Monday, August 24, 2009

Intensive Medicare

Medicare is a classic example of one of those "there are two sides to every issue" issues. This, in that, while, yes, it continues to be a popular program with relatively low administrative costs, it's also a program with some serious deficiencies.................................................................................For one thing, while it may in fact be popular with patients, it isn't even remotely popular with providers. The reason for this, folks, is that Medicare, flat-out, is a free-loader. It has consistently been underpaying service providers for years. Now, clearly, this may not be a big thing when patients have secondary insurance (Medigap). BUT when they don't, a lot of times doctors and hospitals end up eating the difference. Or....they end up raising prices overall, passing the rates on to those of us with better insurance. Seen from this perspective, private insurance companies have actually been picking up the tab for Medicare..................................................................................As for these relatively low administrative costs of Medicare, that, too, is utterly misleading. For example, the last time that there was a formal report on Medicare fraud....WAS 1996! And, yes, during that time, the Inspector General of the Department of Health and Human Services estimated that Medicare made approximately 23 billion worth of improper payments (over 10% of Medicare costs for that year). So, sure, the administrative costs are low. But, so, too, is the frigging oversight!..................................................................................Of course, the most shocking aspect to this story is that increasingly more and more physicians aren't even accepting Medicare anymore. Not that it's yet anywhere near as bad as Medicaid is (where damn near close to 50% of doctors refuse to participate), mind you, but, still...............................................................................And don't even get me going on the extreme paucity of cost controls with Medicare. This, I'm saying, in that, while, yes, they do in fact undercut the medical community on basic care, they also do NOTHING in terms of comparative analysis. For example, say that there are two medical procedures, equally effective, one that costs $5,000 and another that costs $20,000. Medicare consistently will cover the more expensive one (though, yes, they obviously will under-reimburse as well). This, while the system is clearly heading for bankruptcy. It makes no sense, I'm telling you.......................................................................................P.S. This admittedly strong critique of Medicare is in no way an attempt to glorify/support private insurance companies. Clearly, they do not in any way have a spotless record, either. My only goal here was to throw a little perspective into the mix, put forth a strong counter to the liberal mantra that Medicare is peachy-keen, etc..

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