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View Diary: Medicare: What can we do about it? (314 comments)

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  •  interestingly, this is what the single payer folks (24+ / 0-)

    say, and I do not know if it is correct:

    What about the proposal to lower the eligibility age for Medicare to 55?

    Lowering the eligibility age for Medicare to 55 only works if it is mandatory.  Otherwise it becomes the place where all the sickest patients get dumped.  That might be okay for the sick people since Medicare is often better and more secure than private coverage, but it would drive total health care costs (and premiums)  up, not down.

    Yes, it has to be mandatory. mandatory is not a dirty word.

    http://www.pnhp.org/...

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Sun Aug 21, 2011 at 07:18:28 AM PDT

    •  correction (6+ / 0-)

      correct if mandatory. my misread.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Aug 21, 2011 at 07:28:24 AM PDT

      [ Parent ]

    •  This is already how Medicare already works (8+ / 0-)

      probably 99% of the elderly population has already been dumped into Medicare. I don't really see this as a problem.

      It is still a net savings to the system to get these people treated a decade earlier. Better they get paid for diabetes meds now than an amputation and 24x7 care down the road.

      "What could BPossibly go wrong??" -RLMiller "God is just pretend." - eru

      by nosleep4u on Sun Aug 21, 2011 at 09:06:42 AM PDT

      [ Parent ]

      •  they are talking about expanding it to (3+ / 0-)
        Recommended by:
        fladem, Uncle Milty, Kimball Cross

        say, 55 or 50... if you do, you have to take all comers, not just the sick. IOW, it has to be mandatory. Do 50 yo's want to give up their current insurance and go on Medicare? i do not know. But those that don't have any... you bet.

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Aug 21, 2011 at 09:12:06 AM PDT

        [ Parent ]

        •  I would love to go on Medicare - I just turned 56. (13+ / 0-)

          My husband and I are self-employed, so we pay for our own individual insurance. Like many other micro-business owners, we don't have enough full-time employees to qualify for group insurance. So, we are paying through the nose for not-so-great insurance because we, like many, many people over 50) have developed pre-existing conditions that healthy lifestyles haven't been able to fix. (Things like high blood pressure in my case, high cholesterol in my husband's, which appear to be fairly inexpensive to control with medications.)

          I suspect that if Medicare included people 50 and older, you might see a number of people decide to get out of the rat race and start their own business after dreaming of it for years. That would perhaps open up jobs for younger people and we might see things start to turn around for the economy.

          A society grows great when old men plant trees in whose shade they know they shall never sit. -Greek proverb

          by marleycat on Sun Aug 21, 2011 at 09:21:41 AM PDT

          [ Parent ]

          •  I think it is an important idea to explore (2+ / 0-)
            Recommended by:
            marleycat, joedemocrat

            As I said in the post, it has to be total health care cheaper than private insurance to cover the same amount of people. The increased cost will be those who have nothing now having medicare. I just don't know how the numbers shake out.

            Definitely needs to be looked at.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Sun Aug 21, 2011 at 09:32:05 AM PDT

            [ Parent ]

          •  Yes...but (0+ / 0-)

            ...who is going to pay for it.  That's he problem.  You, like most people in their 50s, want to consume a lot of health care.  And, like most people, would prefer that someone else pay for it.

            It's not fair to our kids.  All along, your generation has paid in assuming everyone gets Medicare at 65, and they haven't paid in enough to make the program solvent.  Now that they are in thier 50s, they want to get cheap coverage.  But it's your kids that will end up paying for the current insolvent system, your more generous benefits than you paid in, and have to set enough aside for themselves.  How is that fair?

            •  "Want"? (4+ / 0-)

              Spoken like a true Republican.

              I mean, "want to consume a lot of health care"?  Um, not really.  

