First off: While I believe that the Ryan proposal is dead on arrival, we did get several days of Very Serious People talking about Ryan's Very Serious Proposal. (Why is it that when you keep capitalizing everything like that when talking about the pundits you wind up with something that looks like Batman: Arkham Asylum: A Serious House on Serious Earth? There's probably some sort of comparison there, preferably without all the overdone artwork. But I digress.)
Anyway, as we all know by now, what's probably the centerpiece of the Ryan proposal is to eliminate Medicare for everyone under 55 and replace it with a voucher program. It's a lousy idea for all the reasons that have been detailed by others last week. But if it were to pass, why should someone like me be willing to pay 1.45% of each paycheck?
A brief review: Medicare, like Social Security, is Pay-As-You-Go. There is no magical box of money with your name on it. Everything paid goes straight to covering those on Medicare. The only way you get benefits (and I realize this is oversimplifying) is to pay while working and then have your children and grandchildren pay for you as you paid for your parents and grandparents. So it's a form of social insurance, and hey, I like social insurance. Does the system need some fixing? Sure. But I don't want to get rid of it.
Here's the thing: If you get rid of my end of the social contract, where is my motivation to keep paying in? If nothing else, right now I could justify supporting Medicare (and Social Security) through pure self-interest. I pay a small amount now so that I don't have to worry about coverage in the future. In addition, my small contribution, pooled with your small contribution, means that neither of us needs to worry as much about supporting our elderly parents or grandparents when they get sick or injured. We may argue about how much should be spent on end of life care. On what can be done and what should be done. Those are discussions that don't have to pertain to the basic idea of "pay in now, be covered later." And hey, at least we're not individually on the hook for thousands of dollars in medical bills.
But let's say a voucher plan passes. I no longer get the coverage my parents and grandparents did; instead, I get a coupon. This coupon will not cover what they got without higher out-of-pocket expenses for me. I've now spent 35 to 40 years paying more (I'll have to increase my overall savings and I'd expect to pay more in taxes) for less. Less than my parents got, less than my grandparents got. And once my own selfish concerns (parents dead, grandparents dead, in-laws dead) are no longer there, why should I be willing to keep paying for your parents and grandparents under the old system?
Once again, it seems like an easy setup for class warfare and generational warfare. As easy as it is to laugh at or be angry with the Teabagger Walker Brigade with their "Keep Government Out Of My Medicare" signs, as tempting as it is at times to give them their wish (with their cognitive dissonance ably covered by Matt Taibbi), I can't do it. I just can't find the selfishness needed. But it can be so tempting.