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Preserving Medicare and Medicaid
More than 100 million Americans depend on
Medicare or Medicaid for their healthcare; with
our population aging, that number will increase. To
preserve Medicare and Medicaid, the financing of
these important programs must be brought under
control before they consume most of the federal
budget, including national defense. The good news
is that it can be done, and it can be done without
endangering the elderly and the needy who depend
on those programs. We intend to save Medicare by
modernizing it, empowering its participants, and
putting it on a secure financial footing. We will
preserve the promise of Medicaid as well by making that program, designed for 1965 medicine, a vehicle
for good health in an entirely new era.
Medicare’s long-term debt is in the trillions, and
it is funded by a workforce that is shrinking relative
to the size of future beneficiaries. Obamacare
worsened the situation — and imperiled seniors —
by imposing hundreds of billions of dollars in cuts
to Medicare providers to pay for its new spending.
When a vital program is so clearly headed for a train
wreck, it’s time to put it on a more secure track.
That is why we propose these reforms: Impose no
changes for persons 55 or older. Give others the
option of traditional Medicare or transition to a
premium-support model designed to strengthen
patient choice, promote cost-saving competition
among providers, and better guard against the
fraud and abuse that now diverts billions of dollars
every year away from patient care. Guarantee to
every enrollee an income-adjusted contribution
toward a plan of their choice, with catastrophic
protection. Without disadvantaging present retirees
or those nearing retirement, set a more realistic age
for eligibility in light of today’s longer life span.
This is an agenda to improve healthcare, not
just to manage its costs. We reject the Democrats’
approach of rationing inherent in Obamacare. We
recognize the de facto rationing of healthcare
caused by reduced access to doctors who
increasingly opt out of participating in Medicare
and Medicaid. We will not accept that or any other
approach which denies care — or lowers its quality
— for America’s elderly.
Medicaid presents related, but somewhat
different challenges. As the dominant force in
the health market with regard to long-term care,
births, and persons with mental illness, it is the next
frontier of welfare reform. It is simply too big and
too flawed to be administered from Washington.
Most of the vaunted expansion of health insurance
coverage under Obamacare actually has been an
unprecedented expansion of the Medicaid rolls in
many states. We applaud the Republican governors
and state legislators who have undertaken the hard
work of modernizing Medicaid. We will give them a
free hand to do so by block-granting the program
without strings. Their initiatives — whether premium
supports for purchasing insurance, refundable tax
credits, alternatives to hospitalization for chronic patients, disease prevention activities, and other
innovations — are the best strategy for preserving
Medicaid for those who need it the most. Block
granting Medicaid is particularly needed to
address mental health care. Mental illness affects
people from all walks of life, but there has been
little success in developing effective system-wide
medical models for addressing mental health. For a
variety of unique reasons, government is often the
first frontier for people experiencing mental health
problems — from first responders who deal with
crises to publicly funded mental health facilities
and prisons where large numbers of inmates
suffer from mental illnesses. Using block grants
would allow states to experiment with different
systems to address mental health and develop
successful models to be replicated in states across
the nation. The current federally dictated mental
health care regime is wasteful and ineffective, and
moving to a block grant approach would allow for
state and local governments to create solutions
for individuals and families in desperate need of
help in addressing mental illness. We respect the
states’ authority and flexibility to exclude abortion
providers from federal programs such as Medicaid
and other healthcare and family planning programs
so long as they continue to perform or refer for
elective abortions or sell the body parts of aborted
children.
Saving Social Security
We reject the old maxim that Social Security
is the “Third Rail” of American politics, deadly for
anyone who would change it. The Democratic Party
still treats it that way, even though everyone knows
that its current course will lead to a financial and
social disaster. Younger Americans have lost all faith
in the program and expect little return for what
they are paying into it. As the party of America’s
future, we accept the responsibility to preserve and
modernize a system of retirement security forged
in an old industrial era beyond the memory of most
Americans. Current retirees and those close to
retirement can be assured of their benefits. Of the
many reforms being proposed, all options should
be considered to preserve Social Security. As
Republicans, we oppose tax increases and believe
in the power of markets to create wealth and to help secure the future of our Social Security system.
Saving Social Security is more than a challenge. It
is our moral obligation to those who trusted in the
government’s word.[3]
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Pence on federal assistance programs
