Part of me— the reptile-brain part— rejoices over the tangle Republicans are in with Medicare. They, after all, relentlessly attacked what they call “Obamacare” with lies and distortions by stating total falsehoods as fact (such as death panels and throwing grandma out of Medicare).

But my better part— my granddaddy heart— deplores this “lowest common denominator” style of politics. It has as its end goal getting the upper hand in public opinion rather than finding the best path to a healthier and economically sound America.

The current debate over Medicare is a prime example. The “voucher-care” plan authored by Representative Paul Ryan and supported by a united Republican party in the House and the Senate is deplorable. Substituting vouchers for traditional Medicare will subject my children and their children to the mercy of the private health insurance corporations.

The Republicans insidiously tried to buy off the current and soon-to-be Medicare recipients —people like me who are high-efficacy voters— by keeping us in the present system. But they underestimated our commitment to ensuring that our children receive the affordable and quality care we now enjoy.

The Congressional Budget Office (CBO) data on the Ryan plan determined that future generations of seniors would pay an additional $6,000 in 2022, and that would rise to $11,000 in 2030… just five years before my eldest daughter becomes eligible. Consider those increases in recipient cost of care along with the fact that in 2010 half of all Medicare beneficiaries had incomes of less than $21,000, and less than $2,000 in savings. They clearly could not afford health care under the Ryan plan. Perhaps the problem is that members of Congress simply can’t conceive of retirees living on that sort of margin. People like that do not exist in the rarefied air of their environment.

Republicans made another mistake in projecting their Ayn Rand mindset of selfishness onto all of us, and they deceptively cloaked the proposal in deficit-reduction rhetoric. Ryan’s Medicare proposal has little to do with the deficit; rather, it is aimed at dismantling a program that Republicans have been against since it was first proposed in 1965.

A review of legislative history shows that a majority of GOP Senators voted against the original Medicare bill, dismissing it as a step into socialism.  Nebraska Senator Carl Curtis led their opposition by saying the program “is not needed. It is socialism. It moves the country in a direction which is not good for anyone, whether they be young or old. It charts a course from which there will be no turning back. It is not only socialism… it is brazen socialism.”

Republican Presidents Ronald Reagan and George H.W. Bush, along with their cohorts in the House and Senate, tried repeatedly to cut the program. During his 1996 Presidential campaign, Senator Bob Dole bragged   “I was there fighting the fight, voting against Medicare because we knew it wouldn’t work.”

Dick Army, the Republican House Majority Leader, said in 1995 “We need to wean our old people away from Medicare”, and House Speaker Newt Gingrich said in a speech to a Blue Cross/Blue Shield conference that “We don’t get rid of Medicare in round one because we don’t think it is politically smart… but we believe it is going to wither on the vine because people are going to voluntarily leave it.”

However, despite their disingenuousness, I give Republicans kudos for having the courage to put their “each person for him/herself” social philosophy into legislative language. I also recognize that they are right when they say that something must be done to ensure the solvency of Medicare.

There is no question that the program cannot sustain the steady growth in members while at the same time absorbing the cost of health care inflation. The CBO projection is that Medicare spending, if left unabated, will nearly double in the next decade.

The Medicare Trustees predicted on May 13 that if nothing is done the Part A (hospital care) Trust Fund would run out of money in 2024, owing to the recession-caused decrease in payroll tax revenue, increased enrollment and cost inflation.  The Trustees also stated that provisions enacted under what Republicans call “Obamacare” strengthen the fund.

As much as I am opposed to the Ryan plan, the Congressional Democrats are to be shamed for not offering solutions of their own. Rather, they have done nothing but posture politically— full of sound and furry, but without substance.

They, in my opinion, have correctly affirmed the nation’s commitment to providing health care to America’s retirees, and have made it clear that they will not be bullied into abandoning it. But the commitment is hollow unless they enact changes that will keep the program solvent.

There are not any painless ways to do this, but there are ways:  increase premiums on Part B (doctors’ services, outpatient care, home health services, and other medical services) from covering 25% of expenditures to the original figure of 50%; increase co-payments and deductibles for wealthy beneficiaries; add an income-related surcharge; fully implement the changes enacted in the Affordable Care Act (Obamacare); focus on controlling costs and limiting expensive procedures that have questionable benefits; eliminate the $106,000  ceiling of wages that are taxed to fund Social Security and Medicare under the Federal Insurance Contribution Act (FICA)  and tax all wages; increase the employee and employers FICA tax to 7% of gross wages.

I reject the popular proposal of raising the age for receiving benefits for Medicare and Social Security because many retired people have worked for decades in body-taxing physical labor. Many of them are not able to continue beyond 65 (if they make it that far). On the other hand, public policy is set by people who sit behind desks and get their exercise in the Congressional gym. They do not have the slightest idea of the challenges faced by a 65-year old who labored for 45 years in coalmines, agriculture or construction.

This issue is one of life and death for millions of Americans who deserve more than the reptilian thinking of Republicans and the posturing of Democrats. They deserve the dignity of affordable access to quality healthcare. This is as much a moral issue as it is a financial one, and the approach we choose will go a long way in defining the kind of people we are.