Posted on 04/29/2008 7:08:28 PM PDT by libertarianPA
WASHINGTON (Reuters) - Medicare is lurching toward disaster and it is too late for the Bush Administration and Congress to do anything about it, U.S. Health and Human Services Secretary Michael Leavitt said on Tuesday.
He said the next administration will have to act to stop rising costs and get control of the $400 billion federal health insurance plan for the elderly, which now covers 44 million people.
"Higher and higher costs are being borne by fewer and fewer people. Sooner or later, this formula implodes," Leavitt said in a speech to the right-leaning Heritage Foundation and American Enterprise Institute think-tanks.
"There is serious danger here," he added. "Medicare is drifting towards disaster."
Leavitt's speech echoes repeated warnings from other federal government officials who have noted that Medicare spending is projected to be 3.3 percent of gross domestic product in 2009.
A separate report released on Tuesday from the National Cancer Institute estimated that Medicare spent $21 billion on cancer alone between 1999 and 2003.
"The disaster is not inevitable. If we act now, we can change the outcome. In health care, the core problem is that costs are rising significantly faster than costs in the economy as a whole," Leavitt said.
But the administration of President George W. Bush and the current Congress are out of time, Leavitt said.
"So, given the strong possibility this won't get fixed in the next 266 days, I would like to add some general advice on the creation of a political construct for action and a general strategy to solve the problem," Leavitt said, saying he was speaking as a Medicare Trustee and not as a government official.
Leavitt said paying for each medical action separately is wasteful and "it often results in bad referral decisions, sloppy hand-offs, duplications, fraud, and poor quality of care. The result is inappropriate care and unnecessary cost."
Last week the Government Accountability Office blamed HHS in part for this, saying the agency had not used its powers to force hospitals to provide better care and less waste.
"It troubles me that this matter is not receiving more attention in the presidential candidates' discussions. The next president will have to deal with this in significant part," he said.
Oh well. Just throw more money into it. Problem solved.
If you haven’t saved enough to pay for your own medical care by the time your in your 70s well then its time to slip away quietly.
This is somehow a shock?
Well, perhaps to the assorted statist scum who can't add 2 and 2 and get 4 twice hand-running, as for instance this bureaudork.
How can you tell Medicare is wasteful? Just watch the TV ads for “free” electric scooter-chairs, “free” diabetes supplies, “free” oxygen supplies, etc.
The costs will be controlled by major hits on reimbursement to hospitals and patient care providers....until the point that hospitals collapse, and physicians refuse to accept new medicare patients due to reimbursements not being sufficient to cover the costs of providing the care demanded.
It ain’t going to be pretty, but Medicare will go the way Medicaid is going now...which is bankrupt.
Truth be told, if you don’t win the “health lottery” and do require any medical procedures, you won’t have saved enough to pay for it without some sort of insurance. I had a friend tell me today that she received her hospital bill for a 5 day stay which included surgery for an emergency bowel problem. The bill was for $67,000. That’s for 5 days in the hospital. And since she’s been home, she’s having to have a liquid IV diet which runs around $2,000 per week. Unless one can guarantee they won’t have illness (and no one can)...saving up will not help that much.
My dad received a free scooter even though his doctor would not approve it. He really has no need for it because it is too big inside the home and he does have a van to put it in. The cost was covered by Medicare and his GE health care. What a waste!
The problems with Medicare are much deeper than wasteful spending. Medicare and Social Security are generational Ponzi schemes. The tsunami of coming retirees will overwhelm these programs. A combination of massive tax increases and benefit cuts are coming. Health care will simply not be available to the elderly in 20 to 25 years as it is now available. Hopefully other countries will have excess capacity that can be utilized assuming the dollar does not collapse.
I cannot understand why the boomer generation has not revolted about the coming disaster in entitlements. The greatest generation has refused to allow changes to fix these programs. Privatization, personal savings, and lower taxes were the only answer. It now seems too late to avoid a disaster.
