According to the most recent report from the Trustees of Medicare, the system will go belly-up in 2017.
Now if you ask me, this should be an area of concern, perhaps even more so than the use of the word “retarded”. As I see it, we can respond in three ways: increase Medicare taxes, cut Medicare benefits, or transfer money from the general fund. If we don’t do some combination of these three, then the system runs out of money.
Raising taxes is out. The Republicans will block any tax increase.
Cutting benefits is out. The elderly are too large a voting block, and the AARP is too good at lobbying.
Transferring money from the general fund may be out as well. Right now the federal deficit is so large that people are talking about it. In a few years, there may be actual consequences, such as rising interest rates, soaring inflation, and a downgrade on the debt rating for treasuries. If so, then spending enormous sums to keep Medicare solvent won’t be an option.
So in summary, it’s a looming financial disaster that few people are willing to even talk about, and no one is willing to deal with.
What we need to do, but probably won’t, is end “fee for service” health care. Pay doctors a fixed salary instead of for every procedure (which gives them a perverse incentive to order unnecessary tests).
How will that help? The doctors who currently accept Medicare are already those lower on the totem pole than their colleagues. Doctors don’t like Medicare as it stands now, if you changed it to the doctors who take medicare will be provided a “fixed salary”, I’d laugh at the doctors you’d have on the approved list.
We also need to increase the overall supply of doctors. Congress should allocate some very generous financial aid for people going to medical school. If we flood the market with doctors, simple supply and demand will dictate that prices will go down. It would be worth the investment in the long run.
Not if they lack the votes to do so.
Pre-emptive defeatism such as you describe is not an acceptable option.
If the best choice is to raise taxes, then we should raise taxes regardless of what the minority thinks of that option.
It’s my impression that the bottleneck is the number of positions in medical schools, not the number of applicants.
But regardless, I don’t see any solution in cost controls for doctors visits, when those are only a small part of total medical costs. The real monetary hits come in long hospital stays, prescription drugs, and expensive procedures such as cancer treatments. As the baby boomers retire, there will be more of those things, and fewer working adults supporting each retiree. We simply have promised too much to the retired and the soon-to-be-retired, and it will be financially impossible to fulfill all those promises.
Nah, shit happens.
What’ll the pubbies do if they do get back in, kill medicare?
Then they’ll just be back out again.
And the dems’ll be in majority again.
The flux of decades is just not sufficient excuse to go all Caspar Milquetoasty, much as the Republicans might want Democrats to think so.
You know,** ITR**, I don’t often agree with you on matters of public policy and such, but I do like to give credit where credit’s due. That was freakin’ hilarious!
I doubt it, but that’s not really the point I was making there. If the Dems were to try and ram things through without bothering with even paying lip service to the ‘minority’, then when the worm turns the Pubs will do the same things. Perhaps you think that’s exactly what they did do, when they had the upper hand, but from my perspective they were just as hamstrung, even when they seemingly had all the cards.
Sure…it will all turn around again. And again. But the resentment will linger…sort of like the resentment and frustration that seems to be driving some Democrats these days. The two parties are at each others throats, and they seem to be escalating the rhetoric. Maybe you think that’s a good thing, that the party in power should use their power and ignore the minority party and do whatever they think is best. I’m just pointing out that doing so invites a further escalation when the worm turns and the Pubs are back in the drivers seat…and that you probably are not going to be very happy with the short term gains that the Dems MIGHT push through now, as opposed to what the Pubs might just push through when they have the whip hand again.
YMMV of course…guess we’ll see which route the Dems take.
Got a cite showing the breakdown? In my lifetime, anecdotally, the length of a hospital stay for a given problem has drastically decreased.
Page 366 of this pdf link shows that the average stay has decreased from 11.4 days in 1975 to 6.6 days in 2005.
Not that many people get cancer. Lots of people go to the doctor. If we could eliminate half an unnecessary test for each, we’d save a fortune. The New Yorker article certainly showed significant differences in cost between best in class and worst in class, with no difference in outcome. Of course, this reform won’t happen if moron Republican politicians scream death panels at every attempt to fix things.
You may not have been listening, but Obama said one of the major reasons that healthcare reform was imperative was that not doing it was going to bust the budget. Your information supports him. I don’t see a lot of alternatives from Republicans besides “let 'em die.”
I have been hearing about this for years. Those in the know would laugh about concerns regarding the Social Security Trust Fund’ solvency, knowing that Medicare issues would hit first. What to do?
Here is my proposal for everyone to shoot down:
Combine the Social Security Trust Fund with the Medicare Fund.
Combine the two taxes into one line item.
Uncap that line item (i.e. you pay that flat percent regardless of income level).
Now you just have one big issue, instead of two big issues.
The REAL issue is that we are not longer growing our population at the same rate, while we are also living longer and having more expensive treatments.
Population Growth - I personally oppose adding more bodies to the US. I have no desire to incent more immigration or natural population growth. Let it happen as it is currently happening.
