Of course, that doesn’t mean Medicare doesn’t need to be reformed. I am not at all unsympathetic to the concerns of deficit hawks in both political parties. As someone who worked for President Clinton and Vice President Gore on a project to shrink the government, I understand the importance of fiscal discipline. But cutting Medicare is a lot tougher than cutting midnight basketball programs from the juvenile delinquency section of the Justice Department.
So what is to be done? James Pinkerton, a veteran of Ronald Reagan and George H.W. Bush’s administrations, has been thinking outside the box on health care for a few years now. His idea is to switch the paradigm: have the government focus on curing the diseases that cost so much to treat. Take Alzheimer’s, for example. “[I]f AD is handled the way we handle many other diseases—with an emphasis on paying for it, as opposed to curing it—then we face fiscal calamity, as well as medical calamity,” writes Pinkerton. His argument is compelling: imagine if, 70 years ago, the government had been obsessed with funding iron lungs for all the children expected to get polio, instead of funding the research on vaccinations that led Dr. Jonas Salk to find the cure.
Voters will support federal dollars to cure the diseases that cost us so much. What they will not support, after all this time, is a fundamental change to Medicare.