Universal U.S. Healthcare "drifting towards disaster": U.S. official
I quite agree. But many people have been forced to pay huge sums into the Medicare system for OTHER people’s medical care, that they haven’t been able to save enough for themselves. It’s time to stop this scheme, and stop promoting the idea that everybody has a right to all the medical care they can possibly benefit from, regardless of whether they are able to pay for it. We increasingly have hard-working responsible people, who take responsibility for their own financial well-being and healthy lifestyles, forced to subsidize those who who spend most of their waking hours lounging in front of the TV stuffing themselves. This is simply unsustainable, and the longer it goes on, the uglier the end will be.
Yup...health care is expensive...even moreso because there are many people that do not pay a dime to get their health care.
And, what is more important than someone’s health anyway?
Don’t get me wrong, I know the sticker shock involved...my daughter away at college had a kidney stone (we thought it was appendicitis), and her 4 hours in the ER and diagnostic tests etc was $4,000 (reduced of course by the facilities engotiation with the health insurance to about $2800).
But people DO NOT save for the health insurance costs or medical care at all for the most part.
They have no problem taking out a $50,000 loan for a car, a loan for a large house, paying for cellphone service, season sports tickets, vacations, dining out, cable TV, satellite TV etc...but when do you hear anyone say “you know, in addition to retirement I put some money away in case I get sick”? Heck, most people don’t even save enough for retirement!
There are plenty of people that are just betting that they get to Medicare age before they get sick...and for most it works out. But if it doesn’t, they express dismay at the cost of the bill despite knowing that it’s expensive. Further, if anyoen thinks that Medicare is going to continue on in it’s present form, and social security for that matter too, they’re not seeing the big picture.
People look at a bill and say, how can that be? Well, really it ain’t that hard to understand.
Some people pay nothing (self pay without assets and medicaid), hospitals and providers lose money hand over fist to provide this care....mandated by, you guessed it, the government. Not only do they mandate that we provide the care, but they make the federal system’s regulations nebulous (like the tax code) and then accuse both of fraud in billing. Throw on top of that piles of government regulation, malpractice costs, record keeping costs and you start talking some serious overhead. Technology is VERY expensive too...an anesthesia machine costs more than a decked out BMW and while I have no idea what an MRI or CT Scanner costs, I’m sure it’s well over a million dollars. Who pays the people to be on call for your friend’s ‘emergency’ surgery too, whether someone comes in to the facility with an emergency or not?
Not ragging on you, I just get exasperated sometimes with the constant displays of astonishment when they get a hospital bill...HEALTH CARE IS EXPENSIVE, and cost containment that is not market driven will decrease the availability and quality of the care available.
Most people who work and handle their finances prudently, and also maintain a healthy lifestyle, could afford to pay for private medical insurance throughout their lives (REALLY private, not the government-hyperregulated stuff that passes for “private” insurance these days), if they hadn’t been forced to subsidize other people through both government programs and government regulation of private insurance that drives costs through the roof.
Because they are being fooled...
They think they can see the finish line just ahead...but the government is just going to keep moving the finish line further away as they approach...there are going to be some very unhappy people in the next decade or so.
So because I couldn't work much past age 44 due to medical problems you are advocating killing me by withholding medication in a few years? I thought your type commited suicide in the Führerbunker in 1945.
Xer Ping
Ping list for the discussion of the politics and social (and sometimes nostalgic) aspects that directly effects Generation Reagan / Generation-X (Those born from 1965-1981) including all the spending previous generations are doing that Gen-X and Y will end up paying for.
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Our solution (my husband’s and mine) is never to retire, LOL. Neither one of us would be covered for certain things under a private health care policy (we both have pre-existing conditions...he was unlucky enough to have a sports injury at a relatively young age and require a hip replacement, so any complications with that and there likely will be as he ages wouldn’t be covered...I have MS, and that’s a whole other story.) We aren’t counting on Medicare, and we do save a large portion of our paychecks. But we will probably need to stay covered under a group policy in order to have our existing medical conditions covered, so the obvious solution is to avoid retirement!
You cannot be serious.What if you need kidney dialysis or a heart transplant? What if you get severe burns and are laid up for months? How much would you have to save up for that? Then you also have to save for retirement, plus college for two kids. Sheesh you'd need 2 millon or more. Not everyone is cut out to be a millionaire tycoon wage earner.
