Blood pressure measuring. Doctor and patient.  Health care.

Jan will be a strong advocate for protecting and enhancing Medicare for present and future seniors. By contrast, Republicans, led by Speaker of the House Paul Ryan, have sought to privatize Medicare by converting it to a “premium support” or “voucher” system. Representative Vern Buchanan has repeatedly voted for Ryan budgets that would end Medicare as we know it.

More specifically, privatizing Medicare would effectively deny healthcare to millions of seniors in the United States. Support payments/vouchers are expected to cover only about 40 percent of insurance premiums and additional healthcare costs. Privatization could thrust this country back to the situation before enactment of Medicare in 1965, when half of seniors had no health insurance and almost all lacked access to tax-subsided policies from employers. Moreover, as already indicated, most retirees fail to amass adequate resources to finance basic necessities, let alone to defray escalating healthcare costs.

That said, even though recent measures such as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have had some beneficial effects, and even with wealthier Americans already paying substantial surcharges for their Part B and Part D Coverage, Medicare is ailing. The system faces grave financial problems, due both to the hordes of Americans reaching senior status while the workforce is shrinking and to the burgeoning and excessive healthcare expenses in the United States. The former is inexorable; but the fact that this country spends more on our healthcare system by any measure than all other industrialized countries, with no better or worse outcomes, need not be.

Medicare may itself offer a path to a solution. Allowing all Americans to buy into the system at relative actuarial costs – if need be through the Obamacare Health Insurance Exchanges — may offer the best means for stabilizing Medicare, reigning in future healthcare expenses and protecting the health of Baby Boomers and their successors. The Patient Protection and Affordable Care Act of 2010 is unwieldy, excessively expensive and in need of reform, and some of us continue to believe that a single-payer national insurance system would be preferable, more effective and less costly. Nevertheless, there has been an estimated reduction of 20 million adults without health insurance since passage of the ACA, a major achievement of historic proportions.

Meanwhile, the United States remains the only wealthy, industrialized country without a comprehensive national health insurance or healthcare system. Government control of healthcare delivery mechanisms, national healthcare or socialized medicine in traditional terms, appears contrary to the political and economic culture in this country, as well as repugnant to the medical community and large portions of the citizenry. Jan opposes such proposals. On the other hand, expanding Medicare (or a scaled-down Medicare), a social insurance program, progressively to cover younger age groups on a voluntary basis seems the least disruptive and most promising path to achieving universal health insurance, reductions in the costs of American healthcare and a healthier population. Jan favors pilot programs to this end. In any event, it should go without saying that any and all remedial measures must include continuing and expanding efforts to cut down the fraud, waste and abuse that plague the system at healthcare provider levels.