Unplugging the Third Rail: Choices for Affordable Medicare

[KenH]

“This paper looks only at the question of affordability. It identifies the minimum changes required to prevent further expansion of Medicare’s share of GDP, while retaining the existing structure of the program.

Three modifications can be phased in to meet that objective. About 41 percent of the required savings can be achieved by slowly raising the program’s eligibility age and by restoring the original criteria for disability benefits. The eligibility age could first be harmonized with the rising age for full retirement benefits from Social Security and then continue to increase consistent with rising life expectancy.

The remaining savings would require more cost sharing by beneficiaries. The first steps would be to increase deductibles and coinsurance to values that are typical for commercial insurance among the working population. Further increases would be required after another 30 to 50 years. These changes may seem large, but changes such as these are necessary to undo the substantial problem that history has given us. The good news is that if we begin soon, the changes can be made gradually, and current beneficiaries would face no benefit reductions.”

Unplugging the Third Rail: Choices for Affordable Medicare

 

[FollowTheWay]

“This paper looks only at the question of affordability. It identifies the minimum changes required to prevent further expansion of Medicare’s share of GDP, while retaining the existing structure of the program.

Three modifications can be phased in to meet that objective. About 41 percent of the required savings can be achieved by slowly raising the program’s eligibility age and by restoring the original criteria for disability benefits. The eligibility age could first be harmonized with the rising age for full retirement benefits from Social Security and then continue to increase consistent with rising life expectancy.

The remaining savings would require more cost sharing by beneficiaries. The first steps would be to increase deductibles and coinsurance to values that are typical for commercial insurance among the working population. Further increases would be required after another 30 to 50 years. These changes may seem large, but changes such as these are necessary to undo the substantial problem that history has given us. The good news is that if we begin soon, the changes can be made gradually, and current beneficiaries would face no benefit reductions.”

Unplugging the Third Rail: Choices for Affordable Medicare

Our healthcare system is extremely inefficient. It's the most expensive in the world but about number 15 in terms of meeting the needs of our citizens. One thing we need to do is push further use of technology in the medical field. Another thing is to do away with for-profit hospitals. Insurance companies also contribute to higher costs. We need to stress preventative care and extend the number and responsibility of Physician's Assistants and nurses.

 

[Revmitchell]

Keep for profit hospitals and keep them competitive. Make medical services and drug prices available up front so patience can shop around. Stop creating a victim status that leads people to believe they cant get ahead in this country as a result they don't try they just whine and demand free stuff.

 

[just-want-peace]

1 Rein in the malpractice profession!
2 Return insurance (or at least give person the option) to covering catastrophic illnesses as opposed to every Dr visit!
These are just 2 changes that popped up on the spot. I'm sure others can add many more that would help.

 

[FollowTheWay]

1 Rein in the malpractice profession!
2 Return insurance (or at least give person the option) to covering catastrophic illnesses as opposed to every Dr visit!
These are just 2 changes that popped up on the spot. I'm sure others can add many more that would help.

I agree with tort reform. But your second point is unacceptable. You realize we're talking about Medicare, right? Almost everyone who retires these days gets that for retirement medical even people like me who worked 38 years for one company. Do you want only catastrophic insurance in retirement?

 

[Revmitchell]

Unfortunately obamacare was nothing more than catastrophic coverage. When you insurance is 12000 dollars a year and your co-pay if you will is that or more then catastrophic coverage is what you have. This is what you have when you force the middle class to pay for coverage for things they need no coverage for. That does not benefit the poor or the middle class. It hurts them. I never could afford obamacare and I never signed up for coverage.

 

[FollowTheWay]

Unfortunately obamacare was nothing more than catastrophic coverage. When you insurance is 12000 dollars a year and your co-pay if you will is that or more then catastrophic coverage is what you have. This is what you have when you force the middle class to pay for coverage for things they need no coverage for. That does not benefit the poor or the middle class. It hurts them. I never could afford obamacare and I never signed up for coverage.