There's Oprah, there's your barber, and the guy who paints your house. All work hard. What you are saying is that Oprah lives if she gets old and needs a heart transplant...she can pay for it. But if the postman needs one when he gets old...too bad, he can't afford it...death for him.
Is it a conservative principle that it is your tough luck if you are just an average Joe wage earner and get old and sick and can't pay all your medical bills? My mother-in-law would have died, 15 years earlier by your view.
Soylant Green solves it all.
In an ideal world, people would save for their old age when they are young and healthy. Health insurance would be for catastrophic care so that you are not wiped out by large medical expenses. You would pay for routine care without third party payment. For health care in old age, one would purchase a retirement account to provide some level of health care benefits beginning at some age. Of course, there would be a safety net of health care welfare for those who cannot pay. There would be strong incentives to restrict usage of health care welfare.
Of course, we do not live in an ideal world. Even in this non ideal world, health care is not denied. You will get treated even if you canont pay. The issue is payment, not health care.
I reject the notion that health care is a right. Health care is an economic good and service subject to basic economic laws. Making health care a right will lead to rationing by government regulators. I prefer to increase the role of individual consumers in health care decisions and payment. In most cases, health care welfare should be means tested and time limited.
I’m not advocating killing you, I’m advocating not using my tax dollars to keep yourself afloat, and I really don’t appreciate the nazi implication its immature and irrelvant.
Your assuming the government is the only way you can get medication, there are charities and if this whole Medicade fiasco was written out of the books health care would cheaper for everyone.
Now let me compare what I think to what a nazi would.
Nazi: “You can’t work I’ll ethnically cleanse you.”
Me: “Government solutions like this are inefficent and cost working class people large amounts of money they don’t have. You should be saving for your own retirement and medical care”
Ass
And how many years did the world survive before Medicare and hospitals?
If you haven’t saved enough to pay for your own medical care by the time your in your 70s well then its time to slip away quietly.”
What about all the money you paid into SSI that you’re never going to see?
And how many years did the world survive before Medicare and hospitals?
Do you think the world is the same place now?
Last time I looked it was still earth.
Last time I looked it was still earth.”
Wow, great non-committal, non- answer.
Sorry, at this time of night I don’t have the strength for great debates. I’ll be heading for bed soon.
The world survived, but a lot of people died young.
I guess enough lived to carry it on. :)
So your suggesting everyone should have saved hundreds of thousands of dollars for their old age health care?
Thanks for the laugh.
That's not always the case. Many of my friends (college students and recent graduates) almost never see the doctor or go to the hospital but have to pay insurance premiums and Medicare taxes anyways. The reality is that Medicare, like Social Security, is a generational redistribution of wealth from younger or middle-aged citizens and taxpayers to the "elderly" and "retired."
I predict massive and severe tax increases. There may be reduction in benefits, but older, retired folks will not give up on their entitlements, especially since they believe that they are simply getting back what they paid for, through taxes, and they will voluntarily damn the younger generations if they must.
I think if you dug down into the numbers, you’d find that Medicare isn’t an intergenerational wealth transfer at all, but rather a transfer from the working classes (especially the middle and upper classes who work) to the non-working classes. All you need to get on Medicare is to get kidney failure, even if you’re 20 years old. And the welfare class has a huge incidence of self-inflicted diabetes and accompanying high blood pressure, which most refuse to manage effectively, even when Medicaid is willing to pay all the expenses.
So huge numbers of them come down with kidney failure way before reaching the age threshold for which Medicare has been sold to voters, and immediately start getting full coverage for EVERY medical condition, in addition to dialysis and other kidney failure treatments. Most of them are obese and smoke, so they have a long list of medical problems, and if they ever worked, it wasn’t for very long, because they went on disability welfare early in their adult lives, and wasn’t at an income that involves paying much tax of any kind, since they’re poorly educated and not any more motivated to succeed at a career than to take care of their health. This is largely being paid for in taxes on middle-aged and older workers’ earnings, and retired people’s investment and pension income.
