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A modest proposal for Medicare

By Steven Wall • Guest Columnist | With so much division in our country, and some  folks even losing faith in democratic government, I would like to offer a proposal concerning Medicare. I do this in the hope that such a proposal if implemented could help restore some  faith in  government. 

I am calling upon the Biden Administration to lower the Medicare age of eligibility to 55.

Most of us either rely on Medicare for our own health care, having reached 65, or have a dear relation or friend who does.  After our armed forces, Medicare may be the most popular part of the U.S. federal government. Since its adoption in 1966 it has kept millions of our senior citizens healthy and out of poverty once they qualify at age 65.

But by age 55, many people have been working for 30 years or more. Many are tired, and are beginning to suffer from various chronic illnesses. Unfortunately many are under-insured, uninsured or paying very high premiums. Some are small business owners who have tried to keep their employees insured (I was one of these employers).

We all know of folks “hanging on” until they reach 65, foregoing medical care, afraid to change jobs or start a business. Lowering the Medicare eligibility age would be a triumph of decent and potentially bipartisan politics. It could renew faith in the system for many who feel angry, left out of the American Dream, unappreciated and even betrayed. 

How could this be paid for? By raising the $133,000 ceiling of the Medicare payroll tax, as has been proposed for years now. Today, someone earning $500,000 a year pays the same total amount of Medicare tax as someone earning $133,000. By raising the ceiling — to $250,000 or whatever actuarial figure is appropriate — the increases in Medicare expenses  will be paid for. When upper income people complain about their higher taxes, they should be reminded that they too would be eligible for Medicare at age 55 and be freed from their insurance premiums. Private supplements should of course remain available for those who wish to add them to their Medicare insurance.

Businesses will also pay more as they match the Medicare contribution of their employees — recently 1.45 percent of payroll.   This will be greatly eased by being released from paying premiums for middle-aged workers who often have the most expensive medical bills. 

The anger and division in our country can perhaps be partly explained by the burden of health care insecurity and the enormous related economic challenges encountered by many families. Bankruptcies, for example, are a well-known and unacceptable feature of our nation’s failure to address these issues effectively. The 55-65 years of age cohort is certainly affected by this. 

If you find this proposal of interest, contact congressmen Madison Cawthorn, Patrick McHenry and others. They need to hear from you!

(Stephen Wall, MD, FAAP, is a retired pediatrician who lives in Waynesville.) 

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