One tempting idea for saving money on Medicare, a program that vacuums up some 15 percent of federal spending, is to raise the age at which Americans become eligible for it. We ourselves have succumbed to this temptation, on more than one occasion.
Raising the eligibility age a couple of years, to 67, remains an attractive idea; it would save the program a lot of money. It’s just that there are a lot of other things Washington should try first.
“Should try”? C’mon….
But Bloomberg does, at least, identify the issue with that sort of “recommendation”:
The problem is that such a change would do little to control overall health-care costs, which should be the ultimate goal of all health-care reform. If 65- and 66-year-olds can no longer receive Medicare, they would have to find other health insurance. Some would remain on their employer plans. Some would fall back on Medicaid. Some would join the people shopping for insurance on the state exchanges, perhaps qualifying for federal subsidies.
In other words total spending on health care might actually go up instead of down! While the Federal Government would shed some of the budget impact it would simply be shifted.
This, at its core, is the flaw with all such “savings”; they aren’t savings. They are simply shoving the check onto someone else’s table and then playing “dine-and-dash” so that the recipient of the game has no alternative but to pay.
Bloomberg goes on to claim other attempted “savings”, but the end result doesn’t change. For example, they claim (and again use the usual fraudulent game of claiming 10 year “savings”) of $206 billion over four different policy changes.
But this is $20 billion, approximately, on an annual basis when we have a $1,200 billion annual deficit.
Worse, given the spend of $850 billion a year (all federal medical spending) in 2011 at the historical growth rate the Federal Government will spend $2,012 billion per year 10 years from now. Suddenly that so-called $20 billion “savings” annually is only 1% of the total, and is utterly meaningless when it comes to the budgetary impact and what must be done.
This is only a partial list of strategies, but it illustrates the range of ideas for saving Medicare money. To preserve the program for future generations — and to help the federal government get its budget in order — Medicare’s costs will have to be reduced. At some point it may even be necessary to increase the eligibility age to help Medicare remain solvent. But not yet.
Nice sentiment eh?
Now where are the real program suggestions to achieve the goal?
Missing, that’s where, because you can’t get there from here by attacking the program and its operation. The underlying problem is in the medical system and the monopoly protections it has in law as a whole, not medical “entitlement” spending.
This is very similar to the “gun control” debate arising from Sandy Hook; indeed, it is effectively identical in form and fashion. It’s a diversion and a scam to avoid discussion and debate of where the problem lies.
Post Sandy Hook the discussion has all been about “Guns.” The problem isn’t guns, exactly as the problem isn’t Medicare or Medicaid when it comes to “entitlement” spending.
The problem with “entitlement spending” is the medical system as a whole; it is the monopoly protections and cost-shifting that has led to the explosion in medical spending.
Here are several examples of what our current medical system produces:
- Juanita the illegal Mexican immigrant comes into the country 7 months pregnant with a history of alcohol and drug abuse. She has never seen a doctor during her pregnancy. She goes into labor 2 months premature and the baby requires both extreme levels of neonatal care and is permanently disabled. In the United States this incident will be charged to you; the NICU bill alone could be over $2 million, and the permanent support costs for this child (who we deem a citizen) could easily hit another $2 million. When you subsequently show up with an acute need to have your appendix removed the cost is $20,000 instead of $2,000, because the hospital must somehow cover the care it was forced to provide to Juanita and her newborn or it will go out of business. In every other nation if you tried this you’d be lucky to not be deported before you could actually give birth and in no case would you be able to foist this expense off on the taxpayers.
- Canada tells Pfizer that it will only pay $2 per tablet for Viagra. If Pfizer refuses to sell it for $2, then Canada will break Pfizer’s patents. Pfizer accedes to this demand. But in the United States Pfizer then amortizes the entire development cost of the drug on our backs, using the backing of the government to prohibit anyone from bringing the drug back into the US, even though it’s authentic and made in Pfizer plants, to protect the US price. The result is that we wind up paying for the development of every new drug and device treatment modality and the rest of the world consumes those modalities at reproduction cost. This can only happen with explicit government protection. The medical industry claims that if you didn’t have these protections their business would collapse. The truth is a bit more complex — if Pfizer had to go to Canada and tell them “yes, you could break our patents, but if you do we will not be able to develop these drugs, and thus there will nothing for you to steal” then the market would resolve the issue. Costs in other parts of the world would rise but they would plummet in the United States — perhaps as much as 80%!
- EMTALA (a Reagan-era law) says that if you are in acute medical distress the closest facility that can effectively treat you must do so, irrespective of your ability to pay or insurance status. This law effectively shut down charity care in the United States, with the exception of places like St. Jude’s which treat serious but not emergent conditions. The consequence of the “no turn away” policy ensconced in the law is that indigent people flood emergency rooms across the country, driving costs through the ceiling — and since they don’t have any money, can’t pay and can’t be turned away you get the bill.
There are literally dozens of additional examples, but this shows you where the problem lies. An uncomplicated birth, when the price from 1963 is taken and inflated by the CPI, should cost under $1,000 in cash in the hospital including a three-night stay. Today you’re lucky if you can buy one room-night without any treatment of any sort for that amount of money, and the actual cost of what is an utterly-routine medical procedure and event tends to run 10x as much.
The Oklahoma Surgical Center shows that common procedures can be performed for one-fifth of what is typically charged where “insurance” and these distortions are permitted to infest the system.
The fact of the matter is that if we dismantled these monopoly protections we would basically eliminate the need for virtually all medical “entitlement”!
If the cost of an uncomplicated birth was $1,000 instead of $10,000 nearly everyone could pay for it, especially when you consider that you have nine months to amass the money. That’s $100/month, more or less. If push came to shove, sell the X-box and the fancy rims on your car.
We refuse to deal with the real issue that is driving these costs and which will destroy the nation in this case, exactly as we refuse to deal with the underlying issue that is producing the rage-monsters that are shooting up schools and movie theaters.
To America and our lawmakers:
STOP CODDLING THE DAMNED MEDICAL INDUSTRY.
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