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Forced Into an Unhealthy Choice

The opinions expressed by columnists are their own and do not necessarily represent the views of

Can you imagine the government forcing you to take benefits you didn’t want? How about a situation where you’d have to sue the government to get out of taking those benefits?


Welcome to Washington -- and the upside-down logic behind federal entitlements.

Policymakers here are well aware that Medicare and Social Security are living on borrowed time. The Medicare Trustees reported earlier this year that the program’s Part A (the hospital insurance program) will start spending more than it takes in through taxes in 2011. The Part A trust fund will be totally exhausted eight years later. At that point the government will either have to slash benefits or jack up taxes, since it will run a deficit from that point on, forever.

You’d expect those who run entitlement programs to jump at any chance to trim expenses and save money. You’d be wrong.

Over the years, some have tried to withdraw from Medicare Part A and rely on their own health insurance. But federal policy says you can’t pull out of part A and still collect Social Security benefits. It’s a package deal. Washington thus compels citizens to take Medicare Part A, even if they wish to finance their own coverage.

This is a bipartisan political error.

In 1993, under President Clinton, the Social Security Administration changed its rules so it was no longer possible for a person to decline Medicare Part A without forfeiting Social Security retirement or survivor’s insurance (RSI) benefits as well.


In 2002, under the Bush administration, SSA reaffirmed its policy. Today, though, two separate attempts to change it are underway.

In one, three men are suing the Department of Health and Human Services, demanding they be allowed to opt out of Part A and still collect Social Security. “[The plaintiffs] all believe they can obtain better health care, and the health care they desire, privately and with less interference from third parties,” their lawyer Kent Brown announced at a press conference.

The men, Brian Hall, Lewis Randall and Norman Rogers, say that since Medicare is supposed to be voluntary, they ought to be allowed to decline it and pay for their own insurance. That makes sense.

Moreover, they note that, “If just 1 percent of current retirees chose not to participate in Medicare, Medicare expenditures would decrease by about $1.5 billion per year immediately and by approximately $3.4 billion per year by 2017.” Certainly a substantial savings for taxpayers.

At least one lawmaker also wants the SSA to change its rules.

This month Rep. Sam Johnson, R-Texas, introduced the Medicare Beneficiary Freedom to Choose Act. This measure would allow seniors to forgo Medicare Part A. It would also allow seniors to contribute pre-tax dollars into a Health Savings Account, so healthy older people could continue saving money they might eventually need to pay for future medical care.


“If Warren Buffett wants to pay for his own medical care, I say we should let him,” Johnson said, sensibly. And that, of course, is the greater problem with all federal entitlement programs -- they treat everyone exactly the same way, even those who can afford (and want) to go outside the taxpayer-supported system.

“It’s sad that people who want to make their own health care decisions feel like they have no other option than to sue the federal government,” Johnson says. “People should make their own medical decisions, the government shouldn’t force health care decisions on anyone.”  

Virtually everyone -- outside of Washington, that is -- would agree.

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