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Monday, December 14, 2009
Is Medicare Really A Good Deal?
Suppose you don’t want the government’s health care plan for seniors? What then? Can you opt out?
 
You may wonder: Who would not want Medicare health insurance? It’s generally touted as the best health care plan that money can buy. However, it’s not such a good deal for the taxpayers. At last count, the program was some $11 trillion dollars in debt, that is, it had an unfunded liability of $11 trillion.
 
The reason Medicare seems to work well for senior patients is because providers’ fees for services, doctors, hospitals, labs, etc., are not set by market competition. Instead, they are unilaterally established by the federal government. In other words, fees are not determined by the free market. The government decides how much they will pay, regardless of cost. What’s surprising is that, even with that advantage, Medicare consistently loses money.
 
Furthermore, Medicare health insurance is not really an option or much of an option for seniors, because it’s mandated by the Social Security Administration, which operates the program. Seniors who wish to opt out are confronted with a penalty that would be prohibitive.
 
The Institute for Health Freedom (IHF) provides some interesting but somewhat startling information about Medicare that is generally not known:
 
·        “Medicare has the final say on hospital and doctor fees and threatens to expel doctors from the program if they charge patients extra for ‘deluxe’ versions of services already covered by the program.”
 
·        “Medicare dictates what services and treatments are ‘medically necessary’ and covered” for patients. “Some patients have found that Medicare coverage has actually hurt, rather than helped their treatment regimen.”
 
·        “Medicare requires that claims be submitted to the federal government and audits provider/patient information for fraud and abuse. Seniors who want to maintain a truly confidential doctor-patient relationship might opt to pay privately.”
 
·        “Individuals entitled to monthly (Social Security) benefits which confer eligibility for (Hospital insurance) may not waive...entitlement.” If a senior wants to avoid the requirement to enroll in the Medicare benefit program, he or she is required to repay all retirement benefit payments they have previously received from the Social Security program.
 
·        The federal government enforces mandatory enrollment in Medicare by requiring citizens to sign up for Medicare hospital coverage (Part A) at the time they apply for Social Security benefits.
 
IHF also reports that Medicare was not originally supposed to work this way: “When Medicare was created in 1965, Congress promised that the program would not interfere with citizens’ freedom to purchase private health insurance. The original Medicare law…included the following provision” (which remains unchanged):
 
Sec. 1803 OPTION TO INDIVIDUAL TO OBTAIN OTHER HEALTH INSURANCE PROTECTION: Nothing contained in this title shall be construed to preclude any State from providing or any individual from purchasing or otherwise securing, protection against the cost of any health services.
 
However, the Medicare law was also subsequently amended to include a provision that “penalizes physicians who accept private payment for Medicare-covered services: any doctor who does so must stop seeing all Medicare patients for two years.”
 
Considered in light of the current health care debates in Congress, the foregoing information offers strong evidence about how Medicare health insurance coverage has been mandated for seniors and how existing government health care programs can be imposed on patients and changed at the whim of Congress.
 
While the rationale for forcing all seniors to sign up for Medicare may make sense from the standpoint of providing a large base of participants to generate sufficient revenue for the program, it’s important to bear in mind that what the government bestows it can also take away from citizens.
 
It’s also worth noting that when the time comes to fund the $11 trillion deficit in the Medicare program, it will have to be done by increasing taxes or reducing services, or both. Furthermore, the health care bill that is currently being considered by the Senate proposes to expand enrollment in the Medicare program by lowering the age requirement to 55, to provide health care services for many of those who are currently uninsured, while, at the same time, cutting Medicare funding by $500 billion over five years. This will immediately add an estimated 35 million new enrollees in addition to the approximately 45 million people currently enrolled in the Medicare program (in 2008). 
 
So, how can Medicare possibly continue to provide the same level of services to seniors when the number of enrollees is increased by 75% and its funding is cut by about 40%?
 
As usual, the actions of Congress turn logic on its head.
 
© 2009 Harris R. Sherline, All Rights Reserved
 
Read more of Harris Sherline’s commentaries on his blog at www.opinionfest.com
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