But we are talking about Medicare. right? Obamacare was undermined by Republican state legislatures and governors who did everything they could to destroy it. You can see that by comparing the costs and deductibles for red states versus blue states. Insurance in New York is cheaper than it is in Mississippi. That in no way reflects the real costs.

 

[Revmitchell]

But we are talking about Medicare. right? Obamacare was undermined by Republican state legislatures and governors who did everything they could to destroy it. You can see that by comparing the costs and deductibles for red states versus blue states. Insurance in New York is cheaper than it is in Mississippi. That in no way reflects the real costs.

Uh no it wasn't it just wasn't doable. Blue states were trying to spend money they did not have but wanted to raise taxes even more. Red states are not going to raise taxes to make a bad law work. That in fact does reflect the real costs.

 

[Reynolds]

Our healthcare system is extremely inefficient. It's the most expensive in the world but about number 15 in terms of meeting the needs of our citizens. One thing we need to do is push further use of technology in the medical field. Another thing is to do away with for-profit hospitals. Insurance companies also contribute to higher costs. We need to stress preventative care and extend the number and responsibility of Physician's Assistants and nurses.

The government either has to completely take over healthcare or completely get out of it. The way it is now is a pure mess.

 

[Reynolds]

But we are talking about Medicare. right? Obamacare was undermined by Republican state legislatures and governors who did everything they could to destroy it. You can see that by comparing the costs and deductibles for red states versus blue states. Insurance in New York is cheaper than it is in Mississippi. That in no way reflects the real costs.

It never would have worked regardless.

 

[MartyF]

The government either has to completely take over healthcare or completely get out of it. The way it is now is a pure mess.

I suggest we start with the military. The medical and Nurse costs too much money, have the soldiers pay for their own medical care. Get rid the veterans' administration. It's never worked and its a waste of money. Just tell veterans/soldiers to invest in medical savings plans.

 

[FollowTheWay]

Uh no it wasn't it just wasn't doable. Blue states were trying to spend money they did not have but wanted to raise taxes even more. Red states are not going to raise taxes to make a bad law work. That in fact does reflect the real costs.

If Obamacare had been done in a bipartisan way it would have saved money. Things like allowing Insurance companies to sell across state lines and tort reform, which Republicans wanted, could easily have been included. BTW, the Heritage Society originally suggested something very much like Obamacare in the 1990's as a market based solution as opposed to single payer which is a govt. solution.

 

[Revmitchell]

If Obamacare had been done in a bipartisan way it would have saved money. Things like allowing Insurance companies to sell across state lines and tort reform, which Republicans wanted, could easily have been included. BTW, the Heritage Society originally suggested something very much like Obamacare in the 1990's as a market based solution as opposed to single payer which is a govt. solution.

I disagree, the primary thing that would make obamacare work is the mandate. Never going to get conservatives to except that. The other failure in obamacare is making everyone pay for coverage they did not need. Never going to get conservatives to except that. Those two things were the primary reasons it would never be bipartisan.

Furthermore, so much of it was hidden until it was passed in congress in a partisan way.

"We have to pass the bill so we can find out what's in the bill" Nancey Pelosi. The failure is all Democrats.

 

[FollowTheWay]

I disagree, the primary thing that would make obamacare work is the mandate. Never going to get conservatives to except that. The other failure in obamacare is making everyone pay for coverage they did not need. Never going to get conservatives to except that. Those two things were the primary reasons it would never be bipartisan.

Furthermore, so much of it was hidden until it was passed in congress in a partisan way.

"We have to pass the bill so we can find out what's in the bill" Nancey Pelosi. The failure is all Democrats.

chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/https://thf_media.s3.amazonaws.com/1989/pdf/hl218.pdf

Here is the Heritage Foundation's solution:

A CONSUMER-BASED SYSTEM

All of these measures, from the basic tax treatment of health care to the encouragement of long-term care insurance, would introduce a far greater degree of consumer activism into the health care market. This strategy, combined with a requirement for basic health coverage and the focusing of government assistance to those who need it most, would change the foundations of health care in America. Rather than the current system with its built-in inflation and enormous gaps in coverage, the result would be a system providing not only coverage to all but also a powerful set of incentives for the health care industry to be as efficient and consumer sensitive as possible.

