Medicare into the red this year, bankrupt by 2019

[Forkman]

quote:

---

Originally posted by Al:
[QB] Well its a disaster.... But interestingly the Democrats who said it didn't go nearly far enough now are crying that it costs too much.

---

That's what I find so funny about the whole situation. For years its been "We need to get seniors drug coverage and better overall coverage under Medicare," from Democrats. Now that they've got what they've been championing for years they're suddenly saying that its too expensive. The only way to reduce projected cost would be to force drug companies to sell to Medicare at a set price... and I'm not even going to open that box of worms and the problems it would lead to.

I used to answer calls for the 1-800-Medicare line (gov't contract w/ private company). What a nightmare that was with people constantly calling in and screaming at me about perscription drug coverage. Sometimes they'd be so pissed off that I'd break script and have a serious discussion with them regarding the cost of implementing such coverage, where the money would come from, and how it was inevitable that future generations would be screwed en-mass if something like this passed. Along with the possibility of Medicare going bankrupt if something like that was implemented.

The typical response I got was along the lines of "So what? I don't care about what happens in the future. I want my drug coverage now. I could care less if it goes bankrupt in 15 years I'll be dead before then." Me me me me me me me me me.... pathetic.

quote:

---

TheRepublicans are merely doing as Democrats have done for years- legislating to buy votes. Nothing new here

---

Agreed.

 

[Forkman]

quote:

---

Originally posted by needtoknow:
[] Forkman, the concept that if people would just do this or just do that the world would be perfect is a great idea but is not reality.

---

True, but not holding people responsible solves nothing and simply implies that it really isn't there fault and that there is someone else that they can point their finger at and lay the blame at their feet.

quote:

---

Somehow protecting Drug companies from Medicare negotiating lower prices does not make any sense. Do we ban the military from negotiating the best price?

---

Negotiating a better price is fine. Legislating one (with cost caps) is b.s. and will drastically reduce R&D into new drugs... laugh all you want, I've looked into it and often some of the high cost is justified to recoup development expenses. As far as the military negotiating the best price... have you ever really looked into military procurement proceedures... years and years of red tape before weapons systems are finalized and deployed. They don't look for the best price either. They look for the best end product.

quote:

---

Also giving millions directly to drug companies and HMO's and not using that to either reduce the cost of the program or give better coverage also does not make sense.

---

Please expand on this point, as I'm not exactly sure what you are referring to.

quote:

---

The US has the higest healthcare costs of any western nation, this in a country that prides itself on creating an efficient business climate. I also don't think you really believe that Democrats invented subsidies but I'm willing to look at the evidence. ]

---

I'm not pointing the finger at anyone in particular, I'm pointing the finger at everyone who's led us down the road of this f-ed up mess. Those who fought for a system like we currently have and those who stood idly by and said nothing because they didn't want to commit political suicide. I also point the finger squarely at "the public" in general for being a bunch of half-wits that will swallow promises of a never ending supply of golden eggs despite the fact that the goose has been ill for quite some time and is now knocking on deaths door and they all know it.

You mention the high cost, and yes it is higher than it needs to be. Some of the cost could be eliminated by stream-lining certain things (most notoriously all the bureaucratic paperwork - witness the new HIPAA laws that went into effect recently). Ultimately though our costs will always be higher than other nations because we don't ration health care. If you can afford it (either directly out of pocket or through a good insurance plan) you get it now, when you need it. I urge you to look closely and with a critical eye at systems such as Canada's and the UK and just how much rationing is done and how long waiting list for simple proceedures are... its shocking.

 

[needtoknow]

Forkman,
Here's the expansion to my point about money to HMO's and Drug companies.

From USA Today
(in reference to Medicare Bill)
Winners

1.The makers of name-brand prescription drugs will be big winners. They once fought against a Medicare drug benefit for fear that it would prompt the federal government to impose limits on drug prices, as foreign governments do. That's also the case now for drugs distributed to veterans by the Veterans Affairs hospital system and to the poor through Medicaid.

But the drugmakers and their powerful trade organization, Pharmaceutical Research and Manufacturers of America, won a critical provision from Republicans that prohibits the government from negotiating prices or discounts. That will be left to private insurance companies and drug middlemen, known as pharmacy benefit management companies. Critics say that forces Americans to continue paying the world's highest drug prices. Perhaps reflecting the good prospects, drugmakers' stock prices rose Monday.

2.Pharmacy benefit management companies, which currently handle drug claims and some mail-order services for employers and health insurers, stand to gain. They are likely to be tapped to negotiate with drug companies on price. They may also provide mail-order drug services for seniors who enroll in the drug plans.

3.Doctors will be winners because they'll get more federal money. The American Medical Association will win increases in compensation rates for doctors who treat Medicare patients. Instead of a scheduled 4.5% rate cut that was scheduled to take effect Jan. 1, they'll get a 1.5% increase.

4.Rural hospitals will get $25 billion in higher payments to compensate for a low volume of patients and a disproportionate share of low-income patients. Small urban hospitals that have a disproportionate share of low-income patients also will get higher payments.

5.HMOs and other health insurers stand to gain business and federal aid. These managed-care plans will be encouraged to create private alternatives, subsidized with $14.2 billion from the federal government, aimed at coaxing seniors out of traditional Medicare. Insurers also will receive incentives to offer new stand-alone drug policies for seniors not in managed-care plans.

