Long, long ago (“in a galaxy far, far away”), I was a schoolboy near Liverpool, England. In 1960, I won the Old Wallaseyans Stumps Speeches Debating Trophy. It was nice to win, but the really good part was that in the final round, I beat my brother Stewart. He and I competed for everything from grades and awards to girls. Now fifty-five years later, I need to fall back on debating style to raise an important question about Medicare.
Point No. 1: Entitlements Are Free
An entitlement is a right to have or to do something. Such a right is granted to you by God or by the government. (Often, the latter thinks it is the former.) You pay nothing for an entitlement. Indeed, that is a hallmark of an entitlement–it is free.
“What about taxes,” cries my opponent? I counter softly with, “Yes, what about taxes? Do those who are 'entitled' to get Medicaid pay federal taxes? In fact, their income is below 138 percent of the poverty line and thus they pay no taxes.”
Point No. 2: Corollary of Golden Rule
The Golden Rule states as follows: He who has the gold makes the rules. The corollary is obvious: the one who has the gold and therefore makes the rules also controls the spending of said gold, also known as money.
(AP Photo/Bradley C Bower, file)
Point No. 3: If It’s Your Money, You Decide
There is no such thing as conditional property. You either own your house or the bank does. Your car is the title company’s property until you pay off the loan. If the money is your property, then you control it: you decide how to spend it. If the money isn’t yours, that is, the money is someone else’s property, then that person or group decides what to do with it.
Point No. 4: Medicaid
Medicaid is a true entitlement. The government provides it at no cost to the enrollee. The Medicaid Program offers the right to sign up for free health insurance. The government or its subcontractor insurance company decides what benefits you get. In other words, it’s their money. They spend it how they choose and you get what they say you get.
Point No. 5: Social Security
Social Security is called an entitlement but isn’t, not really. You paid into the fund for most of your adult life. The government holds the money, but legally it is your money held in trust by Washington. When you retire and enter the so-called Golden Years, the trust doles out your money to you each month. You decide how much to spend on sustenance, rent, entertainment, and most important, espresso. As it is your money, you decide what to do with it.
Point No. 6: Medicare Is Medical Safety Net
Social Security is your old age safety net for general living expenses. Medicare is the healthcare equivalent–it is your medical safety net supposedly there to make sure that your health care needs are covered during the Golden Years. It is generally called an entitlement, but is it?
You paid into the program for 40 years or more. The money went into a bank account called the Medicare Trust Fund. Notice the word “trust.” That sounds to me like that is your money, held in trust for you, just like Social Security, not some “freebie” granted to you by the government.
Can you be “entitled” to your own money? That question in turn leads to my final point, which itself is a question.
Point No. 7: A Question
You decide how to spend your Social Security money that comes in monthly checks.
Why doesn’t the government give you your Medicare money the same way, as monthly checks? In other words, why does the government decide how to spend your old age medical money, money that they have been holding in trust, money that you have been putting away for decades in order to have good health during your Golden Years?
Someone please explain. I don’t understand. (Or maybe I do understand and I just don’t like it.)
Dr. Deane Waldman MD MBA is author of award-winning “The Cancer In Healthcare;” Professor Emeritus of Pediatrics, Pathology and Decision Science; and Adjunct Scholar (Healthcare) for the Rio Grande Foundation, a public policy think tank. Dr. Deane also sits on the Board of Directors of the New Mexico Health Insurance Exchange, as Consumer Advocate. Opinions expressed here are solely his and do not necessarily reflect the opinions of the Board.
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