Because it works, and should be expanded to everybody!
By Jack E. Lohman
This subject is surely getting old, but because it is still unsolved and our politicians are still being paid by the insurers to make sure it doesn’t get fixed and expanded, we cannot let these jerks win.
OF COURSE there are Republican fixes, and if Paul Ryan and his cronies would agree to first try them on federal and congressional employees including themselves, perhaps he’d get our ear. But he keeps using the “similar” word, which doesn’t cut it. I want Ryan to have Medicare too; not his gold-plated taxpayer-paid policy.
The problems with Medicare exist in the private sector as well… fraud and over-use being the biggies. The latest is all of the prescription drugs that are addictive and being freely sold, but as long as political money also remains addictive, don’t count on a fix. That our politicians are pocketing a piece of the action is unconscionable.
Fraud: Yes it must be eliminated in both Medicare and private insurance, and the best way is by adding protections for whistle-blower employees. But campaign cash from the offenders have kept such fixes off the table.
Over-use: Yes it must be eliminated in both Medicare and private insurance, but again, campaign cash from the offenders have kept it off the table. We pay doctors on a fee-for-service basis… every time they do an ECG they get paid. So whether you need it our not, they order an ECG. At least a few do (many doctors shun overuse). Solve it with either socialized medicine (salaried doctors) or increased oversight. (I could accept either one, but political cash is not on my side.)
Don’t throw away good stuff! Certain surgical procedures use 1 or 2 tools out of a surgical package. Rather than recycling the unused tools they are thrown away. Why? Because the hospital or clinic makes more money that way, while the costs are simply passed on to the patient (Medicare or private).
Negotiate drug prices: Thanks to campaign cash, congress has protected the pharmaceutical industry from having to bid on drugs. You know, the “free market” way. The VA gets a 50% discount on drugs, and so should Medicare. Better yet we should pull drug research from the industry, which manages to maximize its profits (in the range of 25%) thanks to its sweetheart relationship with our congressmen. It should be a public-private partnership between government and scientists at universities.
Better utilize nurses and pharmacists: Let them practice low-level medicine and dispense drugs for colds and minor ailments. Nurses can be housed at pharmacies, as they now are when giving flu shots. Keep patients away from the expensive emergency room.
Restore the Certificate of Need: Repealed thanks to massive campaign contributions from hospitals, this state law required legislative approval before hospitals could build needlessly in areas — not because they were needed but because they could drain market share (unfairly, not the free market way, especially when they employ their own physicians). Doubling hospital beds makes sense only when doubling population.
Prohibit hospitals from employing referring doctors: This is a direct conflict of interest, especially when the doctors are given “productivity bonuses” to increase patient admissions or the ordering of expensive testing, whether needed or not. I want my doctor overseeing hospital quality, not beholden to it.
Implement a national patient database: Secure with no names and double passwords if necessary, but listing all patient diseases with doctor treatments and outcomes. The VA VistA system is available for free and has already been funded by the taxpayers. Let’s do it!
Tort reform: Yea, let’s replace the 12-man jury of idiots with a three-judge panel of retired doctors, nurses and judges. Then we won’t need caps and people who are truly injured will still be treated fairly.
… but none will take place as long as our politicians are allowed to take cash contributions from the health care interests that want the system to remain broken.
This is NOT an issue of finding the right answer, it IS an issue of finding politicians who are not being paid to keep the status quo and obstruct progress.
OF COURSE a single-payer Medicare-for-all system makes the most sense, but the insurance and healthcare industry gave $125 million in campaign dollars to make sure that didn’t happen. So what we have coming is a federal system that will mandate that 100% of citizens buy a policy from the insurance industry.
At their price!
And yes, Ryan’s plan sucks, but cut him some slack. Insurance was his biggest contributor! But that he’d sell out the country at such a small price is troublesome. Adding 20% to Medicare to offset private profits and CEO salaries is, uh, sort of stupid. Importantly, with public funding of campaigns Ryan would not likely favor trashing Medicare for his private contributors.