A Modest Proposal for Preventing Medicare from Being a Burden on Taxpayers

by Paul Ryan

From time to time, we offer free space to citizens with something to say. Today, Congressman (and former Oscar Meyer Wienermobile driver) Paul Ryan has a new crazy proposal that explains how Medicare can be saved — delivered in his own, inimitable language.

It makes the youth of the nation and the working class melancholy when they hear senior citizens importuning our elected officials on both sides to preserve Medicare in its current form. These seniors, instead of being able to make themselves useful, are forced to employ all their time writing letters-to-the-editor and calling their legislators.

Probably all Americans agree that the overflowing Medicare needs of seniors, is, in the present budgetary crisis state, a very great additional hardship; and, therefore, whoever could find a fair, cheap and easy method of ensuring the medical needs of these elderly, would deserve the admiration of both of the nation’s political parties.

But my intention is far from limited to providing only for the health care of seniors; it is of a much greater extent, and it aims to address all Americans little able to insure themselves, and who thus demand access to expensive, but necessary, entitlement programs.

For many years I’ve focused on this important subject, and weighed several of the mainstream proposals. They’ve all been grossly mistaken in their accounting.

The number of Americans on Medicare is estimated at 45 million. Of these, it’s calculated about 27 million are of comparatively sound health; from that number, subtract 5 million who will be conscientiously unwilling to submit to the new program, leaving a core of 22 million healthy Medicare enrollees. Of the remaining 18 million of the original total, 10 million have health so poor as to require conventional care beyond this proposal.

Those larger picture figures in mind, I believe my party has architected a solution to the unsustainable financial burden the Medicare entitlement system has placed on the American taxpayer.

I have been assured by the most expert American health professionals and health policy researchers that a younger, healthy Medicare enrollee, well trained, is perfectly suited to provide for the basic healthcare needs of other, older Medicare enrollees.

Our plan is that of the 22 million enrolled seniors willing to participate in the plan, 15 million at any one time would serve as Associate Medicare Team Members. While it would be impossible to train these seniors to the level of a registered nurse (RN), experts nearly unanimously agree that a senior between the ages of 65 and 72 easily has the mental acuity to reach the training level of a Certified Geriatric Care Manager or similar.

Not only will this put the health care services within closer reach of the seniors who need it most, but it will also deliver that care from a trusted peer. and not from some hurried unknown person in a lab coat in a foreign, unfamiliar environment sterilized of not only germs, but also compassion.

Clearly, Associate Medicare Team Members will be limited in the care provided. An exploratory committee of medical experts has recommended that procedures such as medication administration, demanding bowel evacuation, catheter insertion and removal, CT scanner operation and basic wound stitching are all well within the abilities of a trained senior.

Naturally, more complex surgical operations will be limited to MDs, who, thanks to this program, will have more time for procedures. As such, we project the added benefit of a decline in malpractice cases.

Initial calculations by the Congressional Budget Office prove that our proposal would save taxpayers $435 billion after just five years.

The first ten years would require an investment of $20 billion in training, infrastructure and professional development to set up the program, putting it in line to begin serving those who are now 55. Those 55 and above will see no changes to Medicare whatsoever.
An added outcome of bending this cost curve is that, in the years after the program is fully operational, existing Team Members would be able to handle the larger part of the duties of training incoming Associate Team Members, creating a self-sustaining and fiscally sustainable Medicare system.

Congresswoman Bachmann, whose virtues I highly esteem, was lately pleased to discuss this matter and offered a refinement. She said that many states, having of late found themselves in billion-dollar budget shortfalls, might be willing to see their own low-income Medicaid systems participate, wherein uninsured families and those in economic need would also receive free basic health care treatment from Associate Medicare Team Members.

A variation of this program is already practiced in some African nations, where it has proven unanimously popular, boasting participation rates well over 95 percent.

The numerous advantages of this proposal are obvious and beyond debate.

Not only would this proposal cut down on health care spending, but it would also allow Medicare to exist and continue in its current form, something recent poll and election results have proven is what people, especially seniors, want.

As always, we are not automatically set to reject any offer proposed by our fellow members on the other side of the aisle. But before Democrats act in contradiction to this plan, we call that they address two points.

First, as things now stand, how does the nation propose tens of millions of Medicare enrollees continue to receive care when the system is fundamentally unsustainable, without further breaking the backs of taxpayers, and, as well, the business engines of our economy?

Secondly, we demand that these representatives will first poll the seniors themselves, whether they would not, at this juncture facing our nation, think it a great happiness to have heath care of some kind, provided by a trusted peer, and thereby avoid the unknown of a crumbling Medicare system in which they are forced to take their chances.

This modest yet revolutionary proposal has no other motive than to right the sinking ship that is our economic state, and to save a Medicare system for the elderly that our children can count on for their own health care needs, both to give and take, whenever those come.

Paul Ryan is the U.S. Representative from Wisconsin’s 1st congressional district.