Andrew Sabl on Medicare

Link here, via Matt

I think it has to do with the dynamics of self-interest and self-deception. Some of the most virulent opponents of health reform are the elderly, who already have government-provided health insurance. While some may be too silly to know that that’s what they have, a great many assuredly do know it, and are happy to pull up the ladder behind them. Medicare is already very successful and very generous. Under universal coverage, it’s unlikely to get much better (except for prescription drug coverage, but not all the elderly take a huge number of pills). And it could, for all one knows, get worse. To avoid that risk, better that some youngsters go without.

This reasoning, though, is brutal–too brutal to acknowledge. While we’re a pretty selfish country, “I’m all right, Jack” is not an argument people comfortably make when others’ lives are at stake. But “if this passes, they’ll euthanize me and my friends” is another kind of argument altogether. It’s false, but easy to seize on as a morally comfortable pretext for opposing a bill that threatens one’s self-interest.

Francois' response: I'd already figured this out. I've been saying for years that the elderly will never support universal health care because it would necessitate cutting Medicare. Matt and the President are optimistic that Medicare can actually be improved while still saving money. But as Megan McCardle has pointed out many times, why have you been waiting so long? Fix Medicare to prove to all of us that the government can run an inexpensive, effective medical payment service before asking us to trust you with health care for all.

For the elderly, the response is entirely rational and expected. A program paid for by all, but which benefits only a minority, can be pretty much as generous as it wants to be. A program paid for by all and that benefits all can't be as generous.

Plus, the elderly don't trust the government. Few people do, actually. Medicare and Social Security aren't examples of a benevelont government generously showering goodies on old people. They were meant to buy votes, and they did. Problem is, once the bill came due, Democrats would be in a fix. And so they are. They need a way to cut costs, but they know that politically, cutting Medicare as a standalone bill is impossible to pass. So they've been trying to do it under the guise of reforming the whole system. Why they thought this ruse would work, I have no idea. I knew it wouldn't, and I'm not a full time beltway pundit. But I do know a lot of elderly people, having been raised by my grandparents. I knew what Medicare was before I knew how to count to 100.