Tuesday, January 8, 2013

MEDICARE FINANCES

The problems with the future financing of Medicare are well advertised and have been known for decades.  I do not support the proposal to do away with Medicare entirely and replace it with a "voucher" system.  Instead we must reduce the costs of Medicare.  One component of the $716 billion in expenses "removed" by Obama from Medicare, the so-called "Doc Fix," of reducing the payments to physicians was always unlikely and is now gone.  Hospitals, however, had agreed to cutting their costs because of increased patient "flow" from Obamacare.  There has been resistance to other cuts which were called by insulting names like "death panels" and "rationing."*  About the only cut in Medicare services proposed likely to pass is raising the age of eligibility from 65 to 67, but this could be self defeating by leaving a large group of people without health care and pushing them into emergency rooms, the highest medical cost option.  At times there is mention of tort reform to cut the costs of "defensive medicine," but this proposal never seems to gain traction.  I would hope this would get done.

More than a decade ago, a writer's group of which I was a member was nearly entirely composed of seniors.  Once we had a discussion concerning what cuts in Medicare did we think we could live with.  The unanimous choice was "rationing" of major operations, say a limit of one each of heart, liver, lung or kidney transplants and two hip or knee replacements per patient.  So far as I know, no politician has proposed such a limit.  Yes, this is rationing, but Medicare is full of rationing already as I have discussed before.**  More recently, I recently got a shot for shingles.  These are not covered by Medicare and cost me $225, but I know of five people who have had shingles, including my wife, and it is serious business.  One friend lost an eye to it, and another was on heavy doses of pain killers for a year.  I think that ultimately more rationing is inevitable.

I don't know how we get to this point, but "fixing" Medicare is going to require a stop to trying to gain political points through unpleasant names and false accusations*** and both political parties are going to have to jump off the "cliff" together.****

* http://stopcontinentaldrift.blogspot.com/2012/12/death-panels-715-billion-from-medicare.html
** http://stopcontinentaldrift.blogspot.com/2011/05/medicare-rationing.html
***  http://stopcontinentaldrift.blogspot.com/2012/10/dr.html, http://stopcontinentaldrift.blogspot.com/2012/10/the-obamacare-committee.html
**** http://stopcontinentaldrift.blogspot.com/2011/02/after-you-alphonse.html

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