“The debate already is generating plenty of claims and counter-claims about what is and is not working- often based on misinformation about how Medicare actually functions today. Solet's take a look at the six biggest myths about Medicare, along with thefacts.”The “facts” as outlined by Mr. Miller are as believable as Rep. Todd Akin (R-MO) being endorsed by NOW. Let’s take a look at his Myths and the reality in Medicine today.
Myth 1: MEDICARE COSTS ARE
OUT OF CONTROL
This myth assumes that once you agree that the government should be in the business of managing healthcare and that secondly that even though “Medicare spending will soar in the years ahead as the number of seniors grows” it is okay because” its per-capita growth is slower than private health insurance”. The problem is that my tax dollars do not go to supporting private health insurance, yet a deduction for Medicare is taken out of every one of my paychecks. Comparing Medicare to private insurance is inappropriate since they operate on different guidelines and financial contributions, i.e. Medicare being mandatory by the government and private being a choice by the consumer (for now).
As to whether or not Medicare costs are out of control, a report by the
CBO projects that “The cost of Medicare is expected to nearly double over thecoming decade…. Medicare's spending is expected to increase to $1,058 billionin fiscal 2022 from $565.3 billion in fiscal 2011. The program's annualspending increases—7.6% in fiscal 2011—are expected to slow to 1.3% in fiscal2012 before accelerating to 10.7% in fiscal 2022.”
Finally, let’s go with Mr. Miller’s
assumption that Medicare is needed, then let’s look at a true representation of
spending of a government agency by comparing it to growth in the economy. In a report by the Center for American
Progress it states that “{a}lthough Medicare spending perenrollee has grown more slowly than private health care spending for most ofits history, health care spending in general and Medicare in particular havegrown faster than the economy.”
Myth 2: MEDICARE IS GOVERNMENT HEALTHCARE
Mr. Miller reports his fact as “The government funds Medicare, but
healthcare delivery is entirely private.”
Mr. Miller argues that since the government does not actually provide
the medical care, as in England under the National Health System or here in
America as the Veteran’s Administration, it is not government healthcare. He offers as further proof a quote by Richard Kaplan, a professor at the
University Of Illinois College Of Law who specializes in elder law matters:
"The government provides the financing, so it's appropriate to say the government is the health insurance company… But all the doctors, pharmacies, and nursing homes are private. The provider sends a bill - instead of Blue Cross Blue Shield, the federal government writes the check. But you go to whatever hospital you want."
Thus Mr. Kaplan argues that Medicare is not government health insurance
due to the right to choose your own hospital.
However, in an article on the BBC reviewed by Dr. Gill Jenkins on Oct.
2010, patients in England were being offered more choice about where they want
to be treated.
So, like England, the US government offers choices of where a patient
can go to be treated and then pays the doctor for that treatment. So in going back to Mr. Miller’s “fact,” what
is the difference between Medicare and other government healthcare?
Finally, to argue that Medicare is a government entity, Medicare was
voted into law by the United States Congress and Senate and signed into law by
President Lyndon B. Johnson on July 30, 1965.
As a medical practice manager, I am directed by the Center of Medicare
and Medicare Services (CMS), a government agency, on how to distribute care,
how to bill, and most importantly what I will be paid by the government for
treating patients with Medicare. In all
cases the doctor is paid directly by the federal government for services
rendered, based on a fee schedule designed by the government.
Myth 3: OBAMACARE SLASHES $700 BLN FROM MEDICARE
This is my favorite myth of all: how defenders of Obamacare state that a
reduction of payment to doctors is not a cut but instead a savings. First, let’s go back to myth 2, that Medicare
is not government healthcare because the government does not provide
healthcare, but only pays for it. Mr.
Kaplan even confirms that Medicare is an insurance company. Now, the purpose of any insurance company is
to pay doctors for medical treatment performed on their beneficiaries. If what the insurance company reimburses, i.e.
pays, a doctor is too low, then the doctor will not see patients under that
insurance. If Medicare does cut reimbursements,
i.e. pay, to doctors by $700 billion over 10 years, reducing an already meager
payment to even less, then how many doctors will continue to provide treatment
to Medicare patients? Not Many.
Mr. Miller reports that “Obamacare does cut $700 billion in Medicare
spending over a 10-year period. But the cuts are adjustments in payments to
Medicare providers, which are mostly
meaningless to patients.” (emphasis added) Really? When doctors begin dropping patients
then these cuts will become very meaningful.
Myth 4: DOCTORS WILL NOT ACCEPT
MEDICARE BECAUSE OF ALL THESE CUTS
Please re-read answer to Myth 3
while I laugh hysterically.
Mr. Miller reports that “Most Medicare patients do not have trouble
finding doctors who will see them.”
What he neglects to recognize is that Medicare patients are finding doctors
under the current fee schedule, but doctors have already reported that any cuts
to the Medicare Fee Schedule will result in them dropping patients. Thus he cannot extrapolate circumstances in
the future based on current conditions.
Myth 5: THE WEALTHY ARE GETTING A FREE RIDE
Mr. Miller reports joyfully that those individuals who earn more money
have the honor of paying more to Medicare.
Why should the amount of one’s income affect how much an individual pays
to Medicare? As a medical practice
manager, I am not allowed to discriminate in health care to a person by income,
why does the government discriminate based on income for a service that pays
equally for all individuals across the board?
Medicare is defined on the government website as “the federal healthinsurance program for people who are age 65 or older, certain younger peoplewith disabilities, and people with End-Stage Renal Disease (permanent kidneyfailure requiring dialysis or a transplant, sometimes called ESRD).” The definition does not include the words “of
a certain income” or even “rich” or “poor;” only people age 65 or older.
Never fear, to ensure that Medicare does stay funded
Mr. Miller points out that “Wealthy Americans - of all ages - also will start paying a
new 3.8 percent Medicare contribution tax on unearned income. The tax affects
individuals with more than $200,000 in modified adjusted gross income (MAGI),
and married couples filing jointly with more than $250,000 of MAGI.”
Myth 6: RISING LONGEVITY WILL SINK MEDICARE
So let me get this straight: health care insurance designed
for individuals age 65 or older, entering a stage of life when more health care
is needed and health care is more expensive and when more people in America are
turning 65 and living longer, as a result of better medical care, will not
affect Medicare? Really??
The average life expectancy of an American today is 78.5
years, thus a person will be on Medicare for an average of 13 years. Beginning in 2011 the first boomers turned 65
and for the next 18 years 10,000 baby boomers will become eligible for Medicare
every day. The current structure of
Medicare is unsustainable under these facts.
Not to worry though, because as Mr. Miller points out, “It is
true that people are living longer, and Medicare's eligibility age is fixed for
everyone at 65. But that does not mean Medicare costs are rising as a result.
That is because nursing homes, which are the biggest area of expense incurred
in advanced age, are not covered under Medicare.”
Living expenses are not covered, but medical expenses provided by
visiting doctors are covered and paid for by Medicare. Thus regardless of where
these old people are living, they will still need to be treated by doctors,
who will need to be paid.
Conclusion:
Mr. Miller’s "myths" are, in fact, facts. Medicare is costly, cuts to doctors will
result in doctors closing doors to Medicare patients and the onslaught of baby
boomers will crush the system. I
understand that for supporters of Medicare and Obamacare, the reality is
difficult to swallow, but the reality is that Medicare is a doomed social experiment. Since this is difficult to accept, they
resort to playing the game of if you repeat a lie often enough and loud enough
then maybe people will begin to believe it, even if, as in this case, it is
laughable.
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