 

[Revmitchell]

chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/https://thf_media.s3.amazonaws.com/1989/pdf/hl218.pdf

Here is the Heritage Foundation's solution:

A CONSUMER-BASED SYSTEM

All of these measures, from the basic tax treatment of health care to the encouragement of long-term care insurance, would introduce a far greater degree of consumer activism into the health care market. This strategy, combined with a requirement for basic health coverage and the focusing of government assistance to those who need it most, would change the foundations of health care in America. Rather than the current system with its built-in inflation and enormous gaps in coverage, the result would be a system providing not only coverage to all but also a powerful set of incentives for the health care industry to be as efficient and consumer sensitive as possible.

The Heritage runs left on a lot of things I quite reading them a long time ago. They are not representative of the conservative community at large.

 

[church mouse guy]

“This paper looks only at the question of affordability. It identifies the minimum changes required to prevent further expansion of Medicare’s share of GDP, while retaining the existing structure of the program.

Three modifications can be phased in to meet that objective. About 41 percent of the required savings can be achieved by slowly raising the program’s eligibility age and by restoring the original criteria for disability benefits. The eligibility age could first be harmonized with the rising age for full retirement benefits from Social Security and then continue to increase consistent with rising life expectancy.

The remaining savings would require more cost sharing by beneficiaries. The first steps would be to increase deductibles and coinsurance to values that are typical for commercial insurance among the working population. Further increases would be required after another 30 to 50 years. These changes may seem large, but changes such as these are necessary to undo the substantial problem that history has given us. The good news is that if we begin soon, the changes can be made gradually, and current beneficiaries would face no benefit reductions.”

Unplugging the Third Rail: Choices for Affordable Medicare

The idea of charging normal deductions for Medicare is sadistic. The overwhelming majority on Medicare are on Social Security and little or nothing else. There are no pensions anymore for most people. We just had 8 bad economic years with Obama and it is very possible a socialist could win in 2020 with the help of the FBI.

 

[FriendofSpurgeon]

I don't see any of the three going anywhere.

One of the biggest savings - to both the federal government and to consumers - is the expansion of Medicare Advantage Plans. Depending upon where you live, there can be an array of consumer options. Here, you typically have little or no co-pays or deductibles and it includes Prescription Drugs. Yes, you do have a network, but most of us do.

Regarding the ACA, the only way for insurers not to have pre-existing conditions in their policies is to have everyone in the system. Hence, the need for the individual mandate. Otherwise, why not just wait until you get sick, have cancer, etc. before buying coverage? It's like being able to buy homeowner's insurance after your house catches on fire. It just doesn't work.

Regarding the essential health benefits that are in the ACA, this was done to ensure that basic insurance coverage is the same throughout the country - even though by law it is regulated by the states. In any event, mental health, chemical dependency, chiropractic care, etc. are not the true drivers of costs.

Lastly, the costs for pharmaceuticals are very high. While they are improving and saving lives, there are related costs with this. The next time a drug is advertised on television, take a moment to research its costs. For example, Humira (widely advertised) goes for about $14k a year for continuous treatment. Who can afford that? In addition, new biologicals are staggering. A recently approved therapy is set for a $2,000,0000 cost (that's right, $2 million). It will save babies lives, but it is $2m.

 

[KenH]

The next time a drug is advertised on television

I wonder if patients pay the cost of these frivolous advertisements. What do they expect viewers to do, tell their doctor to give it to them?

 

[FriendofSpurgeon]

I wonder if patients pay the cost of these frivolous advertisements. What do they expect viewers to do, tell their doctor to give it to them?

The problem is that we all pay the cost for these advertisements. The individual patient does not. He/she simply pays their co-payment of $10 (or whatever). The cost is actually passed on to the insurance company who then passes on the cost to their customers via increased premiums. A vicious cycle.