              Most of us would prefer to consume as little health care as possible.   My personal preference is that I interact with the medical system for routine physicals and the like that always declare that I'm healthy and not in need of further care.  And have that trend continue until I'm, oh, maybe around 100 years old.  That's my "want".  I suspect that most would echo that -- and that few want to "consume" a bunch of expensive heart bypasses, knee replacement surgeries, and chemo treatments for cancer.  The problem is that what we want and what is actually likely diverge significantly in this instance.

              Political Compass: -6.75, -3.08

              by TexasTom on Sun Aug 21, 2011 at 12:14:20 PM PDT

              [ Parent ]

              •  Do you really think... (0+ / 0-)

                ...that ACA will provide an endless supply of new technologies and drugs and procedures AND cover everyone AND give them everything they...what's the word...need?  Oh yeah, and it's going to save us money too.

                The level of care offered today for the three procedures you mentioned did not exist 10 years ago.  We are constantly developing new drugs, procedures, devices, etc.  Those cost money.  There will be new procedures 10 years from now that get invented through tremendous risk and development costs (because the companies think they can make evil profits).  

                Do I want those today?  Do I need those today?  Does it matter?

                The won't get invented (or provided) unless someone pays for them.  That's the point of the diary.  We are consuming MORE and MORE healthcare, and ACA won't change that.

                We have to get serious about who is going to pay for this.  If we don't, congress will be making those decisions.  Future Bush-like administrations will be making those decisions.

                •  yes,that is a point of the diary (0+ / 0-)

                  that is true, but ACA and anything we do to lower costs is a good thing. As noted in last weeks part I:

                  Dr. Robert Levine wrote this piece a few years ago, and estimates that about a trillion dollars is wasted every year in our health care system between unnecessary care, administrative waste and fraud (not all in the Medicare system, but a substantial portion).  Find it hard to believe?  Then you have not read enough.   Physicians are part of the problem in ordering and performing unnecessary tests, procedures and surgeries, as outlined here by Dr. Rita Redberg.
                  there are costs to cut that are not descreases in care or starving the innovators.

                  "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                  by Greg Dworkin on Tue Aug 23, 2011 at 05:01:51 AM PDT

                  [ Parent ]

            •  So let's forget about single-payer and turn (2+ / 0-)
              Recommended by:
              tardis10, janinsanfran

              health insurance over to private companies. That's what I hear you saying. The whole point of medicare for all is that it will lower costs for everyone, including my three children. Furthermore, who the heck do you think is paying for private health insurance already? You and me. Maybe your company pays a portion of the premium for you (aren't you lucky - it's not considered a taxable benefit), but one way or another we are all paying through the nose for insurance in which the middle-man insurance companies are making huge profits, and which have the effect of driving up costs.

              And, I agree with Texas Tom on this: no one "wants" to consume a lot of health care. But I really resent having to pay an insurance company over $10,000 a year, with a $5,200 family deductible before they even start paying 80% of the bills, and basically all we do is see a doctor for annual physicals and occasional med checks. On top of that I am already paying into medicare and have been for the last 41 years of my life. I want Medicare for All.

              A society grows great when old men plant trees in whose shade they know they shall never sit. -Greek proverb

              by marleycat on Sun Aug 21, 2011 at 12:40:49 PM PDT

              [ Parent ]

              •  No... (1+ / 0-)
                Recommended by:
                DemFromCT

                ...my point was that it isn't fair to your three children to make them pay for Boomers who want to take advantage of all the new drugs/procedures and have someone else pay for it.  

                The Boomers didn't pay enough in along the way and now (per parent comment above) I hear many saying it would be great if they could just slide in to Medicare at 50.  The system is already insolvent.

                We need to get used to the idea that modern technology will invent cool thigns if we are willing to pay a lot of money for them.  The reason your plan costs 10-15k per year is because that is what it costs, on average.  One baby in the NIC unit, one car accident, one instance of cancer, one heart surgery...they all cost tens (if not hundreds) of thousands of dollars.  

