Excerpts from Party Platforms on Social Security and Medicare/Medicaid
Republican
While no changes should adversely affect any current or near-retiree, comprehensive reform should address our society's remarkable medical advances in longevity and allow younger workers the option of creating their own personal investment accounts as supplements to the system. Younger Americans have lost all faith in the Social Security system, which is understandable when they read the non- partisan actuary's reports about its future funding status. Born in an old industrial era beyond the memory of most Americans, it is long overdue for major change, not just another legislative stopgap that postpones a day of reckoning. To restore public trust in the system, Republicans are committed to setting it on a sound fiscal basis that will give workers control over, and a sound return on, their investments. The sooner we act, the sooner those close to retirement can be reassured of their benefits and younger workers can take responsibility for planning their own retirement decades from now.
Unlike Social Security, the problems facing private pension plans are both demographic and ethical. While pension law may be complicated, the current bottom line is that many plans are increasingly underfunded by overestimating their rates of return on investments. This in turn endangers the integrity of the Pension Guaranty Benefit Corporation, which is itself seriously underfunded. In both cases, the taxpayers will be expected to pay for a bailout. As the first step toward possible corrective action, we call for a presidential panel to review the private pension system in this country of only those private pensions that are backed by the Pension Guaranty Benefit Corporation and to make public its findings.
The situation of public pension systems demands immediate remedial action. The irresponsible promises of politicians at every level of government have come back to haunt today's taxpayers with enormous unfunded pension liabilities. Many cities face bankruptcy because of excessive outlays for early retirement, extravagant health plans, and overly generous pension benefits. We salute the Republican Governors and State legislators who have, in the face of abuse and threats of violence, reformed their State pension systems for the benefit of both taxpayers and retirees alike.
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.
Democrat
Social Security and Medicare
We believe every American deserves a secure, healthy, and dignified retirement. America's seniors have earned their Medicare and Social Security through a lifetime of hard work and personal responsibility. President Obama is committed to preserving that promise for this and future generations. During their working years, Americans contribute to Social Security in exchange for a promise that they will receive an income in retirement. Unlike those in the other party, we will find a solution to protect Social Security for future generations. We will block Republican efforts to subject Americans' guaranteed retirement income to the whims of the stock market through privatization. We reject approaches that insist that cutting benefits is the only answer. President Obama will also make it easier for Americans to save on their own for retirement and prepare for unforeseen expenses by participating in retirement accounts at work.
The Republican budget plan would end Medicare as we know it. Democrats adamantly oppose any efforts to privatize or voucherize Medicare; unlike our opponents we will not ask seniors to pay thousands of dollars more every year while they watch the value of their Medicare benefits evaporate. Democrats believe that Medicare is a sacred compact with our seniors. Nearly 50 million older Americans and Americans with disabilities rely on Medicare each year, and the new health care law makes Medicare stronger by adding new benefits, fighting fraud, and improving care for patients. And, over 10 years, the law will save the average Medicare beneficiary $4,200. President Obama is already leading the most successful crackdown on health care fraud ever, having already recovered $10 billion from health care scams. We will build on those reforms, not eliminate Medicare's guarantees. The health care law is closing the gap in prescription drug coverage known as the "doughnut hole." More than five million seniors have already saved money - an average of $600 last year - and the doughnut hole will be closed for good by 2020.
In short, Democrats believe that Social Security and Medicare must be kept strong for seniors, people with disabilities, and future generations. Our opponents have shown a shocking willingness to gut these programs to pay for tax cuts for the wealthiest, and we fundamentally reject that approach.
(NOTE: Democrats do not have a separate Medicaid platform section; the only reference is its expansion to more working families under Affordable Care Act (ACA).
Roadmaps From Democrats and Republicans: 