When I was an intern/resident an earth shattering metamorphosis took place in America. The introduction of Medicare and Medicaid represented an entirely new approach to the care of the elderly and the indigent.
Significantly physicians in practice were faced with a new phenomenon, namely government intervention in the health care system as never before. One immediate change was the abolition of the old charity ward. Until then, indigent patients admitted to the hospital were admitted on “service.” This meant that residents under the supervision of Attendings took care of these patients on a teaching ward.
The new system meant that suddenly those with Medicaid were now admitted directly to the care of an attending physician. Whereas previously the attending received no remuneration for helping the house staff, (even if it meant coming out in the middle of the night to assist at surgery), now everything changed. Physicians who complained about their heavy charity load were suddenly getting funding for their efforts. Of course along with the growth of these programs has been an equal growth in government interference and bureaucracy.
I bring this up to introduce my thoughts on the Presidents Social Security plans, which I believe represent culture shock to many Americans. Accepting such changes requires patience, education and perseverance.
Firstly, I believe the President should tackle making the income tax cuts permanent which was a clear and major campaign promise. It will be easier to pass since it is easily understood and will require little political capital to pass. It will allow him extra time to formulate a coherent plan on social security.
I and my wife are on social security and therefore have no concerns regarding the plan. However, if I were 50-54 years of age I do not think I could mentally be prepared for such a drastic change in the program within the time they are talking about. Therefore, I believe that the transition should be changed to those 45 or below to allow them 20 years to prepare.
Every individual knows social security is in trouble. They also realize that a private investment plan will far outstrip the benefits of what we have now. However, the President has not prepared the nation with the real details of the budgetary implications for the transition period, including what percentage of your funds can go into the private accounts? What are the consequences to benefits if you choose not to join? And so on.
Yes, speeches on the stump are great, but he should not rush consideration of any bill until there is more information available to the public. As for the Democrats, I don’t believe the public appreciates a stone wall of legislative obstructionism on these issues. They act like the Sunnis in Iraq, at their own peril, and to the detriment of the nation.
