Friday, December 10, 2010

How to Save Medicare – A Radical Plan

When seniors learned that Obamacare was to be funded by diverting billions of dollars from Medicare, they knew instinctively that either Obamacare would fail or that Medicare would be destroyed, and they revolted. Right now Congress is getting ready to restore some of the Medicare cuts, diverting funds from Obamacare, and Obamacare is going down the drain even sooner than predicted.

However, Obamacare is only one of the problems facing Medicare, a program that has been doomed from the start; whenever there is unlimited demand for something in short supply, i.e. medical services, costs (prices) go out of sight. Every year Social Security recipients pay more for Medicare, deductibles go up and up, while at the same time, more and more doctors refuse Medicare patients because they can’t afford to treat them.

I’ve been on Medicare for several years now, and I have witnessed what one of the underlying problems is, and it is related to the unlimited demand: when you have supplementary insurance, or you live in a state that outlaws balance-billing, there is usually no cost whatever for Medicare-funded services. Many seniors, therefore, then run to their doctor or to emergency rooms at the slightest sign of a sniffle or arthritic pain, and the system becomes further overwhelmed. Many seniors seem to make a career out of doctor visits and doctor shopping, some with only imaginary ills.

One way to reduce demand on Medicare-funded services is to require some kind of out-of-pocket, cash payment for the service provided. This can be a minimum co-payment, but it cannot be covered by supplementary insurance, or the discipline enforced by the co-payment is lost. In fact, what I am suggesting is that supplementary insurance policies for Medicare be made illegal, and all medical costs not covered by Medicare be billed to and paid-for by the beneficiary of the service.

This is drastic action I know, but drastic action must be taken to save Medicare and convert it to a program that is entirely supported by premiums and by cash payments. We already crossed a huge line when higher income recipients began to be charged higher Medicare premiums than lower income recipients – thus making Medicare a welfare program. Let’s make it self-supporting and also return it to a program where everyone pays the same premiums.

Our country is on its knees largely because of the existence and misuse of entitlement programs and the whole notion of ‘bringing home the bacon’. Social Security and Welfare also need drastic reforms. Lets us as seniors show the way by making some sacrifices for the common good and for our grandchildren.


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At 2:47 PM, Anonymous Anonymous said...

I agree that a deductible is a good idea- providing it is reasonable (like maybe $25.). I disagree that all supplemental plans be made illegal. Let's say a senior has to have open heart surgery. Let's assume that the total medical bill for that is $90,000. Medicare usually pays 80% That would leave a balance of $18,000. That's one hell of a bill for many seniors who did not have great income producing jobs when they worked. Leave the supplement plans in place.

At 3:45 PM, Blogger RussWilcox said...

Thanks for your comment. Good law is not made by extreme cases. Why should Medicare pay $90,000 for open heart surgery? The recipient should mortgage his home to pay the difference, not the rest of us; and you can't enforce a co-payment if there is supplementary insurance.

At 3:47 PM, Blogger RussWilcox said...

A further point is that we seniors need to take more responsibility for our problems, as our grandparents did.

At 9:18 AM, Anonymous Anonymous said...

I agree with this idea.

I heard about a "new" billing practice that I thought already existed...maybe it was new to just NY? Car accident "victims" (participants?) are being billed for their emergency services.....and being surprised at the bill. I think the "extra" users of ANY coverage should pay extra (extra above normal tax coverage, extra above normal medicare)


At 2:38 PM, Anonymous Anonymous said...

Open heart surgery is not an extreme case. It is rather very common. And you mentioned that someone should mortgage his/her home to pay the bill (assumming he has a home). That makes no sense. People have insurance to pay for incidents that may or may not occur, but if they do, the premiums that are paid in help offset the cost. With your logic, why have any insurance? House burns down, no insurance, well, just buy another house. Why have car insurance? You total your car, just go out and buy another one. Maybe if you are independently wealthy or have a great state/federal pension with full benefits. I'll keep my health insurance thank you, and the supplemental which I also pay for. What bothers me most are the irresponsible people who have no insurance and show up at the hospital expecting someone else to pay the tab.(nor have any other type of insurance, expecting others to pay for their accidents and liabilities).

At 6:10 AM, Blogger RussWilcox said...

Perhaps legislation could be crafted that would permit supplementary insurance that would only cover catastrophic health events, but the individual would still have to make cash payments for routine medical care.

At 9:37 AM, Anonymous Anonymous said...

I don't see the issue with the supplemental. If someone elects extra coverage...and PAYS for it, that's what it's for and should be ok. I do agree that there should be a copay cost to help limit abuse (but that cost can be defrayed by extra insurance)...there is still payment)
the issue is "run to their doctor or to emergency rooms at the slightest" this should be addressed with the mandated copay

the bigger issue for both SS and medicare is that we all need to work longer. You cannot have retirement at age 66 when average life is 80-85.



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