Is Medicare an entitlement? Pensions, medicare, social security. It
seems like the American taxpayer is being fleeced by business and government. We
pay all our lives to see our work stolen from us.
Doctors need to make money. This is an absolute truth. And Doctors need to be,
and should be reasonably compensated for their services. But as one who is
caring for both my own as well as my wife's aged parents. I see a lot of
warts in the system. It has become completely clear that there are some
doctors that have turned themselves into medicare mills. While they do provide
decent care for their patients, they are more than willing to act as referral
hubs for specialist... whether that be testing or other medical practices. It is not uncommon for us to have 4 or 5 doctors appointments a week
scheduled. I am constantly asking the providers now why, and what they expect
the outcome to be of a particular test or treatment. Often I find that these
test are fishing expeditions, and even sometime just to placate the elderly, to
make them feel they are doing something.... when the reality is sometimes aging
is very unforgiving. The problem needs to be address at many
different levels. Doctors sometimes are as much the problem, as they are the
"That is no way to run a national health care system."The
real question is whether there should *be* a national health care system."Political realities make it impossible to repeal the act."And yet repeal is the first step toward any good solution.
If we get our medical costs down to the level of Germany, or France, or Japan,
or Australia, or any other developed country, there would be no Medicare crisis.
It would also solve most of our long term budget problems. Americans pay almost
twice as much for medical care as do residents of all other developed countries.
We don't seem to get anything in exchange for all of the extra spending.
First, as a Social Security and Medicare recipient, I'm getting
increasingly tired of hearing of these termed "entitlements" when I
paid into them every payday while I was working.Second; we need one
program in this county that is supported by the government. One for everyone.
Congress, the president, everyone should have one program. Third;
what happened to the Doctor's oath that they do no harm. I guess you do no
harm if it doesn't get in the way of profits.
Let us consider some social welfare programs that the government runs:Social Security: going bankrupt and seeking more taxpayer dollarsMedicare: going bankrupt and seeking more taxpayer dollarsMedicaid:
going bankrupt and seeking more taxpayer dollarsDoes any rational person
actually believe the Affordable Care Act/Obamacare will be any different?Something else to consider: Most doctors that accept Medicare set quotas
limiting how many Medicare patients they will serve. Why? Doctors LOSE money
with every Medicate patient they serve. Expect more limits from doctors
regarding Medicare (and Obamacare) patients that they'll serve, besides
those who drop Medicare patients altogether. The health care crisis is about to
get a lot worse.
Socialized medicine is fast approaching. We need to be working on a viable
option to ACA or just accept it and work with it. There is no going back to the
way it was.
There is an EASY fix to this. For example, a surgeon's fee for a total hip
replacement may be $5,000. Medicare/Insurance's predetermined and
advertised reimbursement for that procedure code may be $1800. The surgeon
should be able to bill the patient for the remaining $3200. If the patient is
unable to pay the balance, that is between the surgeon and the patient...no
government or insurance involved. This "balance billing" is not allowed
under current Medicare and insurance rules.The amount of
reimbursement per procedure from Medicare or insurance should be the same in
every part of the country. Not necessarily the same from company to company or
Medicare, but the same throughout the country. If a doctor practices or a
patient chooses to live in a rural area or large city, it shouldn't
matter.With a set amount of reimbursement available from
Medicare/insurance (known prior to the procedure), patients can plan and wisely
use their own resources to make up the balance. Cavalier use of the medical
system would abruptly stop, Medicare procedures would be greatly simplified and
those using medical service would be paying more of their "fair share."
SLars,Insightful comment. Consider that one person has to be
robbed/fleeced/taxed in order for the government to provide welfare services
such as Medicare/SS/Medicaid to another. The insidious nature of it is that the
situation pits one generation against another. Senior citizens fight/vote to
ensure that the government keeps taxing/fleecing younger generations to preserve
the government provided welfare services for the senior citizens.
The opinion article basically said we don't like that doctors won't be
paid as much and therefore there may be less available to serve the Medicare
patients...and so something needs to be done. It would be nice to have read what
they would suggest congress do specifically. And just repealing the cuts to the
doctors was not a valid suggestion as was pointed out since they realized the
congress would never get the law changed to do that.
If we put medicare patients, and every other person in the nation, into a single
payer health care system we could get costs under control.
Sounds to me like the bloated cost of insurance is finally taking its toll. Time
to move to a single-payer system. Rather than let insurance companies goug let
everyone pay a certain tax to have everyone covered and treated.
LittleStream,It is with some pity that I must inform you that you
never "paid into" anything while you were working, unless it was your
own 401K program or your own healthcare premiums. All those Social Security and
Medicare taxes were just that, TAXES. Your taxes paid for those who were on the
receiving end of the ponzi scheme. Now you are on the receiving end of the
ponzi scheme. Problem is, the ponzi scheme is collapsing in on itself.
Historically that pretty much always happens with ponzi schemes.
