A Medicare Prescription: Sleight of Hand, Slight of Mind

2011 may well be a pivotal year marking the end of the world as we know it. So the Mayan’s may have been wrong about their 2012 prediction. What with Congress haranguing and flailing over the 2012 federal budget, the run up to the gladiatorial 2012 Presidential and other elections, and just for kicks the US economy will be suffering from high oil and gas prices and anemic job growth. All in all, the stars are aligning to portend the inevitable apocalyptic outcome from the confluence of ideological political policies, rabid special interest groups smelling pork, and an economic environment enfeebled by lackluster political leadership. Add to this the dullards’ debates on and pathetic proposed plans for how either the Democrats or the Republicans will ‘save’ Medicare and you have the spark to ignite the powder keg that blows us all to hell.

The Republicans are going to require future Medicare seniors to choose from the for-profit market place, and that choice will somehow magically save money. It may save the government money and thus the Republicans will be able to prevent Medicare’s astronomically increasing costs from busting the budget. But it only stops medical costs from devouring the federal budget, leaving the unquenchable beast free to feed upon the vast resources that the seniors will surely have in their treasure vaults. I am not trying to demean the Republican proposal because that would imply that it has any worth, value or merit whatsoever.

You can’t blame the Republicans though. Their proposal adheres to a couple of their core tenets of ideological faith and so must be right. The problem is that the Republicans are no better at translating their ideology into practical and well conceived policies and programs than say, the Democrats are to theirs. But that won’t matter, if they are wrong then 20 years from now it won’t be a problem that they care about because they will either be retired, dead or most likely be the first to blame someone else.

Now don’t think that you can turn to the Democrat’s to save you either. Their proposal is, well not actually a proposal, is to trim some here and there; to reduce some payments on this and that; and to encourage and reward providers that improve their quality and avoid unnecessary tests. Doesn’t sound like the kind of inspired reinvention of a Medicare approach that fulfills our promise to insure medical care for seniors over 65. They don’t really know what to do either.

The secret pill that they are looking for is to leverage competition, yes the market place, but not to trust the medical industry or insurance companies; rather to watch and verify, to reward for achievement and to penalize for failure [unlike Congress], and to limit the program to it specific objective. Even if Congress understood this, they are not the people to implement it; and therein is the biggest problem: Congress cannot be the agent of change, they can only be the authorizers of a solution.