How the Medicare Debate Will End

All the recent debate about the future of Medicare is missing a fundamental truth: the odds of any major changes to Medicare are next to zero, no matter who wins this November. Oh, maybe there will be a little tweaking—some cost-cutting here and there, some minor reforms. But mark my words: nothing much is going to change. Every 10 years or so, politicians attempt to mess with Medicare—and the public responds with a swift and clear “no.” Back in 1988, a Democratic Congress passed (by big margins) and a Republican president signed the Medicare Catastrophic Coverage Act, which called for substantial changes to Medicare. Sixteen months later, after a full-fledged revolt by seniors, the bill was repealed in the House by a vote of 360–66 and in the Senate by a vote of 99–0. It was the first time a major entitlement reform had been scrapped since President Roosevelt invented entitlement programs.