Monday, December 17, 2012

AARP published "15 Medicare Proposals You Should Know About" in its "Earned a Say" column

The AARP has a web reference to the “15 Medicare Proposals You Should Know About” in its “You earned a say” series, here.  (See a similar story about Social Security Nov. 27.) 

Medicare is generally seen to be a bigger problem in entitlement budgets that Social Security, and even less of it is covered by pre-paid special taxes.

It’s easy to see problems with most of the major proposals.  Gradual raising of the Medicare eligibility age won’t do much to reduce expenses in the short run. Seniors would have to fend for themselves (or deal with their last employers and COBRA or retiree policies), but that may be inevitable as lifespans raise.

Since highest income seniors already pay more for Part B and D supplementals, raising their premiums with means-testing would eat further into the middle class.

I think there is an opportunity to encourage providers not to order unnecessary tests.  My recent dental surgery resulting in a biopsy, which was justified by ruling out malignancy,  but probably added $1000 or so to Medicare’s bill for a test that was largely unnecessary.  I think I am prudent in the way I use services, taking advantage of generics and informing myself of the enormous volume discounts hospitals and providers can give  large insurance companies.  I try to ask about prices and competition. But it is very hard to control what providers insist on doing, even with relatively healthy beneficiaries.  We need to think seriously about reforming fee for service.  Like it or not, health care is a business.

AARP has some petitions for visitors to sign, but I think that form petition letters are self-serving and ineffective. 

Another proposal would be that the government no longer indemnify providers when patients don't make copays. 

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