Monday, September 03, 2012

"Fortune" writers recommend straightforward fixes for entitlements

Allan Sloan and Geoff Colvan had an article in Fortune Aug. 16, “Forget Washington: Here’s how we’ll fix the economy”.  In the Sunday Business section Sept. 3, in print, the article is called “Enough already! A common sense proposal for steering America’s economy out of its run”. The Fortune link is here

Perhaps their suggestions do come from Thomas Paine.

They want to limit end-of-life care support in Medicare.  That means that patients (or families) would have to pay for end-of-life care beyond a certain point.  Families, facing filial responsibility, could have to make very difficult decisions out of self-interest.  The authors say that insurance companies will offer supplemental end-of-life policies, which might be a tough sell.

I do recall that my mother was on Hospice for the last thirteen months of her life (you can get on it only when the normal life expectancy is six months or less, but she made it all the way to 97). I saw the bill once; from Capital Hospice in Arlington, the charge to Medicare was close to $4000 a month for weekly home visits by nurses, doctors (sometimes), and social workers.  It seems that this should have been less.

Sloan and Colvan would also raise Medicare premiums for smokers and the medically obese.

On Social Security, they want simply to raise the wage base maximum, and gradually increase retirement age, and reduce the growth in benefits for high-income retirees (mild means testing – would they look at accumulated net wealth?).  They say that doing so will make Social Security “pay as you go” again without today;s accounting gimmicks using the Trust Fund to loan to the Treasury. 

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