FINANCING MEDICARE B: A COMMENT

In 2010 there were 47.5 million people on Medicare (http://www.census.gov/compendia/statab/2012/tables/12s0146.pdf)  Looking at the table, it looks like the number of people on Medicare is growing about 0.1 million/year so in 2013, the number should be close to 47.8 million.  Each of these people pay a deductible of $300 on the first $300 of expenses.  Suppose the deductible is raised by $10 to $310, then $480 million in additional revenues would be raised.  If the deductible is raised by $20 to $320, nearly a billion dollars would be raised.  This should help Medicare expenses considerably and not be too arduous on even those poor who can raise the $300.  Though this option has been discussed elsewhere, it does not receive any press.  I think it is preferable to raising the age of qualification, for example.

As distasteful as it is to our politicians, there should be tort reform too at the very least.

The reduction in reimbursements to doctors, has now been rejected by law and the so-called annual "doctors fix" has been made permanent.

Hospitals have agreed to a lowing of their rates because they expect increased activity from the increased personal coverage of Obamacare.

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