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Medicare Part E


This would be part of my solution to what we’ll do if and when Obamacare fails. Financially, it looks as if the numbers will not work as Obamacare gets implemented.
Most people want to be able to go to the doctor of their choice and get treatment when they want it. They also don’t want an even bigger bureaucracy between them and their health care, especially in the post-antibiotic world where an infected cut can cost you your life to MRSA.
We have about 110 million people with jobs. They have to pay for the health-care for everyone: themselves, their child and their parent add up to about the 316,000,000 of us. At a whopping $8k per person, the average worker would have to put in $24k per year to pay his share.
Not possible.
So, if we do the cost cutting measures I suggested in my last blog, especially with end of life costs, how do we cover everyone without any more dollars?
In a fairy tale world, we’d toss out the insurance companies that suck money from the system. But that’s not going to happen. A single-payer system would allow us to see whom we please, cover everyone with the dollars we have, but the lobbyists control DC. “Medicare for all” is an idea whose time has NOT come.
Keep the mandate for private insurance to take all comers. Those who cannot get insurance could go into Medicare part E (for Everyone else not already in insurance or Medicaid). These patients would participate on a sliding scale of realistic costs. Yep, it is expensive, so you’d better plan on quitting smoking to pay for your health care premium. You’ll also have to give up beer. Might even have to give up cable. Health care takes up 1/6 of our GDP, so plan on health care premiums hurting. Maybe you’ll get your lazy ass out of the recliner and take a walk. Or take your blood pressure medicine so you don’t have a stroke when you open your health care premium bill.
Medicare’s administrative costs are far lower than private insurers, throw in the pay to play taxes that I advocated in the last blog. See how far short we are and then start the horsetrading.
Make preventive care free to the patient. It saves society money. Giving away meds for blood pressure, high cholesterol and diabetes might be cheaper than treating the strokes, heart attacks and retinal disease. Since we can’t give them away, let’s make them cheaper: Ban direct to consumer drug advertising and that’ll knock 20% off the top of drug costs.
Have the NIH fund drug studies. Private drug companies have paid billions of dollars in fines for hinky studies to convince people their drugs should all but be in the water supply. Drug companies could create the drug, and the NIH could study it. The science is decent and everyone benefits. Fewer bad drugs reach the market and the drugs companies get to keep the profit.
Every patient makes a sliding co-pay. Why? A huge percentage of acute illnesses are cured by tincture of time. The money wasted on doctor visits for the common cold is HUMONGOUS. “Treat a cold vigorously and it will go away in 7 days. Ignore it and it will go away in a week,” is an old saw that still applies. Public education of when to go to the doctor would decrease unnecessary visits.
Use tiered care, as they do in Mexico. Yep. Mexico does something better than we do in health care. You have clinicas that see minor things. Hospitals fall into three groups: ones that do routine things like deliver babies and treat simple things (like the throw-ups in an otherwise well person). A second tier sees more complicated things (like the throw-ups in a diabetic). A third tier is basically only for ICU patients. But in the US, we try to do all three in one hospital. That’s inefficient and causes HUGE overhead for piddly things.
Going into the ER at “my” hospital for a stomach bug, means I have to pay the freight for a place that does friggin’ heart transplants. That’s stupid. It also means that they aren’t very attentive to my throw-ups, as they have transplants to do.
Are we going to be able to finance Medicare Part E solely through patient contributions? No. Why? The average person doesn’t make enough money. We will mandate that people buy in or face real fines.
But we also are going to have to throw in some gub’mint money. Say, the foreign aid we give to countries that hate us anyway. That’ll go a loooooong way. Of course, the companies that sell US flags for burning will be SOL, but that’s a small price to pay.
Those are a few of my ideas, what are yours?