Living Longer - nothing to do about this either.
Expensive Treatments. It is time to bring on the death panels and rationing. My 94 year old grandmother is in the hospital right now. She fell once again, and broke her hip. Medicare paid for a hip replacement. Medicare is now paying for her shut down kidneys and feeding tube after surgery on a 94 year old woman (with dementia). Medicare is pissing away money on her to the tune of thousands of dollars a day. A long, hard look at cases like this will be necessary - similar to how Oregon looked at their spending years ago and tried to eliminate certain procedures. This will suck, and the rich will buy the right to better care, but Medicare itself will need to start officially limiting certain procedures based on your current age and health.
What, like start a war of conquest based on faked up evidence, refuse to regulate the financial sector, let a city drown or turn America into the ‘torture democracy’? They’ve already done all those things, there is no point at all in trying to cultivate their good will. Should they regain power, it’ll be “my way or the highway” all over again, so the dems’d be foolish not to adapt a strategy of doing what’s best for the nation any time that they have the power to do so, and to hell with lipservice to the lie that is the ‘loyal opposition’.
Just sayin, XT, maybe you can point to legislation which the GOP has been helpful in advancing this past year?
Even when they’re in the minority, there’s no sign of anything but obstructionism from the pubbies in congress. I’m staring to think they’d rather see the terrorists win than have the nation emerge from a deep recession or get its financial house in order under democratic guidance.
Nah, let’s allocate Medicare money to districts based on the voting record of the Congresspeople, with a share for senate records too. Maybe it could be based on number of no votes. The obstructionists would get lynched by their constituents.
Well, yeah; I’m deadly accurate when aiming at my foot, haha! But it’s rather irksome to have people who already got theirs voting against others having theirs, too.
EXACTLY like that, except that next time they might not strive for what they actually got…which was bi-partisan support. But the Republicans certainly did run roughshod over the Dems when they had the majority. Here’s the thing…you and a lot of Dems are VERY resentful of that. Now you have the whip hand and I’m sure the temptation is there to just keep rolling on the escalation. Problem being that eventually the worm WILL turn, and whatever short term satisfaction you get from beating up on the Pubs now will be short lived as they up the ante when they are on top again. I think Obama understands that…which is, I suspect why he’s not trying to push things now, even though it makes some Dems exasperated with him.
Think about it…why WOULD the GOP be pushing legislation through at this point that would be helpful? What legislation concerning Iraq did the Dems offer up to ‘solve’ the problems there when the Pubs were in charge? That’s not really how our system works, is it? The party out of power strives to just sit back and point out the errors of the party in power, not offer up solutions that, if adopted, will only benefit the party in power. Right now it’s up to the Dems to figure out solutions and to do so in a way that doesn’t run roughshod over the system or the minority party. If they can, they need to TRY and at least pay lip service to bi-partisanship, and at least make the attempt to reach out to the less rabid Republicans and bring them on board, nominally at a minimum. And if they can’t do that, then they need to demonstrate conclusively that they aren’t trying to just run over the process or the minority party, but instead have made a good faith effort to work with the opposing party. Which, I believe, is exactly what Obama IS trying to do…and which is, seemingly, pissing off the more fervent Dems who really do just want to steamroller through their own agenda, damn the consequences.
Just sayin’…that’s how it looks from my perspective.
I believe the AMA tries to artificially limit the supply of doctors to keep wages high and unemployment low. There is no shortage of people who want to be doctors (or nurses), just a shortage of programs for them to train.
I don’t agree with the OP that the only options are raise taxes, cut benefits or transfer funds. Reforming health care to make it more efficient is another tool to look into.
If we could provide high quality health care to everyone for 11% of GDP instead of 17% (11% is high by OECD standards and what it takes in places like France & Germany. Some nations like Japan, Taiwan & the UK do it for 8%) then that would shave tens of trillions off of Medicare’s unfunded liabilities. I don’t know the exact stats, but if we competently reformed medicare I’m sure we could cut the unfunded liability in half or more.
Sadly, a lot of rich and powerful people like health care the way it is. If we could provide the same quality of health care for 1.5 trillion instead of 2.5 trillion, that means a trillion less in revenue for hospitals, doctors, nurses, pharmaceutical companies, insurance companies, etc. They would fight tooth and nail against reforms to improve efficiency as they’d lose profits, job security and market share.
No idea what’ll happen. But the most important thing we can do is reform our health system to promote lower costs and higher quality. But I don’t see that happening. Powerful companies and the GOP (as well as most dems IMO) aren’t going to stand for that due to either ideological reasons or fear of retribution from health care industries. Plus the public tend to get timid easily.
Doctors buy labs and then direct all their patients to have tests that will make them money on both ends. The tests are made to make money not for defense . Other labs kickback to doctors if they will send lab work their way. Doctors make that claim about lawsuits but malpractice claims are about 2 percent of the medical care. They are not a cost problem at all.