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In our opinion: Medicare in crisis

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  • SLars Provo, UT
    Aug. 4, 2013 3:41 a.m.

    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.

  • UtahBlueDevil Durham, NC
    Aug. 4, 2013 7:22 a.m.

    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 cure.

  • Nate Pleasant Grove, UT
    Aug. 4, 2013 7:24 a.m.

    "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.

  • Roland Kayser Cottonwood Heights, UT
    Aug. 4, 2013 8:02 a.m.

    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.

  • LittleStream Carson City, NV
    Aug. 4, 2013 8:07 a.m.

    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.

  • Shane333 Cedar Hills, UT
    Aug. 4, 2013 8:24 a.m.

    Let us consider some social welfare programs that the government runs:
    Social Security: going bankrupt and seeking more taxpayer dollars
    Medicare: going bankrupt and seeking more taxpayer dollars
    Medicaid: going bankrupt and seeking more taxpayer dollars
    Does 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.

  • FDRfan Sugar City, ID
    Aug. 4, 2013 8:24 a.m.

    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.

  • Legal? Saint George, UT
    Aug. 4, 2013 9:13 a.m.

    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."

  • Shane333 Cedar Hills, UT
    Aug. 4, 2013 9:30 a.m.

    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.

  • l.cee Ridgefield, WA
    Aug. 4, 2013 9:55 a.m.

    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.

  • Hutterite American Fork, UT
    Aug. 4, 2013 9:56 a.m.

    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.

  • FreedomFighter41 Provo, UT
    Aug. 4, 2013 10:03 a.m.

    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.

  • Shane333 Cedar Hills, UT
    Aug. 4, 2013 10:12 a.m.

    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.

  • Shane333 Cedar Hills, UT
    Aug. 4, 2013 10:14 a.m.

    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.

  • wrz Pheonix, AZ
    Aug. 4, 2013 10:21 a.m.

    @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.

  • marxist Salt Lake City, UT
    Aug. 4, 2013 10:49 a.m.

    "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.

  • Irony Guy Bountiful, Utah
    Aug. 4, 2013 11:08 a.m.

    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?

  • marxist Salt Lake City, UT
    Aug. 4, 2013 11:27 a.m.

    If Irony Guy is right, then this editorial is incendiary. If so, for what purpose?

  • sergio Phoenix, AZ
    Aug. 4, 2013 11:41 a.m.

    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..

  • SLars Provo, UT
    Aug. 4, 2013 12:00 p.m.

    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?

  • Eliyahu Pleasant Grove, UT
    Aug. 4, 2013 12:23 p.m.

    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.

  • dave4197 Redding, CA
    Aug. 4, 2013 12:31 p.m.

    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 . . .

  • Tekakaromatagi Dammam, Saudi Arabia
    Aug. 4, 2013 1:46 p.m.

    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.

  • philaD Clifton Heights, PA
    Aug. 4, 2013 1:59 p.m.

    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 better.

  • JSB Sugar City, ID
    Aug. 4, 2013 4:19 p.m.

    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 it.

  • wrz Pheonix, AZ
    Aug. 4, 2013 8:28 p.m.

    @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 Seblius.

  • Nate Pleasant Grove, UT
    Aug. 4, 2013 8:44 p.m.

    @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.

  • sergio Phoenix, AZ
    Aug. 5, 2013 8:32 a.m.

    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.

  • marxist Salt Lake City, UT
    Aug. 5, 2013 10:19 a.m.

    @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.

  • dalefarr South Jordan, Utah
    Aug. 5, 2013 2:43 p.m.

    I think its time to get serious about cutting military spending and installing a one payer system like other developed democracies do.

  • SLars Provo, UT
    Aug. 5, 2013 9:53 p.m.

    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.

  • m.g. scott clearfield, UT
    Aug. 6, 2013 1:40 p.m.

    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.

  • skeptic Phoenix, AZ
    Aug. 6, 2013 6:59 p.m.

    @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.

  • Mike in Cedar City Cedar City, Utah
    Aug. 7, 2013 9:25 a.m.

    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.

  • SLars Provo, UT
    Aug. 7, 2013 8:02 p.m.

    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.

  • Mike in Cedar City Cedar City, Utah
    Aug. 7, 2013 8:38 p.m.

    I was looking at your first comment. Subsequent comments are more clear. Sorry.

  • BankruptcyLawConsultation Washington DC, DC
    Aug. 9, 2013 9:54 a.m.

    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.

  • Mike in Cedar City Cedar City, Utah
    Aug. 24, 2013 10:54 a.m.

    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