How to Fix Medicare

Conservatives have been obsessed with destroying the social safety net ever since FDR introduced Social Security back in the Depression-era. Their fury has only grown ever since President Johnson’s Great Society introduced Medicare, the program that helps seniors pay for medical care, in 1965.

Lyndon B Johnson

Lyndon B. Johnson

The other program that drives conservatives to the brink of insanity is Medicaid, a program that helps mostly children living in poverty obtain medical care.

The President is forthright in his refusal to consider turning Medicare into a voucher program, something that Paul Ryan, Romney’s Presidential running mate has proposed in the past. Vouchers would create enormous burdens for the elderly in their twilight year, and force many of them back into the workforce at a time when their physical capabilities are waning. Taking this route would ensure that many seniors would face bankruptcy when they could no longer afford to pay a premium to cover the shortfall in their medical plan.

Medicare is an extremely well run program, that has helped keep millions of elderly Americans out of poverty. The irony is that many of those seniors voted for Romney, who would have increased their contributions to their medical.

The Republicans want to put “entitlements” on the table in their negotiations over the fiscal cliff. They want stiff cuts in these programs in lieu of raising taxes on the wealthy. Instead of making the rapacious monetary predators that dominate a tiny slither of society pay more for the society that makes it possible for them to be wealthy, conservatives want to take money from some of the most defenseless members of society.

There are a number of ways to make Medicare and other social programs more efficient, and more solvent without bankrupting the state. The President has a sensible proposal on the table to ensure the solvency of Medicare.

Firstly, the President suggests that we should look at providers that are charging more than is required to care for patients. This is quite common. I have encountered it myself, when I had insurance. I went in for a procedure and the doctor wanted to charge, lets say $3000. The insurance company paid him $900. If I had been a private patient without medical, I would have ended up paying the full $3000. There ought to be a standard list of fees that providers can charge, adjusted for inflation. Providers are taking advantage of medical schemes and charging exorbitant fees. Medicare should be able to negotiate these payments.

Secondly, the President suggests that payments to providers should be altered for those patients that cannot afford deductibles or copayments. Some seniors could be denied care if they are unable to pay these costs. Currently, it seems that the government picks up that cost. That should stop.

Medicare has the ability to negotiate lower prices for prescription drugs. As the largest insurance plan in the nation, Medicare has enormous influence with drug companies. This should be used to pull prices down. In other nations like Canada, drug prices are far lower.

There is no reason that we should continue to finance drug company profits at the expense of the economy, or of seniors. To my mind, if drug companies, many of whom benefit from government research, are unwilling to lower prices, nationalize them. Peoples lives are always more important than corporate profits.

The president has also proposed that there ought to be a means test for Medicare benefits. Those who are wealthy, or have high incomes ought to pay for their own coverage. They are a drain on the system, and they can afford to cover themselves. We can reduce the federal subsidy for those people, just as we should be dramatically raising their tax rates.

In addition, certain beneficiaries choose Medigap plans, a supplemental insurance. These beneficiaries do not have an incentive to consider the costs of their coverage. The president proposes introducing a premium surcharge which should give these recipients an incentive to more carefully consider the costs of health care.

The president very sensibly suggests that to contain the rapidly rising cost of health care, we should implement wellness programs, or preventive care programs before the problems become too entrenched. Encouraging people to get regular medical checkups would go a long way to bringing down the costs of Medicare. Regular screening for both children and adults will improve health outcomes and reduce health care costs. Early detection of serious problems like diabetes and heart disease would go a long way to ease the stresses on the system.

The idea that we could reduce medical costs by making the system more efficient just does not seem to occur to Republicans. Their entire ideology is about forcing people to turn to market solutions and not to the government. It is the kind of thinking that would have society dispose of most of its citizens, who to conservatives are deemed worthless, moochers, or drains on society.

There is no other rational perspective that would explain conservatives insistence on destroying programs that are favored by the overwhelming majority of society. It is clear that conservatives want to destroy the Middle Class, and their democratic rights.

When people pay into an insurance scheme their entire working lives, it is disreputable for Congress to threaten to cut that program. Instead of attempting to find ways to make the program more efficient, which is what the President and Democrats are proposing, they just want to shred the safety net.

I would hesitate to say that it is something that they want to do out of spite, but if the shoe fits. What other reason could they possibly have for hurling greater numbers of people into poverty? Should they not be doing everything in their power to make sure that the program stays alive to help people? Are they really so enamoured of the wealthy and the powerful that they want to destroy those institutions that have served the citizens of this nation so well for so long?

There is another way that they could make this program solvent for a far greater period of time. Two ways, actually. First, increase the percentage that people are paying in to the system. Are people not willing to pay an extra half percent of their salaries to make sure that the elderly are covered, and that they will be covered when they  retire?

The second way to do it is to drop the cap on payments into the system. If all income were subject to the tax, the program would never need to go insolvent. But of course, Republicans don’t want their poor wealthy cohorts to feel the pain of paying a little more. They would far rather throw the entire population under the bus than hel their own citizens. They ought to be ashamed of themselves.

Another solution that no-one appears to have considered is really very simple. If people exercised more, and were encouraged to eat healthier food, medical expenses would drop precipitously. That, of course, would require Congress to tackle the food industry and force them to produce healthier options for consumers. This is about as likely to happen as being struck by a meteorite, and is probably as far from the current discourse as the Van Allen Belt is from Earth. Let it not be said that rational discourse is in fashion in this Congress.

What Republicans want to  do, as their solution to the problem is to raise the retirement age. It has been pointed out before, by people like Paul Krugman, that raising the retirement age would put an unbearable burden on people at a time when their income is falling, when their health is failing, when their bodies are weakening. This is not the time to put additional burdens on the people.

A construction worker cannot continue to work indefinitely. Construction is a physically demanding job, and bodies fail, and break down. The same can be said for a steelworker, a pipe fitter or welder, or someone who needs to stand for eight hours each day. To ask people like this to work for another two or three years is unconscionably cruel.

This is the conservative ideology, that people should just be discarded when they become old or infirm, that we are only here to serve the corporations and the wealthy. It is another form of slavery, a cruel, heartless ideology that has no place in a civilized society.

Obama and the Democrats should reject any attempt to destroy the social safety net. The lives of every person in this country depends on what this President and this Congress does next. As a liberal I refuse to accept any deal that includes cuts to essential social programs. As far as I am concerned, take it out of the hides of the wealthy.

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