Opinion

Why not give current seniors a choice in Medicare?

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Mitt Romney and his new running mate, Rep. Paul Ryan, R-Wis., agree that when Americans reach old age, they should be given the choice between staying in traditional Medicare or enrolling in competing private health insurance plans. Yet their plan would deny this choice to today's seniors.

As with most proposals to reform retirement programs, Ryan has emphasized that the plan he authored as chairman of the House Budget Committee would not affect anybody 55 or older. Romney's structurally similar but less detailed campaign plan also promises that "Nothing changes for current seniors or those nearing retirement."

The political rationale for this is pretty clear. Medicare is a popular program that covers 50 million mostly elderly Americans. They are an active and easily scared voting bloc, so it seems safer to emphasize that nothing will change for them. Also, older Americans who have made decisions based on the current system have less flexibility to adapt to any changes.

But these arguments were much stronger when applied to an earlier iteration of Ryan's plan, which would have eventually transitioned Medicare into a system in which all plans available to participants would have been privately administered. But Ryan's most recent proposal, like Romney's, would permanently preserve traditional Medicare as an option for seniors, and so it's hard to see why there needs to be a 10-year waiting period. Current seniors might welcome more choices.

There are costs to waiting. To start, the longer changes to Medicare take to kick in, the longer it will take to realize savings from moving to a competitive model for the program. Also, the longer reforms take to be implemented, the greater the likelihood that they will be rescinded by future Congresses.

Right now, the only reason repealing Obamacare is even a possibility is that Democrats delayed the implementation of its major provisions until 2014, roughly four years after the law passed. Even if Romney and Ryan win the election and pass an ambitious legislative agenda, it will take a decade for the Medicare reforms to be implemented. A lot can happen in 10 years, and it isn't very difficult to see Democrats retaking Congress and the White House at some point, or future Republicans getting weak-kneed, in which case Medicare reforms could easily disappear.

Earlier this year, Wisconsin Gov. Scott Walker successfully staved off a recall challenge triggered by his reforms to public-sector unions. When I spoke with Walker in the run-up to the election, he told me a big reason his reforms became popular is that they were actually able to go into effect. Parents realized during the school year that the dire predictions the unions had made never came true. If Romney and Ryan delay their reforms, it will give Democrats a full decade to demagogue them before seniors realize the benefits of the new system.

This May, when Ryan met with The Washington Examiner's editorial board, I raised the issue of giving seniors a choice earlier. Ryan called it a "good idea" that was "worth considering," pending more technical analysis.

Since Saturday's vice presidential announcement, Romney and Ryan may very well have boxed themselves in by emphasizing that they wouldn't make changes to Medicare that affect current seniors. But it isn't clear that this is necessarily the best way to sell Medicare reform politically.

The line that current seniors have nothing to worry about is meant to reassure current seniors, but it may have the exact opposite effect by implicitly portraying their future reforms as something worrisome.

In contrast, if Romney and Ryan were to allow the changes to kick in sooner, they could make a much more confident case for the benefits of injecting more choice, competition and patient control into Medicare.

Philip Klein (pklein@washingtonexaminer.com) is a senior editorial writer for The Washington Examiner. Follow him on Twitter at @philipaklein.

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