Ask him why he doesn’t do that now to get his premium’s worth.
At some point it will, simply because health expenses are never going to consume more then 100% of GDP. Eventually growth will be flat or shrink as a share of the economy. But even small differences to the rate at which the bending happen make huge differences in the outlook of Medicare, that dwarf savings available elsewhere.
I don’t see anything in that link that contradicts what I said. Last-Year care is much more expensive then non-last year care. Most people that survive to 65 will live to 69 (more then 90%, according to the SS actuarial tables), so cutting people under 69 from the program saves less money then you’d expect if you just assumed spending would drop in proportion to the number of Medicare recipients that are under 69. I
The paper you linked says dying is cheaper the older you get. But its only a difference of like 8% for the 65-75 cohort as compared to the 75-85 cohort. Compare that to the cost of dying in a given year vs the cost of not dying (more then a factor of five, on average), and its easy to see that cutting out a couple percent of the total deaths that happen under medicare isn’t going to do much to balance the books, even if those deaths are a few percent more expensive then would be the case for those that hold on another couple years.
Raising eligibility would be hugely unpopular and result in very minor savings. If your going to take a political hit for passing unpopular healthcare legislation, you’d be better off doing it by increasing state-directed rationing in the healthcare sector then in raising the eligibility age.
Plus, if you raise the age above 65, and not everyone below the new age buys in, you’ve actually increased the total cost of medical care in the US, since non-medicare services are less efficient.
I agree allowing Medicare buy-ins at an earlier age would be a good idea, and it briefly looked like it would happen during the ACA debate but Sen Lieberman killed it. Hopefully its an idea that will be tried again.
Other nations provide health care for their people at less than half our cost. They also provide better care to the masses. Medicare could be done at half the price if it included everybody and we had oversight over the expenses. But our politicians are owned bu the people and companies that are getting wealthy off of it. That is what has to be stopped.
You claimed
Not just that it is more expensive in that in year than in other years. Yes it usually costs a lot to die, but overall more is spent before then. You overstated the case. Understandable but still overstated.
The challenge was what to do if I had dictatorial powers, not what I could pass.
In terms of those who might not buy in … well they are not costing the program anything. They are just buying less for more for themselves. They should be allowed to waste their own money. I think few would make that choice in a fairly short while. The reason it got killed is because the insurance companies know that they cannot compete and win. Medicare is just run more efficiently than they are.
Ah, apologies, misread my own quote. But anyways, we agree on the main point I think. Dropping the 65-67 set from Medicare rolls would create relatively small savings compared to the number of people it dropped from the program.
But to re-iterate my main point, bending the cost-care curve is far more important then making any set of likely cuts, both because the savings realized are much larger, much longer lasting and because it addresses the larger healthcare problem in the States rather then just trying to move it of the gov’ts books, which is that the cost is growing too fast for people, or even the gov’t, to continue to afford.
Back of the envelope, pushing the Medicare eligibility age up to 67 would save about 17% (people spend about an average of 14 years on the program, 75% of the money on them is spent on the first 13 of those years, so 17% spent in the first three years), which is equal to three years worth of Medicare growth averaged 1975-2002 (actually less then that, I didn’t bother compounding interest). So you have a large change in the program, but even that large change has any savings eaten up in just a very few years. Even if you were dictator, you’d be wasting your time twiddling with the eligibility age, what you need to do is limit spending growth.
I couldn’t do both? I’m a dictator after all!
I think that reducing costs of medical care is the key. One way to do that would be to make sure every citizen has health coverage (UHC) so that health issues can be caught when they are more inexpensively treated instead of waiting until they are advanced. Another way would be to have some sort of insurance system that has enough clout to negotiate lower prices. We could call it ‘Medicare’ or something. The bigger it is, the more clout it has. Either way we’re looking at UHC.
But there are a lot of politicians who are in the pockets of Big Medicine. Big Medicine don’t want lower prices. Their stockholders don’t want lower prices. And achieving UHC so that costs can be better controlled is ‘Socialism’. :eek:
Another way is to have a more *efficient *financial system, with overhead costs somewhat lower than the 30% or so the current profit-driven one does. Medicare’s are as close to zero as you could ever realistically have, even if it is “socialized medicine” :rolleyes:
This is a excellent point, the US spends 6-13% more on administrative costs than single-payer Canada does. Those overhead costs you mention are growing even faster than the cost of medical care. Eliminating those should be a priority.
We do not allow Medicare to get bids for prescription drugs. Why do you suppose that is? Americans suffer at the hands of pharmacy and heath companies. It is their piggy bank. Like bankers and the TARP program. They see it as their money.
I should have specified that the 6-13% is of the total cost of health care (ie. Canada spends 4-6% of the total health care budget on administration and the US spends 16-19% of their total health care dollars on administration). Sorry, I can’t seem to find the cite I remember these numbers from. Here is one that gives a similar picture though: News Articles | FindArticles
The new health care bill will force health companies to spend at least 85 percent of their intake in providing health care. The insurance companies hate that. That is why they are jacking rates up so fast. They still want their multi million dollar salaries for the execs.
Head of Cigna 11 mill a year plus benefits like god and a huge retirement package
Health care Group pres. 9. 4 million plus of course enormous retirement and benefits.
Perhaps Obama will actually go after those in charge of fraud. That would be a welcome change. Slap them on the wrist and they come back and do it again and again. I love it when those in charge suffer for the crimes their companies do. They hide behind layers and pretend their hands are clean.