There is consensus that Social Security and Medicare contribute to current fiscal problems, but there is no consensus on solutions. Social Security and Medicare helped many in the past 50 years, and many cannot afford a decrease in payments.
Although a change of 1 percent in the cost of living would result in a decrease of only $150 to $200 per year for an average recipient, many elderly people cannot afford the decrease. I work in a free health clinic and about 20 percent of the patients are between the ages 55 and 65. Increases in Medicare's age eligibility or decreases in benefits would have an adverse impact on these individuals, particularly in Pennsylvania where the government is reluctant to extend Medicaid.
Social Security and Medicare could be made sustainable by changes in the cap on Social Security income, means-testing higher income recipients for COLA adjustments and decreasing payments as a last resort. Medicare could be strengthened by improving efficiency and decreasing waste, which was estimated at about $700 billion in the recent Institute of Medicine report. Decreasing waste is a difficult task because of all the vested interests, but we should be spending our energies on improving value rather than arbitrarily decreasing costs.
Journalists need to discuss the increased inequity and its impact on society and our priorities as a country. Unfortunately, it takes a personal experience for the leadership to understand the problems of the less fortunate in our society, as indicated by Florida Gov. Rick Scott's explanation that one reason for the change in his support for Medicaid is his mother's experience when she needed help.
Journalists should focus on the priorities for the country, and how we can help those who need most help rather than assigning blame.
LAKSHMI P. CHELLURI, M.D.