President Obama on Medicare and Turning 50

President Obama on Medicare and Turning 50

By Marilyn Milloy, AARP The Magazine

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Speaking of your daughters, do you hope their generation will experience aging differently than yours or your grandparents'?

It's already changed for my generation. When my grandparents were in their 50s, they were already "older." They drank, they smoked, they didn't exercise, they ate all kinds of stuff. And so they were already slowing down pretty good. Now I have friends who are 65 and 70 who are in better shape than my grandparents were when I was a kid. Americans want to be judged by their capacities, their interests, their curiosity, their imaginations, and not just by a number. I do want to make sure that when Malia and Sasha are entering their 50s, we still have the security of Social Security. Of Medicare. That we have maintained our commitment to people having basic security if things don't go well in their later years.

Yet in the debate over the deficit, people criticize "greedy geezers" for caring only about their entitlements. Is there any truth to that?

Well, seniors have paid into Social Security. They've paid into Medicare over a lifetime of hard work. And the notion that somehow they are asking for something that they don't deserve makes no sense to me. They're also under severe stress from the rise in things like gas prices, food prices, and home heating-oil prices. And if you're on a fixed income and the inflation rates on things like that are going up faster than your income, you have reason to worry. But I also think that older Americans don't want to leave huge debts to their kids and their grandkids in the form of massive deficits. That's why it's been important to reform the health care system, which is different from simply lopping off benefits under Medicare.

Can you slow the growth of Medicare costs without hurting access or quality?

What we did in the Affordable Care Act was to say there are ways we can get better bang for our health care dollars. The reforms ensured seniors can get preventive care, which could lead to less-expensive care down the road. Routine mammograms and colonoscopies are covered, there are 50 percent discounts on brand-name prescription drugs, and ultimately there's a close in the doughnut hole.

At the same time, we've said to hospitals and doctors: "Let's do things smart." Let's make sure we're not subsidizing the insurance industry for services that Medicare provides perfectly adequately. And that's in contrast to some proposals you've seen that say, "We're going to give you this set amount of money. You go into the open marketplace to try to buy health insurance," and lo and behold, you may not be able to buy it because the insurance companies are charging a lot more than what your voucher's worth. That's a way of shifting costs onto seniors. But we actually want to reduce costs.

What about Social Security?

I think we can make progress. We're ahead of the game in the sense that we're already having a vigorous debate now, and there's no danger of Social Security going bankrupt.

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What about Social Security?

I think we can make progress. We're ahead of the game in the sense that we're already having a vigorous debate now, and there's no danger of Social Security going bankrupt.

The issue is, can we make these tweaks to ensure that everybody who's expecting a dollar in Social Security payments gets a dollar instead of 75 cents? And the sooner we do it, the better off we're going to be. I think that if we can make some progress first on Medicare and Medicaid, because those are the entitlement programs that are really driving the long-term debt, we'll have a framework of negotiations to actually do something on Social Security as well.