Saturday, September 12, 2009


Awhile back I wrote a column entitled, “Medicare – Fix it, don’t Nix it”. I still firmly believe in Medicare and the need to fix it so that it is a fiscally viable sound medical plan for seniors. Recently, I had the occasion to use the medical benefits services of Medicare. Here’s my experience and comments about how to “fix it”.

After seeing my internist (family practitioner) for a medical problem I had, he advised me to see a specialist for the problem I was experiencing. Within a few days I had my appointment with the specialist. After his exam, he ordered me to have a CAT SCAN and an X-Ray. Within two days, I had those diagnostic procedures performed on me.

The medical services I received were fantastic, and it probably cost a pretty penny which will be covered by Medicare and my supplemental insurer. I am appreciative of the medical services I received.

But, all those medical services I received are some of the reasons why the Medicare system is going broke. There is not enough money coming into the system to sustain the amount and scope of the services it is now providing its seniors. 51 million plus people are now eligible for benefits under the Medicare system. With the approaching retirement of the “baby boomers” in the coming years when they will reach the age of 65 and become eligible for Medicare, it will finally break the back of the Medicare system, financially. It is predicted that Medicare will be paying out more than it is taking in by the year 2017 or sooner if the recession continues. It is predicted that we will have a $37 trillion unfunded liability in about 30 years?

The big question is, if we can’t sustain a fiscally sound Medicare system for 51 million people now, how can we sustain it for 300 plus million people under a Universal Medical Insurance plan? The answer is simple, we can’t! The congressional proposals, being put forth, state that in order to meet the extra expenses of instituting a Universal Health Insurance plan, $500 billion will be cut from the present Medicare setup. That means that seniors will bear the major brunt of the cuts in medical funding. It will mean long lines, rationing of services, and extra costs in the form of higher co-pays for seniors. The quality of the present day services, which seniors are now accustomed to, will be no more.

So instead of cutting $500 billion from Medicare, which will gravely affect seniors, we should institute practical remedies to make sure Medicare is preserved and health care is made viable for all who want it. It should not be forced upon citizens by the government.

Why don’t we fix what can be fixed and then tackle the other issues that could make Medicare and general health insurance more viable in the future?

For instance, why don’t we start off by instituting meaningful tort reform by reimbursing to victims, as close to the actual amount, for the loss they have sustained, through medical malpractice, and by capping the amounts for pain and suffering and punitive damages? In addition, to curtail frivolous lawsuits, we should institute “loser pays” for legal and court costs, as is practiced in Europe. The amount of frivolous lawsuits will practically dry up as result. Maybe a mediation and arbitration court arrangement could be setup to handle malpractice cases under government supervision.

Another area of change would be to make medical insurance available across state lines to broaden the pool of insurance providers to foster more competition which will lower costs and make insurance more cost “reasonable”. In addition, we could institute something along the lines of what the Forbes Publishing Co. has instituted – HSA – (Health Savings Accounts) where clients theoretically spend their own money from their account thereby putting a check on health care costs as people are more careful of spending their “own” money rather than having a faceless bureaucrat allocating what medical services you should have to spend your money on.

And finally, the only area that the government should get involved in health care, other than Medicare, is in government oversight to check on waste and fraud which is always present when people are involved. Billions of dollars are wasted every year by unscrupulous beneficiaries, medical services suppliers, and crooked insurers and medical practitioners. We shouldn’t disrupt our whole health care system to attempt to give access to 5% of the population that is in need of health insurance. Don’t throw the baby out with the bath water, fix the problems we can fix and then tweak the system to make it better later on.

Medicare is a great program for our senior citizens, but it must be made fiscally sound by keeping the overuse of services to a minimum and by keeping fraud and waste to a minimum. Once you get a hold on those areas, then you can institute other reforms later on to make the system work better so it will be there when our children and grandchildren become eligible in the future, because they are our country’s future. As it is today, I wouldn’t bet on it. So fix it, don’t nix it!

Written by Chuck Lehmann

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