"Stand Up With Pete" is a politics and current events talk show on SIriusXM's "POTUS" station.  In response to a discussion yesterday about Medicare and Congressman Paul Ryan's reform efforts, I sent the following letter:

Pete,
Yesterday on your show, you were discussing the "Ryan Plan" for Medicare, and asking a question:  are older voters — those in their 50s and 60s — more worried about their Medicare being taken away than other issues?

The question is wrong in its premise:  *nobody* (at least in the mainstream of American politics) is talking about changing Medicare one iota for those already in it, or those soon to be enrolled in it.  The people who are soon to be impacted by Medicare would see no change.  If someone 55 or 65 is voting because he or she is scared of losing his or her Medicare, then obviously some untruths are being propagated.

What Paul Ryan's plan does is make changes for those people who would be enrolling in 10-15 years.  It would replace the "single payer" government plan with subsidies for the purchase of insurance.  The subsidies would be on a sliding scale, so lower-income people would get more, the "richest 1%" would get less.  Contrast that to currently, with the famous example that Warren Buffet gets the same Medicare benefits as the janitor at his office.

But there's another important aspect of this discussion that is getting lost in the debate:  some version of this type of Medicare reform has been proposed on a bipartisan basis.  Before Erskine Bowles served on President Obama's "deficit reduction commission", he was President Clinton's chief of staff.  President Clinton named former Democratic Senator John Breaux to lead the "National Bipartisan Commission on the Future of Medicare".  Guess what type of system they proposed?  You guessed it:  a "premium support system", very similar to what Congressman Ryan proposes.  The entire plan is available at http://thomas.loc.gov/medicare/index.html.

There's a lot more to discuss and debate about such a change in direction, but I did think those points were relevant to the discussion.

Regards,
Dave Smith
Houston, TX