You make a good point, though Medicare eligibility is generally limited to age 65 or above, kidney failure can also make an individual eligible, regardless of age. Some FReeper should dig into the official numbers and chart which groups are getting payments, the geographic distribution of payments, etc. for both Medicare and Medicaid (the low-income, means-tested health care program).
“It ain’t going to be pretty, but Medicare will go the way Medicaid is going now...which is bankrupt.”
Yep. The only caveat I would add is that currently doctors can refuse patients. Hospitals can not. The conventional hospital will be closing but true private hospitals will start opening. We already see this in standalone ER’s, surgery centers, etc. that won’t take Gubmint insurance.
People had better wake up for there own sake, regardless of their country, as the seams are starting to rip. As goes medicine, so goes America.
Per this link http://www.statehealthfacts.org/comparetable.jsp?ind=292&cat=6 in 2004 15.7% of Medicare enrollees were under 65. Given the fast-increasing rate of diabetes and resulting kidney failure, I expect it’s higher now. But more significant is the demographics of the underage group, which is certainly overwhelmingly the low- or no-tax paying segment of society, since that demographic profile is already well-established as very disproportionately accounting for the high incidence of diabetes.
It would be interesting to see what percentage of Medicare-covered people actually get out more than they paid in over a lifetime (including the investment return they would have gotten, had they kept the money and invested it in conservative and safe instruments). I’d be surprised if at least 75% aren’t taking out more than they put in. Classic case of people voting themselves other people’s money, with politicians’ encouragement.
We’re also seeing some states acting to bar private hospitals from opening, other than the kind of “private” hospitals that are designed around catering to Medicare and Medicare patients.
In fact, Thomas Jefferson, while commenting on the Founder's division of federal and state powers, noted that the Founders had trusted the states, not the federal government, with the care of the people. See for yourself.
"Our citizens have wisely formed themselves into one nation as to others and several States as among themselves. To the united nation belong our external and mutual relations; to each State, severally, the care of our persons, (emphasized by Amendment10) our property, our reputation and religious freedom." --Thomas Jefferson: To Rhode Island Assembly, 1801. ME 10:262 http://tinyurl.com/onx4jThe bottom line is that the people need to reconnect with the intentions of the Founders as reflected by the Constitution and its history, particularly with respect to the requirement for constitutionally enumerated federal government powers which reasonably justify federal spending. The people really need to get in the faces of members of Congress who are foolishly following in the footsteps of FDR's dirty, Constitution-ignoring politics, demanding an end to unauthorized federal spending and an appropriate lowering of federal taxes.
I agree with you, FRiend; however, that train left the station long ago. Some would trace it to Pre-WWI, while others would look at the War for Southern Independence. Regardless, this has not been our Founder’s Republic for greater than 4 generations. Most folks cannot name one Amend. of the Bill of Rights.
The chances of rallying around the Constitution are about as likely as rallying around Liberté, Egalité, and Fraternité.
“the people need to reconnect with the intentions of the Founders as reflected by the Constitution and its history...”
“The people really need to get in the faces of members of Congress who are foolishly following in the footsteps of FDR’s dirty...”
The people have little incentive to make trouble and have a substantial risk of receiving pain. The people would rather stare at LCD American Idle (no pun), and eat Dominoes.
That is only sort of true....
If I am on staff at a hospital, most hospitals will require that I take 'call' for emergencies as a part of my privileges. When I am 'on call', I usually have no right of refusal to see patients based on financial/insurance status. So any hospital-based physician kind of has their hands tied...and this is why there are often hospital/physician agreements with income guarantees or stipends etc, because without them, if the hospital had a bad 'payor' mix, no physician would probably work there. Hospitals don't make physicians 'whole' but they at least try in most cases to soften the blow.
But that money has to come from somewhere...and the government's constant squeezing of hospitals and physicians reimbursements cannot go on forever. Eventually hospitals close and physicians/staff move on to some place that isn't overrun with no pay/medicaid/medicare patients.
If everyone knew the half of what the government already does to screw up healthcare, they wouldn't be so fast to clamor for more government control.
ping
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