms could be achieved through premium supports or a refundable tax credit, allowing non-disabled adults and children to be moved into private health insurance of their choice, where their needs can be met on the same basis as those of more affluent Americans. For the aged and disabled under Medicaid, for whom monthly costs can be extremely high, States would have flexibility to improve the quality of care and to avoid the inappropriate institutional placing of patients who prefer to be cared for at home.
You can read the entire platform online, wherein you’ll find the Republican stance on other issues, including but not limited to, ensuring retirement security, regulatory reform, protecting Internet freedom, judicial activism, legal immigration, American Indians, and America’s future in space.