Privatizing Medicare

While I am against the Republican plan to change Medicare into a voucher system, at the same time I’m not na├»ve enough to say Medicare is a perfect system.

For example, a couple of years ago, all the providers were forced to re-sign up, as if they had never been Medicare providers. The fiscal intermediaries then jerked them around by frivolously denying their applications for as much as a year and a half. When they were finally approved, Medicare refused to allow them to back-bill for all the services they provided in the meantime. This is a way of justifying fraud against the physicians, and physicians can’t fight Medicare because they don’t have the clout.

Now Medicare is frivolously denying a small percentage of low-dollar provider claims at random. $20 here and $20 there adds up to billions of dollars after a while, and the physicians would have to spend more to fight Medicare than they would collect, so Medicare gets away with cheating them. The fraud committed by Medicare against the physicians makes any cheating by the physicians pale by comparison.

If we are a just people, we need to insist that the government be as honest as the providers, and pay them according to what the law provides. Cutting Medicare benefits and cheating the providers only runs the risk that at some point, Medicare providers are going to opt-out of the program and leave vulnerable seniors with no health care. Many providers in California opted-out of Medi-Cal (California Medicaid) for exactly that reason.

If we implement a voucher system, the law must provide that the insurance companies provide coverage at least as good as current Medicare Advantage programs, and at no more cost to the enrollee than at present. Otherwise, gouging will certainly ensue, resulting in a skyrocketing senior death rate as a consequence.

I believe that a “Medicare for All” program can be created where private companies and government work together to create a fair system where everybody pays into the system according to their ability to pay. Everyone would be required to participate, and everyone would pay something. Payment would be made through by Medicare, Medicaid, Employer contributions, government and private benefit deductions, payroll deductions, and other sources, just as is done now. In some cases, individuals may be able to choose among several payment options.

A “single payer” system would be created where all insurance companies would be required to pay claims through a single clearinghouse (probably using regional fiscal intermediaries as Medicare does now). Such a system would be more economical for insurance companies, allowing them to provide better rates, and would reduce the physician’s cost of billing also.

Such a system would reduce the government’s role to one of regulation, to keep the playing field level, protect consumers from price gouging, and still allow for a free-market, private sector solution providing health care for all America.

Undoubtedly, I haven’t thought out all the salient details, but such a system can be made to work, be fair, and provide all America with health care. We currently spend more money per capita on health care than other modern nations, so the money to do this is here now.

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