Nov. 18, 2016 – President-elect Donald Trump made a number of promises to his voters. Here is today’s post about a promise that he has already broken. This is already becoming a regular series.

Pre-Election Trump: “We Can’t Do That”

Donald Trump campaigned on a promise not to cut Social Security or Medicare. Because who would campaign by saying they’re going to cut or change those incredibly popular and successful programs?

During the primaries Trump said, “Every Republican wants to do a big number on Social Security, they want to do it on Medicare, they want to do it on Medicaid. And we can’t do that. And it’s not fair to the people that have been paying in for years.”

Variations of his promise were repeated at rallies and in interviews throughout the campaign. The Heritage Foundation’s Daily Signal article, “WHY DONALD TRUMP WON’T TOUCH YOUR ENTITLEMENTS” begins”

“I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump told The Daily Signal. “Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.”

Trump made clear promise to voters.

But The Election Is Over

Now that the election is over, however, things are different. Trump is freed from having to say what voters want to hear. Republicans are talking about privatizing Medicare and replacing it with vouchers to use to purchase private insurance. (In other words, they want to turn it into a programs that works the same as the Obamacare they are vowing to eliminate.)

The Republican platform calls for a “premium support” for Medicare, also known as “vouchers.” Under this system the government’s role is eliminated and people get an “income-adjusted” voucher to use to buy private insurance. (“Privatization.”) “Income adjusted” means he guarantee of health care for all goes away. The voucher would not necessarily be enough to actually buy a private policy. (Ironically this is what Obamacare does, which Republicans are insisting on repealing, because this is what Obamacare does.)

This is not new, Republicans have overwhelmingly voted for this again and again, with Obama there to stop them. Now they are reviving the plan. It has been brought up repeatedly in recent days. For example, Talking Points Memo today has one more top Republican advocating it, in the report, Rep. Tom Price Reveals Republicans Eyeing Medicare Overhaul In 2017:

Rep. Tom Price (R-GA), the chairman of the budget committee, told reporters on Thursday that Republicans are eyeing major changes to Medicare in 2017.

Price, who is being floated as a possible Health and Human Services Secretary in the next administration, said that he expects Republican in the House to move on Medicare reforms “six to eight months” into the Trump administration.

Privatization of Medicare has been a central feature of Speaker of the House Paul Ryan’s budget proposal for years, and the House GOP has voted in favor of it multiple times. Ryan himself said last week that Medicare would be on the table in the new Congress, signaling it could be taken up early in the new year.

There is every sign that they are moving forward with this plan with Trump’s approval. For example, the Trump transition website’s healthcare page uses the propaganda language Republicans use to justify the Medicare phase-out, promising to, “Modernize Medicare, so that it will be ready for the challenges with the coming retirement of the Baby Boom generation – and beyond.”

Does Phasing Out Medicare Really “Save Money”?

Republicans claim Medicare is “too expensive.” They say privatization will “save money.”

When they say it “saves money” to privatize, the reason it “saves money” is the vouchers will not be enough to purchase an insurance policy that covers all the things that Medicare covers. It saves the government money by shifting the costs from the government to individuals.

The individuals also bear greater costs than the government would have paid out on their behalf for the same medical services, because they are on their own and lose the government’s bargaining power and economy of scale. So for the economy as a whole (government costs plus individual costs) it increases costs rather than saving costs because the same people are now each costing (and spending) more than they did under a government Medicare plan.

For those individuals who just can’t afford these increased costs, there is the social cost of the consequences – increased suffering and death – to millions of individuals in the same situation.

Never mind the incredible complexity of researching choosing the best private insurance plan and filtering out the scams and phony promises. Never mind the difficulty regular elderly people, not to mention those with severe medical problems, will have.

The other side of that equation though is that those on the receiving end of those payments GET the benefit of that shift and increase. And the reason they want to “save money” for the government (but not the people) is so taxes on the wealthy can be reduced. In other words, while it shifts costs onto the backs of the citizens, it also shifts those costs into tax savings and profits for a few at the top.

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