False urgency: Social Security and Medicare reform and the ‘fiscal cliff’

It may be necessary to reform Social Security, Medicare and Medicaid, but there is no reason — aside from politics — that such reforms should be a part of the current negotiations between the Republican House majority and the Obama administration. This isn’t an argument of left versus right. This is an argument in favor of thoughtful policy making and against impulsive wheeling and dealing.

Whatever one might say about the White House offer, it wasn’t a rushed effort. They have spent 18 months contemplating their priorities and their offer can be realistically said to represent what they consider their best thinking on the subject. The House proposal, by contrast, has, if we generously assume that they began working on Nov. 7, no more than three weeks of planning behind it. They’ve fitted it to their priorities, true, but they have essentially thrown together a variety of suggestions that approximate those priorities — some concrete, some curiously vague, like cuts to programs that support the elderly.

Yet even if this plan is identical to what the GOP would produce six months from now, the more pressing concern is that there are just two weeks for the American public and legislators to consider and assess the probable impact such policy changes would have on the day-to-day lives of working and retired Americans.

These changes could fundamentally remake programs that are a critical lifeline for America’s senior citizens and, by extension, for their families. What can possibly be gained by ramming them through without time for reflection, analysis and public input?

Forced to retire early

I know firsthand the impact that these programs have. All my life my mother made one thing clear: “I work because I have to,” she told my sister and I, “but I would work even if I didn’t.” Yet at 66 — one year younger than the increased eligibility age floated “unofficially” by Republicans — dementia prompted her to retire from her 44-year career as a nurse.

The bad news is that my parents were underprepared for her “early” retirement; they originally anticipated working for several more years.  The good news was that my father still held his part-time job, my parents still had a house, and they both had health insurance. Also good news: My sister and I were able to move back to Minnesota and into our childhood bedrooms to care for her. We were able to find full-time employment with benefits.

In spite of those blessings, a transition like this comes at a cost, from one-time expenses like hiring an elder-care attorney to reoccurring budget items like my father’s hefty health-insurance premium, which was originally covered by my mom’s employer.

We make it work by relying on three sources of government aid: Social Security, Medicare and the Minnesota Alternative Care program. Her Social Security benefits, combined with her pension, my father’s income and contributions from my sister and me, cover the bills. Medicare lessens the burden of her increased medical needs, which this year included an extended hospital stay and four trips to the emergency room. And Minnesota’s Alternative Care program makes it possible for her to receive quality day care from Monday to Friday, which in turn enables my father, sister and me to continue to work. 

Programs merely mitigate costs

None of these programs eliminates the cost of my mom’s care; they merely mitigate it. Her Medicare coverage would still have left us with a $1,600 ambulance bill; it was thankfully covered under her supplemental insurance, for which she pays an additional $1,224 a year.  The Alternative Care program, meanwhile, requires my parents to pay $700 toward daycare expenses a month.  

Even so, this mitigation of cost is critical for all of us; without it, we would have no tenable way to both look after my mother and earn enough on which to live. Remember too that I have no children, no house, no partner. I have minimal personal debt, beyond my school and car loans. My only serious commitment is to my parents. What, then, are we asking of those who have school-aged children and other commitments — professional or financial — that they must balance with their parents’ care? What of those whose states do not offer cost-sharing programs like Alternative Care?

Changes must be strategically crafted

Social Security, Medicare and Medicaid have practical and immediate value for families who are on the front lines of caregiving. Unless the changes to these programs are strategically crafted and thoughtfully implemented, America could end up turning a shared commitment into an individual and lonely burden, offloading our collective responsibility onto families already stretched for time, energy and resources. We risk asking them to choose between the financial well-being of elderly family members and their own futures. 

A piecemeal approach to reform will fritter away the potential benefits; without question, it will cost taxpayers every time we have to retroactively address policy consequences that, given proper scrutiny, might have come to light before legislation was passed. That may not matter to the House leadership in the middle of a political scramble for “higher ground.” But it will absolutely matter to the senior citizens whose benefits are affected and to the people who love them. 

This country pays a lot of lip service to the value of family ties and family responsibility. If we mean it, then we should treat any changes to the social safety net as an issue complex enough to merit real debate and important enough to demand it. All Minnesotans of every age should be reaching out to their elected officials and reminding them that in policy, as in life, haste makes waste.

Katherine Jumbe works as a volunteer manager and fundraiser at Carleton College and lives in her parents’ home in Bloomington.

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