                If we want to cover everyone, and not limit what we consume, and keep the inventions coming, everyone's costs will go up.  Saying you want Medicare for all and not wanting to pay for it will lead to rationing.  The question is how we do it.

      •  I object to the expression 'dumped into Medicare' (3+ / 0-)
        Recommended by:
        LillithMc, tardis10, janinsanfran

        Medicare works extremely well and is NOT a place to dump the old.

    •  No. Mandatory use of a Not-For-Profit (4+ / 0-)

      Government program isn't at all dirty.

      It's no different than making someone pay taxes for fire protection.

      Why are you unable to differentiate between government and private corporate interests?

      Or is it just....that the difference doesn't matter to you?

      Mayan culture was strong enough to save the Mayan people from Mayan civilization.

      by JesseCW on Sun Aug 21, 2011 at 09:18:20 AM PDT

      [ Parent ]

    •  Actuarily the more paying in the more stable (15+ / 0-)

      the system. Medicares biggest problem is that it is limited to 65 or older. ACA is a good start and definitely all we could get against entrenched interests. Next is to stabilize the system by adding everyone. Besides it is only fair that everyone get the same care.

      Oregon is talking about single payer as is CA because it will drive down costs of subsidizing the system to the tax payer and eliminate the need to be a full time employee to  receive care. Stripping HC away from employers eliminates the impetus to NOT hire people over 50 and those who may have chronic health issues but can still work.

      I see that as imperative to improve the employment outlook as workers either become more efficient or are being placed in competition with countries that do have  a safe background for all business employee iinsurance. I truly think we need to share the amount of work amongst those seeking work  by reducing hours worked. It is a step we have to take as we did before by setting the 40 hour work week. Small businesses who would most benefit from HC reform will thrive (and small businesses are where most new jobs come from). We can not continue at the number of man hours we currently are locked into without driving consumerism to a unsustainable level. And I don't want to see us continue to use WAR as a method of using up some of that overabundance of man hours and production. The earth can not sustain the resource use that applying  that to everyone would require. The US lives at unsustainable levels.

      Fear is the Mind Killer

      by boophus on Sun Aug 21, 2011 at 10:01:08 AM PDT

      [ Parent ]

      •  Mandatory private insurance is not mandatory (0+ / 0-)

        Medicare.

        •  no, it is what funds single payer or universal (0+ / 0-)

          health care in ALL nations that utilise the system.  In many nations it is also supplemented by private health insurance supplemental systems.

           I suggest you do some research into exactly how universal health/single payer care is funded throughout the world before mindlessly calling for Medicare For All and then screaming that asking people to actually pay for it is not fair and illegal and constitutionality.

          Who do you expect to pay for it?  the employed? from their taxes?  because that is exactly what will happen.

          Are you calling for abolition of the current laws that mandate Emergency care treatment for all?.  do you want to return to the days when the poor, black, and in today's diverse population mostly minority people are turned away at the hospital door and denied treatment?

           Go for it! that will be great propaganda!

          Wake up people and try and know what you are talking about.

    •  Interestingly, the moonbat left continues to flog (0+ / 1-)
      Recommended by:
      Hidden by:
      RunawayRose

      a political and budgetary dead horse.  Any talk of "extending Medicare" is going to be utterly rejected because the current program "as is" is not sustainable.  I have tried time and again to tell you people that the only way Medicare can survive and be expended is to use "Medicare Buy In" (for those below 65) as opposed to "tax supported" Medicare.  Those below 65 would see a 17% decrease in their medical insurance costs IMMEDIATELY.  Medical costs across the board and Medicare costs in particular would then be reduced dramatically simply because the POOL of Medicare insured would be greatly enlarged thus creating a monopsony condition approaching "single payer".   And all of it simply uses market forces with NO forced enrollment and NO additional taxes.  The issue is a Republican Terminator Hammer writ large if we can just get the moonbats to stop screeching "single payer" and get on board with saving the American middle class a pile of money.

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