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View Diary: WH Advisor David Plouffe and Goldman Sachs CEO Agree That Medicare and Medicaid Must be Cut (614 comments)

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  •  I agree with most of what you said (0+ / 0-)

    I think at least a certain number of primary care visits should have no copay. But most ongoing problems that require frequent doctor's visits require frequent visits to a specialist, not a primary care doctor. I would not oppose all copays for specialists, but that needs to be capped, because otherwise, even small copays really add up.

    Before I went back to school, I had very good insurance, and copays were only $5. Even still, physical therapy visits added up because I had to go 2-3 times a week. Now I have shitty student insurance that has a $30 copay for specialist visits, and I just deal with the pain because I can't afford to go to PT on a regular basis.

    I think the Bush tax cuts on top earners absolutely need to be restored to at least Clinton-era levels, if not higher. But I know that we won't get that unless we agree to some entitlement reform.

    I do see your point about not wanting to turn Medicare into Medicaid. I don't believe in means testing overall for the program, but I think wealthier seniors can afford to pay a little bit more for certain benefits. There needs to be some sort of incentive for patients to ask their doctors whether all the tests they want to run are really necessary, because the current system incentivizes doctors to do tests and even procedures that are unnecessary and may even be harmful to increase their bottom line.

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