UtahBlueDevil,Doctors often engage in a lot of unnecessary testing because
they know that if they don't, they risk being sued for "not doing
enough". It's one of the reasons why doctors have such high insurance
costs associated with their practice.
@LittleStream:First, as a Social Security and Medicare recipient, I'm
getting increasingly tired of hearing of these termed 'entitlements'
when I paid into them every payday while I was working."It's an entitlement to many recipients who paid in little or nothing."Congress, the president, everyone should have one program."There is but one program for Congress and the president... When
eligible, they go on Medicare as a primary. They can also chose a secondary
insurance to cover what Medicare doesn't... same as everyone can.@Roland Kayser:"If we get our medical costs down to the level of
Germany, or France, or Japan, or Australia, or any other developed country,
there would be no Medicare crisis."Don't worry, Obama is
working on getting medical costs down... Once Obamacare is up and running, the
government will start deciding what you can and cannot eat to keep you
healthy... and how much exercise you will need to get... etc.
"But the choice is clear. Either let the cuts take effect and anger doctors
who, after all, need to turn a profit," A more correct statement would be:
the HMO's doctors work for need to make a profit. Big difference. This is
why many of us wanted a single payer system, medicare for all, something like
Canada has. Canadians have shown no inclination to dump their system in favor
of the U.S. hodgepodge. As a senior citizen I fear an attempt to cut us off
from health care. We will see to it that there are political prices aplenty
before that happens, even if it means a race between accelerating chronic
illness and action. People have rights and they have limits.
We ARE getting entitlement reform in ACA--the spending cut and the tax increase
are intended to bring Medicare back to balance. Everybody knows it has to be
done, so why all the caterwauling?
If Irony Guy is right, then this editorial is incendiary. If so, for what
Every American citizen should have the right and opportunity, and obligation, to
work for paid employment ( workfare and not welfare); and a right and access to
an education; and a right and access to health care, all provided and guaranteed
under a national program..
The Social Security trust fund has paid for the moon landing, wars, etc. Up
until 2010 it took in more money than it paid out. It's the raiding of the
fund that's wrong. Otherwise the program has worked quite well. Once the
economy recovers, we will see a surplus again. Who is putting
generations against each other? The media?
One would assume, from the tenor of the letters here, that nations with
one-payer government-run health care systems provide the worst possible care,
that no one can see a doctor, and that people have to be compelled to become
physicians and to work in that field because it will be a life of deprivation
and poverty. The reality is that health care is much better in most European
nations than in the US and, since the State pays the cost of medical school for
their doctors, the physicians don't have the sense of entitlement that
pervades the American medical system. The biggest difference is that they
don't have insurance companies serving as middlemen, raking off a third of
the health care budget for profit to themselves and their stockholders.
Your editorial fails to point out a potential solution, raise our medicare
"tax" rate. If we're not paying enough to maintain this service we
should pay more. Or cut services like you mention. Mention this alternative in
your opinion piece, for politicians to read, we pay more, and how much more, and
let us debate that. Debate about cutting services or paying more to maintain
some good level of services. I pay 1.45% of payroll into medicare, and my
employer pays an equal amount. A pittance. When I use medicare I'll
probably be income tested, OK. Let's make sure investors (those who
get "unearned income") also pay their full share into medicare, that
would be 2.9% of that investment income (no employer to participate). No cap on
the income that is subject to this medicare "tax".Got more simple
rules, watch my posts . . .
Here is a different question. We have the technology to transplant kidneys for
70 year olds to keep them alive longer. It is really really expensive, but we
claw at every opportunity to stay alive a little longer. We appear to be
terrified of the alternative.That is a Western paradigm. I have
talked to families of 63 year old Polynesians who are dying on behalf of a
doctor who can keep the patient alive a few years longer. They looked at me
and said, "He has lived a full life, let him go." The doctor told me
later with surprise, "But he's only 63?!"When I turn 70
and my kidneys are failing, is there some way that they can just keep me
comfortable without the heroic and hugely expensive efforts to keep me alive for
five more years so that my insurance and heirs can again make heroic and
expensive efforts in a vain and futile effort to keep me from the inevitable?Our technology is good, but it isn't cheap and that is getting us
in a situation that we can't properly educate and develop the young. We
have great technology but little wisdom.
The real problem here is insurance companies, and the meddling of the government
in healthcare. One area of healthcare that is gaining popularity (proving again
that the market works) is cash only patients being seen by a number of doctors.
These doctors realize that the bills being sent to patients are ridiculous and
can provide care at a fraction of the cost, AND still be profitable. These Drs
are able to countless hours devoted to their families or their patients that
otherwise would have been tied up in dealing with insurance companies (both
medicaid/care and independent insurance). If a single payer system is
installed, I'm confident that even more issues will pop up and basically
you will have a tiered system, one that provides excellent care for those with
money to pay cash, and another tier that will provide for "the rest".
there are no easy solutions, but the sooner the government is out of
the healthcare system (and insurance gets out of bed with the government) the
I'm retired and I have put money into Medicare all my life. In 2010 it was
determined that I needed an oxygen concentrator for my central sleep apnea.
