All posts by health_citizen

An Honest Conversation About Medicare (ALEC alert!)

Note that this poster has been exposed as an agent of ALEC, trolling for gullible readers who might be ‘turned.”

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Lately both major political parties in Vermont have been competing to prove that they are the stronger defender of traditional Medicare.  Any policy that might potentially address some of Medicare’s many flaws is characterized as an attack on Vermont’s seniors.  It’s time to get beyond the rhetoric and have an honest conversation about Medicare.  

I do want to mention that I am not raising these problems with Medicare because I am against universal health care.  I believe we can provide universal health care to all Americans in a more cost-effective manner than we currently do and achieve better health outcomes.  So my critiques of the Medicare program have nothing to do with its aims.  It’s just that there are many flaws in the current Medicare program.

1) Medicare is rife with fraud:

In 2012, former CMS Director Don Berwick (a fervent supporter of government-run health care) and Andrew Hackbarth of the Rand Corporation estimated that 10% of Medicare spending, $98 billion annually, goes to fraud.  This is due to Medicare’s “pay and chase” system.  Medicare pays claims without question to speed up the payment process and tries to “chase” down fraudulent payments after the checks have been cashed.  

2) Medicare Part A (Hospital Insurance Trust Fund) will be Insolvent by 2026:  

Medicare has an independent advisory board, the Medicare Payment Advisory Commission (MEDPAC), made up of some of the brightest and independent health care thinkers in the country.  In their March 2014 report to the U.S. Congress, MEDPAC explains that Medicare Part A will become insolvent by 2026 because of “the sustained increase in the number of Medicare beneficiaries.”  

3) Medicare Can’t Negotiate for Prescription Drug Prices:

The Medicare program is not allowed to use its enormous purchasing power to negotiate for lower prescription drug prices.  That means the per unit prices for prescriptions is the same for Medicare if it is paying for 1 pill or 1 million pills.  No one who honestly believes in free markets could support this restriction.  The Congressional Budget Office estimates changing this provision will save Medicare $15.5 billion per year.

4) Doctors Set Their Own Prices in Medicare:

The major trade association for doctors, the American Medical Association, has established a 31-member committee entitled the Relative Value Update Committee (RUC) that decides the value of all procedures performed by doctors in Medicare.  They essentially set their own prices with impunity.

It’s no surprise that Medicare Part A is going bankrupt when there is so much fraud in the system and taxpayers are paying highly-inflated prices to pharmaceutical companies and doctors through the program.  Let’s have an honest conversation about Medicare.  It needs to be drastically changed to remain solvent.  Let’s return Medicare decision-making to the states by using the Health Care Compact as a tool to provide better care to our seniors at a lower cost.  

Dave Sterrett, Esq., a health care advocate and attorney, is Principal at the Health Care Policy Group and represents the Health Care Compact.