6.Employers that offer health plans to their retired workers will qualify for federal help. The bill sets aside $86 billion in subsidies and tax breaks over 10 years to encourage them to maintain those benefits.

7.Affluent workers could save more money tax-free. The bill will create new Health Savings Accounts that will allow all taxpayers, not just seniors, to save and withdraw money tax-free for medical expenses. Taxpayers who opt for high-deductible health insurance plans could put aside up to $5,150 for a family policy, increasing annually with inflation. Critics say it's another way for the wealthy to shelter income from taxes.
end quote

As far as how large a profit the drug companies need to recoup R&D and how the whole drug pricing/R&D/marketing system works, I suggest a whole new thread on that one. I do remember that shorly after the Drug Companies were allowed to advertise drug prices went up about 30% to pay for the ads. Is that efficiency?

Every system has "rationing", here we choose price and access, in countries with government run systems the rationing is usually need. So I guess we might argue which makes more sense. In Canada there is a system to assess need and Canada does not have nearly as much high tech equipment such as MRI's as the US. The hospitals in Canada are also better utilized and with larger patient loads which helps distribute costs better. The wealthy of course have access to the US system if they want instant care. The key difference is attitude for both systems, in the US healthcare is considered an income generator and in Canada it's considered a social cost. You will find Canada's (government run) system far more cost conscience and cost effecient. It's not perfect, but given our system here where nobody is happy, except those making the profits, their system certainly merits consideration.

[ March 26, 2004, 09:43 AM: Message edited by: needtoknow ]

 

[needtoknow]

I wasn't saying 1 thru 7 was all bad but I did not want to edit the article even though it went beyond my comment on money for drug companies and HMO's. The comment about #7 I guess was that a lot of people cannot even afford basic care so how are they going to put away much if any for medical expenses. Do you have comments on 1-6? I'm not in favor of the present MSA system either quite frankly. Every anniversary my wife and I look at the option and figure it's a crap shot, literally. Something Vegas would come up with. At present we don't have much in the way of health costs except of course for premiums. I hope all those sick people are enjoying our money

.

 

[Forkman]

quote:

---

7.Affluent workers could save more money tax-free. The bill will create new Health Savings Accounts that will allow all taxpayers, not just seniors, to save and withdraw money tax-free for medical expenses. Taxpayers who opt for high-deductible health insurance plans could put aside up to $5,150 for a family policy, increasing annually with inflation. Critics say it's another way for the wealthy to shelter income from taxes.
end

---

Well, that is certainly better than the current system where money in MSAs simply goes *poof* if its not used up by the end of the tax year.

Its a way for anyone to shelter income from taxes not just the "evil" wealthy. However, rules may change for these accounts in the future. Currently there is a tax penalty for withdrawal prior to 59 1/2 unless it is for medical expenses. When you hit 59 1/2 you can withdraw the money in the MSA paying tax only on gains.

I can't believe people want to ***** about what amounts to an additional retirement vehicle available to anyone, including the self employed that will help bolster retirement income (assuming you can leave most of it in there till age 60) on top of the pittance from Social Security.

The rest I'll address later as I have to get ready for work right now NTK.

 

[Gary Allan]

quote:

---

I guess I'm just old fashioned thinking that people should be held responsible for their own actions and making the correct decisions instead adopting the "its not my fault" attituded and looking for a convenient scapegoat.

---

I guess I'm just old fashioned in thinking that I hold our corporate and other institutions to those same standards and ideals. Individuals make those choices to make unhealthy lifestyles compelling. How do you get them to pay for their acts? Give them a bonus for great sales of known harmful agents? Admire them and say "Good work!"? Give their share holders a dividend and a good PE ratio? Where is your critique of them?


Forkman ..I'm all for "personal responsibility. There is also socially responsible policy.

Should lawn darts still be on the market? How 'bout the original Pinto? How 'bout radium dials on watches? These things were all marketed via our free market = free enterprise system and all the consumers who used these unhealthy items had free will in buying them. Was the consumer a "slug or a dullard or a buffone ..a slacker" for not thoroughly understanding the consequences of engaging in such purchases? Did they have the ability or knowledge or compulsion to effectively grasp the potential consequences of these purchases?

You can blame the individual for making bad choices. However I would submit that when you have a nationwide problem ..it's not just a problem ..its a symptom of social flaws that can not and will not be corrected by just saying "it's your fault, you ******* !".


The Human life expectancy hasn't changed a whole lot. It has only been the elimination of most of the infectous deseases that has accounted for this statistical anomoly. It's basically in the genes.

So ..when you're complaining about the cost of your minimal EXPENSIVE care (under medicare or any other system) ..you'll be a burden on those who are not using it. Shall we blame you for not maintaining a perfectly functional body? Your parents for not having the insight to make the right choices in "genetic hygiene"? Evolution for not filtering you out via natural selection? After all ..you are a burden ..just not as much when compared to some others.

One viable alternative is to abolish all these systems and let market forces control the access to medical treatment. You, since you maintained such great control over your health, ...could simply opt out and retain all your money in avoided costs. We could make this a "right choice" for someone like yourself. You wouldn't be dragged down by the "defectives" (both of lifestyle AND genetics). Then natural section would provide all the solutions. Those of means could alter this process ...and those of no means ..will just die. They'll die anyway ..so what the heck?

This type of disposition toward humanity will instill the desire, and the will, to always do their best and always make "the right choice" and save us all a bunch of money.