Medicare helped pay for it. Then my wife and I went to California for 2 years on
a senior LDS mission and because of the lower elevation there I didn't need
the concentrator. Now I have returned home and have had the same sleep tests and
I need an oxygen concentrator again. But, it is no longer covered by Medicare!
What's happened? Obamacare has kicked in and money that was once for
Medicare is now going to subsidize Obamacare. In other words, I paid for
something, Obama changed the rules, and I no longer get what I am supposed to
get. Perhaps what he has done is legal, but I surely question the morality of
@marxist:"This is why many of us wanted a single payer system,
medicare for all, something like Canada has."With Canada's
system, sometimes the patient has to get in line and wait for months for
healthcare."Canadians have shown no inclination to dump their
system in favor of the U.S. hodgepodge."The reason Canada keeps
their system is because Canadians can come to the US to receive healthcare if
the need arises. Where can Americans go if denied care under Obamacare?"As a senior citizen I fear an attempt to cut us off from health
care."Mark my words, you will be cut off from certain healthcare
procedures, if the cost is too high and you're too old. The government
will make that decision for you. Obama has already told us as much when to said
for the elderly to 'just go home and take a pin pill.'"People have rights..."Dream on. Under Obabacare the
rights belong to Obama and his Secretary of Health and Human Services, Kathleen
@VST "realistic solutions"Sure, but they need to be
solutions that actually solve something. In the case where Obamacare *is* the
problem, the only solution is repeal -- however long it takes, and with whatever
changes in elected leadership need to take place first.2014 will be
only the beginning.
When Social Security, Medicare, Women's right to vote, compulsory
education, The right for labor to organize, etc, etc, were all first enacted
there were also the same belly achers of gloom and doom as there are today with
Obama Care. They moan and groan, but never have a better plan of their own.
@wrz "The reason Canada keeps their system is because Canadians can come to
the US to receive healthcare if the need arises." This is partially true.
For example, a relative of mine is in the Canadian system. He didn't want
to wait for some imaging. So he went to Buffalo, NY to get the image and then
went back to Canada with the image. At that point the Canadian system took
over. So his care was 80% Canadian and 20% U.S. But except for the delay in
imaging, he likes the Canadian system. The Canadian system isn't perfect,
no system is, but overall it works better and at much lower cost than ours.
I think its time to get serious about cutting military spending and installing a
one payer system like other developed democracies do.
Social security trust fund at the end of 2011, $2,524.1 trillion. Income during
2012 731 billion, (retirement) paid out 645 billion. Social Security disability
trust fund, 153 billion, income during 2012, 109 billion (disability) paid out
140 billion. Social Security took in more than they paid out in 2012. Medicare trust fund at end of 2011, 244 billion (Hospital) income 243 billion,
paid out 269 billion. part b & D trust fund 80 billion, income 293 billion,
paid out 307 billion. Medicare paid out 40 billion more in this economy. There
are a lot of programs that could be cut by 40 billion until the economy
recovers. It's not that bleak.
For those of you who want a single payer system, who would run it? The Federal
Government? Please. You can't actually want that huge bureauracracy in all
their inefficiency and waste to actually be in charge of your health care. Talk
about making bad problems worse.
@m..g.scott,I don't know the answer you pose; but although big
government has its problems of waste and graft it is still way more honest and
conscious of public interest than big business. If you fear big government, fear
big business many times more.
SLars and some other misguided commenters. Medicare and Social Security are
prepaid benefits. I and my employers paid for these retirement benefits during
my working years. I continue to pay for Medicare in retirement as well as fund
a privately insured supplemental. Unlike medicaid and some other health
programs, these benefits are not welfare nor are they government doles. I have
worked "all my life" and nothing has been stolen from me. And it
won't be unless the right wing comes to power and kills these programs in
the name of some self righteous notion of "self reliance"Then we can in good conscience reestablish the county poor house and let older
people die and thereby "reduce the surplus population". I cannot
believe that in this state, where so many consider themselves morally superior,
that political ideology is more important than human need.
Mike in Cedar City, I thought my comments supported your view? It's not an
entitlement, but more an insurance. One that we pay into all of our working
lives. And medicare we pay all of our adult lives.
I was looking at your first comment. Subsequent comments are more clear.
Everyone deserves to get medical care if they need it. What kind of medical
insurance you have should not determine whether you get medical attention or
not. That is just another down side of medical insurance. It seems like the
insurance has been doing more bad than good considering the number of people
that are filing for medical bankruptcy because of it. If your medical insurance
is forcing you to make that unfortunate choice of filing for medical bankruptcy,
go to bankruptcylawconsultation.com where you will be connected with a local
attorney who will assist you in filing for medical bankruptcy.
Funny. I have never had a problem finding a physician or hospital. Perhaps I am
just lucky, but this conservative newspaper just likes to find
"problems" with any government provided service. I think your right
wing bias is showing again DN