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Fixing Medicare

Stanley Feld M.D.,FACP, MACE

As we have seen, Dr. Ezekiel Emanuel’s misconceptions of the true drivers of medical costs are not fact based. President Obama and his administration do not have a clue about how to fix Medicare.


Dr. Emanuel and Dr. Berwick have created a system that Americans did not want and do not like. Dr. Berwick’s replacement was his assistant. She, in all probability, thinks the same way he does. It is likely there will be no improvement in fixing Medicare.

Accountable Care Organizations are a long way from being organized effectively and efficiently. Organizations which would be most likely to develop ACO’s are not signing on. The reasons are obvious. Obamacare provides inadequate incentives to join with great risks.

 I believe the only way to fix Medicare is by developing a healthcare system that permits consumers, not the government, to drive their own medical care choices. Consumers must be responsible for their health and choice of medical care. They must also have control of their healthcare dollars and be educated and incentivized to use those healthcare dollars wisely.  

 To quote Milton Friedman, “There ain't not such thing as a free lunch.”

It will take educated, motivated and incentivized consumers to reduce the costs of Medicare in order for the program to be sustainable in the future.

It is likely that central government control over individual healthcare and medical care choices will create a bigger mess. It will also impinge on individual freedoms.

 Ensuring that Medicare provides quality health care coverage to millions of older and disabled Americans is essential in a compassionate society. How this can be accomplished is the question.

Seniors have been deceived into believing that they have prepaid their retirement healthcare insurance during their working years. They are realizing that they have been deceived by many administrations.

  “Medicare is nothing less than a lifeline for 49 million older and disabled Americans.”

 “It is also hugely costly. The federal government spent about $477 billion in net Medicare outlays in fiscal year 2011 — 13 percent of its total federal  spending. By 2021, it is projected to spend $864 billion — or 16 percent of the total budget — according to figures derived by the Kaiser Family Foundation. That rate of growth is not sustainable indefinitely.”

 Where did the Social Security and Medicare taxes paid by Americans disappear to? The government collected those taxes and then lent them to the government treasury to maintain U.S. solvency. Now the government is insolvent. It cannot pay back the trust funds as Social Security and Medicare payments decrease and the number of eligible Social Security and Medicare recipients increase.

 President Obama’s administration and its bureaucrats are ignoring the real problems in Medicare.

 They think consumers are too stupid to look after themselves and their own money. It is essential to President Obama’s ideology that the central government control consumers’ choice, consumers’ medical decisions and the money consumers paid into the Medicare system.

The federal government has not done a very good job of managing the money consumers, now seniors, have paid into Social Security and Medicare all these years.

Politicians refuse to understand the sources of waste in the healthcare system. This was made painfully obvious as expressed by Dr. Emanuel. All the stakeholders (patients, physicians, hospital systems, healthcare insurance companies, pharmaceutical companies and the government) have contributed to the waste in the healthcare system.

The biggest villain has been the healthcare insurance industry. The next biggest villain has been the federal and state governments for letting the healthcare insurance industry get away with what they are getting away with.

 Healthcare policy experts refuse to understand that the government is not the administrative services provider for the Medicare program. The government outsources all the administrative services to the healthcare insurance industry.

 The government pays over 20% of each healthcare dollar plus a bid price to the healthcare insurance industry’s regional vendor.

 Most of the vendors that administer Medicare and Medicaid are subsidiaries of the major healthcare insurers. They change their name to the disguised subsidiaries because some of the state government exposed the major companies for the abuses the healthcare insurance companies imposed on patients and physicians.

The politicians’ and bureaucrats’ goal is to maintain power. Their decisions are based on maintaining their power or leveraging their ideology to maintain or obtain that power through the next election cycle.

 They are not concerned with the health and welfare of citizens.

  President Obama proves this daily by running for reelection rather than running the country

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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  • Medicare America

    Thanks for this article. Quite sensible.

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