Medicare, an effective program, turns 46

  • Article by: ANN SETTGAST
  • Updated: July 30, 2011 - 8:32 PM
  • 13
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bernice3Jul. 31, 11 1:52 AM

Dr. Settgast is SO right. Medicare provides the peace of mind that comes from knowing you can't lose your insurance, you are not limited to a "network" of physicians and can see a specialist without a referral when you need to, you and your doctor decide what care you need -- not an anonymous "denial specialist" working for a private insurance company who can refuse to honor your claims.

crystalbayJul. 31, 11 8:58 AM

Until two years ago, I was paying $250/month for a 10K deductible. Knowing that probably all medical expenses would be out of pocket (barring a catastrophe), I rarely sought medical attention. I now pay a bit less than my old monthly premium, but have 100% coverage. It is the first time in my 67 years that I haven't felt anxious about my financial health. I wish all Americans could live like this. Medicare is great.

easyrider121Jul. 31, 11 9:07 AM

It is effective. Effective at bankrupting the country by people who think they are entitled to "free" everything.

kil7676Jul. 31, 1112:19 PM

I respectfully and wholeheartedly disagree. Medicare is responsible for our health care crisis. The government has to be all in or all out when it comes to price-setting. Medicare and Medicaid reimbursement rates are artificial and significantly lower than appropriate, an impetus for excessive utilization and cost shifting to private insurance. Some providers supplement lost income by owning machines and therapy centers to which they drive utilization to make up for what insurers and our government do not pay. Partial government intervention caused market inefficiency that has only been exacerbated with consolidation of health providers and insurers. Since the introduction of Medicare our system converted from a system that cures and prevents to one that treats and manages. I am haunted by how my mother is treated in our system. She sees various doctors for various problems, none of them coordinate with each other. She takes a handful of pills every day that probably do not interact well together. Her doctors shuffle her in on a weekly basis. Why? To make up for what Medicare doesn't pay and to maintain a steady income (repeat customer). This wouldn't happen if Medicare actually managed care. She is not open to switching doctors because she enjoys the "community" afforded by her providers' offices. Let me be clear, I strongly believe in a safety net for seniors in the last few years of their lives as Medicare was intended. Medicare eligibility should fluctuate with live expectancy. The government needs to get their hands out of it, enable greater competition, and reinsure a percentage catastrophic claims, which drive the bulk of our system's aggregate cost. Let insurers manage the care and remove price-setting. In that structure, maybe it can become efficient again after the next 46 years and reverse the damage Medicare has done.

alangernJul. 31, 11 2:01 PM

People do find it shocking to hear that Medicare has a significantly better record at controlling costs than private insurance. It's true. As Dr. Settgast says, though Medicare covers the oldest and the sickest people, costs under Medicare have risen slower than costs under private insurance. If we brought everyone into the pool we'd ensure Medicare's long term viability. And we'd all get a better deal. Unfortunately "competition" in the private insurance industry leads to a medical arms race of high technology equipment and infrastructure. This competition also diverts health care resources to marketing and away from care. The fragmentation and complexity is both a financial burden on doctors and a waste of time. Time they could be spending caring for patients. Insurers have learned that the best way to be profitable is to avoid covering the sick. So these marketing dollars go toward "competition" for young, healthy enrollees. (this of course defeats the purpose of insurance. People seem to support the low prices they get from large purchasers like WallMart (which uses its market share to drive Down prices from suppliers) and yet fail to see that a single public insurance plan could use similar purchasing clout to save "we the people" money in the health care system.

mklundJul. 31, 11 3:05 PM

kil7676: Many of the problems you mention pertain to the private insurers also. Cost are bargained, patients have no primary physician, some shuttle in weekly, etc. Some that you mention are your mother's choices. The Affordable Health Care Act actually addresses some of these problems, especially best practices and what we call in MN "Health Homes." Many of the outcome studies on prevention, drugs and procedures come now from European countries with access to data on large populations. Medicare isn't perfect (doesn't cover dental, hearing, or eye care in MN) - but it is better than anything else in our system. Oh, yes, did you all know that Medicare premiums for crystalbay must have risen precipitously if he/she is rich? Yes, they are bracketed by income now. Happy 46th, Medicare!

clemmermnJul. 31, 11 3:55 PM

It is very peculiar that the recent debate on health care reform did not give prominence to a simple idea: drop the Medicare eligibility age to zero. If something works well, why not use it? The next best thing would be for Minnesota to show the rest of the country the way to go by passing the Minnesota Health Plan, solution that also would provide care to all residents for less than we now are spending.

md4medicareJul. 31, 11 7:53 PM

"kil7676" writes (with some difficulty): "Medicare eligibility should fluctuate with live expectancy." Life expectancy in the United States is in fact much lower than in dozens of other countries. If life expectancy in the United States should fall - as it has in recent years for pregnant women in our nation - then, by this argument, it is time to LOWER the Medicare eligibility age! The same commenter calls Medicare inefficient. With <3% overhead Medicare is many times more efficient than private insurers, which have >15% overhead, or more. In another befuddled comment, "disindat" finds a nonexistent "million dollar property" in a post that mentions an unworkable $3,000/year for a health insurance plan that boasts a $10,000 annual deductible. The point, "disindat," is that this kind of private health insurance is not efficient, not affordable and, ultimately, not even insurance - if you get sick you will be bankrupted under this kind of policy. Medicare may have rescued "crystalbay" from financial ruin, but it at the price of foregone wages for decades: 1.45% of income + another 1.45% of payroll. That's what funds Medicare. Thank you Dr. Settgast for such a clear explanation! Those who disagree - please try reading the essay once again.

crystalbayJul. 31, 1110:25 PM

"This poster also brags about her million dollar property,".........This poster formerly known as Dak has been repeating these lies for well over a year. I pity him.

crystalbayJul. 31, 1110:31 PM

"The poster you reference has a lot of gall attacking the rich when she belongs to a group of elite. "..........My 2010 AGI was 23K. So much for my "elite" status.


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