The politics of Mediscare

By smacaulay

Macaulay Associates


The Obama administration has continually expressed the view that their health care reform plan has improved Medicare finances.

Yeah. Kinda like when we tell our children their C average did not cut it and we are not funding next semester’s college expenses. tI sounds good, feels good and would actually be good if we followed through.

Unfortunately, just like my best intentions with my child so it is with Congress and Medicare. No follow through. The real difference is though the government does not make up for the expense elsewhere.

If the law were implemented as it is today Medicare’s long-term liability fell by $53 trillion the day it was signed.

But at what cost? Where does this come from? Primarily funding to Medicare Advantage and to payments to providers. Not the so-called administrative waste and fraud prevention.

Medicare Advantage today makes up for 1 in 4 (25 percent for those of you as simple as me) of all enrollees in Medicare. It is a very inexpensive alternative to the traditional Medicare supplement market that has been the dominant product for decades prior to Medicare Advantage becoming more widespread in the second half of the last decade. In our practice here in a rural market hard hit by the recession it is close to double that. So why not do away with something that is working for seniors today?

In regard to payments to providers, if the current plan is implemented doctors and hospitals will be forced to leave the system.

And guess what? They have no intention of enacting these reductions. It just made for good math in trying to finance the bill. Just like our kid's tuition, an empty promise.

Medicare is in need of help to survive. One would hope that adults would begin a proper debate about how to fix the problem. That requires adults, which there seem to be very few of today in our representatives in Washington, DC. Maybe we can withhold their kid's tuition. Maybe that would get their attention. Sounds good, feels good, if only it would work.