Government austerity with Medicare reform as a top priority

Medicare needs to be reformed, but there’s no easy solution to the problem. As the average life expectancy increases, more-and-more politicians have proposed an increase in the Medicare eligibility age. This increase in life expectancy, however, is an issue that only affects the wealthiest half of America — the people that need Medicare the least — because the life expectancy has only increased significantly in the richest half of our population.

Just look (below) at the life expectancy as it relates to income. The rich are living significantly longer than the poor. To increase the Medicare eligibility age because of the continually increasing average life expectancy is, in essence, penalizing an entire population for the gains seen by only a portion.

Increasing the eligibility age will only exacerbate the financial strain that Medicare is faced with, by excluding the poorest, sickest Americans from much needed healthcare at a time when disease processes like diabetes, hypertension, and high cholesterol can be attenuated, if not corrected. Delaying government intervention, for the people that are least able to afford healthcare, only means Medicare will be left to pick up an even larger tab when these sick patients are finally adopted into the system.

Also, excluding people from the system simply shifts government spending to the private sector. Yes, we may be able to pay less in taxes if we are able to save money through this type of Medicare reform, but the amount saved is offset by the expensive health insurance premiums payed by our seniors. In fact, private spending may increase by as much as $2 for every $1 of government savings. Simply put, the financial relief, if any, that the government gains from a reform of this type, is transformed into a disproportionate financial strain that will be absorbed entirely by our nation’s elderly. Is this really what we want?

Instead of increasing the eligibility age, we should address this problem by first asking questions like, “why is there a difference in life expectancy at all?” and “what does this say about our healthcare system on a national level?” and, furthermore, “what can we do to correct this problem?” The answer will likely require smarter legislative decisions to address national healthcare reform, public health, and health education as well as a concerted effort from physicians and other healthcare providers. What is becoming increasingly clear, however, is that an increase in the Medicare eligibility age is not part of this answer.

Medicare reform is only one part of the solution to our nation’s budget crisis but — because any change in Medicare has the potential to affect the health and well-being of millions of our nation’s elderly — it should also be recognized as one of the most important pieces of the puzzle. For this reason, government austerity needs to be reexamined with Medicare reform as a top priority. After all, the health of our seniors is at stake.

Nathanael Heckmann is a medical student.

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Comments

Devon Herrick
Raising the age of Medicare eligibility is unlikely to reduce Medicare expenditures by much since young seniors — those under age 70 — are by far the cheapest ones to insure.
http://www.facebook.com/people/Steven-Reznick/100000549195050 Steven Reznick
Medicare was designed to be health insurance for the poor elderly when it was originally conceived. We need means testing for participation in Medicare. People should be able to spend what they put into the Medicare system over the years and then be means tested for additional participation.. As they approach using up what they put in they need to be means tested looking at their total financial picture not just their unhidden liquid assets. They can then choose to buy into Medicare if they are above a certain financial level or purchase private insurance or pay for their care from their assets with little or no insurance. Those with less income and assets would continue to receive Medicare benefits after they meet their annual deductible. Sixty Five is a fine starting point for entry. The reforms in Medicare must come in the area of obscenely overpriced procedures, some fair and ethical discussion and decisions on end of life issues and tort reform to eliminate costly defensive medicine costs. A closer handle on eliminating non physician fraud would be helpful as well.
http://drpauldorio.com Paul Dorio
Devon: Raising the elgibility age will, by definition, eliminate expenditures on individuals who are not eligible to receive Medicare coverage. And, of course, over time the “youngest” Medicare recipients become its “oldest.”
Nathaniel: Assuming your chart is accurate, raising the eligibility age makes the most sense if we also institute means testing. As a person who is younger than any proposed or existing Medicare age, it is incredible to me that, as far back as the Carter era, Republicans have proposed, and been lambasted for, raising the eligibility age or otherwise reforming Medicare. I don’t care who actually institutes reforms. I do know, however, that reforming Medicare by solely reducing doctors’/hospitals’ fees is not the answer. For our country’s future economic health, we must reform giant cost-centers such as Medicare and Social Security. Nancy Pelosi has no business holding hostage the future of the USA.

Nathanael Heckmann
Raising the eligibility age with means testing still doesn’t address the underlying problem. If the eligibility age is raised to, let’s say, 67, with means testing at this age, then you essentially add an additional 2 years of high-cost private insurance premiums to the budgets of our seniors, which mean no healthcare coverage for those who can’t afford these costs. The gap in coverage will only be widened. And, as I mentioned earlier, it would only delay the treatment of chronic diseases in this population, resulting in more expensive sequelae. Ten years of insulin is still less expensive than a kidney transplant.
Keeping the eligibility age the same with means testing for inclusion into Medicare seems like a better cost-cutting option. It would allow people in need of care, who can’t afford private insurance, to be adopted into the Medicare system at the current eligibility age of 65, while saving costs by keeping the more affluent from being adopted into the system. Still not the best solution in my opinion, but a move in the right direction if saving money is your primary goal.

Anonymous
Kaiser Health News has posted a very interesting article that refutes much of the political rhetoric coming from certain members of the Congress about the real causes of the skyrocketing cost of health care in general. Direct victims of those rapidly rising costs are the older members of our society that rely on Medicare to survive. It seems that doctors and hospitals need to begin to understand their role in America’s health care cost problems. I urge doctors and hospital administrators to read the KHN article entitled…
“Studies: Doctors, Hospitals Profit As Health Costs Rise”

Nathanael Heckmann
The Health Affairs article that this Kaiser report references, entitled ”A Decade Of Health Care Cost Growth Has Wiped Out Real Income Gains For An Average US Family”, is definitely worth reading.

Nathanael Heckmann
Not surprisingly, health insurance companies like Aetna and pharmaceutical companies like Pfizer support an increase in the Medicare eligibility age as well. Who wouldn’t want two more years of profits?

Read “The health industry case for raising Medicare’s eligibility age” in The Washington Post.

Government austerity with Medicare reform as a top priority

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