Dear Robert:

I read a Washington Post column of yours just after Christmas—the one about the fairness dilemma and how Baby Boomers need to take a hit on Social Security and Medicare. You’ve been making these points for some time now, which you do tell your readers. And that’s great. Repeating your position is fine. I probably repeat mine, too. What is not fine is skimping on the facts when making your arguments, no matter which side they support. So in the spirit of journalistic excellence and helping the public as much as possible, I would like to call out a couple of points on Medicare to keep in mind next time you tackle this subject.

You argue that “neither political party seems interested in reducing benefits for baby boomers,” because that would be unfair to people who had planned retirements based on existing programs. “Not making cuts would also be unfair to younger generations and the nation’s future,” you state, and the “solutions are clear.” They include raising eligibility for Social Security benefits, cutting benefits for wealthier retirees, and making people who turn sixty-five pay some or all of their health insurance costs until they become eligible for full benefits. I assume you mean someone getting full benefits at age sixty-six or sixty-seven or sixty-nine won’t get Medicare right away. All that, of course, is your opinion, which a column is supposed to offer.

Here’s the part that needs more work. You say:

Better-off recipients could pay higher premiums. These and other changes should start soon—in a few years once the recovery strengthens.

And then you note that Medicare premiums for wealthier people have increased modestly, affecting about five percent of beneficiaries, “but politicians fear making major changes” because they’re scared of the AARP and millions of retirees and near-retirees.

Mr. Samuelson. Politicians have already made changes, which you did not mention. You do link to an issue brief from the Kaiser Family Foundation noting that wealthier folks—those with incomes over $85,000 for a single person and $170,000 for couples—already pay higher premiums for Part B services, and they have paid them since 2007. This year, wealthier beneficiaries will also pay an income-related premium for their Part D, or drug benefits. Same income thresholds apply.

The income thresholds for Part B were indexed, which meant that fewer people would pay the higher amounts over time. The health care reform law ended all that. This little-known aspect of the law froze those income thresholds, so that each year more and more “wealthier” people will be subject to the higher premiums. Kaiser experts estimate that by 2019 one fifth of Medicare beneficiaries who enroll in Part B for the first time will pay higher premiums. That year eleven percent will pay higher Part D premiums. The percentage is lower because more higher-income people are likely to get their drug coverage from retiree plans provided by their employers.

The Kaiser brief is a bit too wonky for some people so the public could have been helped by clear explanations on your part. People are hungry for any help they can get these days. It would be a shame if a high profile WaPo columnist couldn’t help them out.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.