The large majority of American voters paid scant attention when Republican House Representative Paul Ryan (of Wisconsin), in his strategy to reduce the national financial deficit, tabled a proposal in the House to reform Medicare and Medicaid.

 Relatively little attention was paid when the Republican-majority House, passed the “Ryan Plan” earlier this year. However, Ryan’s plan – to transform Medicare from a policy in which the federal government guarantees medical care for seniors over 65, into a virtual voucher system where the government provide limited funding for seniors to buy suitable and affordable medical care – has been growing increasingly unpopular as it becomes the latest political game-ball tossed around between Democrats and Republicans.

 When the Republicans lost a traditionally safe New York congressional seat last week, the resounding noise of that defeat in a campaign where Medicare reform was foremost, escalated the nation’s interest significantly. The loss by the Republican candidate in NY was followed by a defeat of the reform proposal in the U.S. Senate, with five Republicans joining Democrats in the nay vote. Now, Medicare (and Medicaid) reform looms as a major political issue going into the 2012 general election cycle.

 There is no question -- politics aside -- that there is great need to reform Medicare to ensure that it delivers the best economies to the nation’s budget.

 Medicare and Medicaid were introduced as social services to Americans in 1965 by President Lynden Johnson. On signing the Medicare legislation Johnson said, “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years.”

 Like other presidents who have introduced social services to help the needy, Johnson was called a Socialist. He was accused of giving Americans a social entitlement, something not included in Republicans plans for Americans. Of course, while Medicaid is a social entitlement – a policy provided by the government and funded by taxpayers to provide medical care to the poor – Medicare is not an entitlement. Most Medicare beneficiaries paid through payroll deductions into a Medicare Fund from which benefits are financed.  Moreover, Medicare beneficiaries pay monthly premiums for their eligible benefits.  So, although the government subsidizes the cost of the healthcare that seniors receive, it is not an entitlement in the real sense of that word.  

 The real reason for the escalating cost of Medicare, which is becoming a major financial burden to government, is that the cost of healthcare is escalating beyond national inflationary rates. What is really needed is for both parties in Congress to develop a formidable policy to control the cost of private and public healthcare.

 In addition to the high cost of medical care, it is no secret that doctors participating in the Medicare program prescribe tests and procedures for seniors that are sometimes unnecessary. Often, a battery of tests are conducted to determine if a minor symptom isn’t a catastrophic ailment, when less expensive measures could have determined the same results. There is definitely need for control at this end.

 Last year’s Patient Protection and Affordable Care Act (a.k.a. Obamacare), contained a number of provisions that attempt to slow the growth of overall medical costs. This must be expanded on so that all Americans can afford healthcare.

 Although the Ryan plan is promoted as a way to reduce the national deficit it is curious that it also seeks to give more power to private insurers – something that the recent healthcare law tried to curb.

 Under Ryan’s plan Medicare beneficiaries would no longer have access to a guaranteed set of health benefits, but would instead receive a voucher to be used to purchase private health insurance. This means the type of healthcare a senior can get will be limited to the coverage he can afford from private insurance companies. This is unacceptable.

 Sensing the political fallout, the Ryan Plan is proposed to become effective in 2021 and is not applicable to Americans currently over 55. But, were it to be approved, millions of Americans who become eligible in 2021 would be negatively impacted.

 There is no doubt that Medicare needs to be reformed, but certainly not by eliminating the guarantee of health benefits to seniors. Consideration should be given to: placing Medicare premiums on a sliding-scale basis, where the rich pay higher premiums than the poor; increasing Medicare deductions paid by workers in higher income brackets; closely monitoring prescribed treatments to control costs; spreading benefits more evenly to include better optical and dental benefits; greater monitoring to ensure physicians and medical institutions do not continue to rip-off the system.

 Developing these reforms seems quite plausible. It makes no sense making Medicare reform a political issue that remains unresolved after 2012. If it’s to be a political issue going into the next general elections, then each party must submit comprehensive alternative reforms so voters can determine which party has the better reform. But, ultimately, Medicare reform is bigger than politics.