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No Escape from the Medicare Cage

David McKalip, M.D.
Campaign For Liberty
June 14, 2010

There is a reason the first three letters of Congress spell “Con”. Like good con artists they continue to promise the impossible and steal your money in the process. Unlike most con artists however, they don’t have the good taste to disappear forever when you finally figure out you have been taken. The perfect example of this is Medicare.

In 1965 it all seemed to make so much sense. The Federal government would make sure that the elderly (over 65 years of age) would have all the health care they would need when they stopped working. To keep its promise, Congress joined in a Faustian bargain with Americans that allowed Congress to take a portion of each worker’s paycheck for their entire working life. That money would be saved in a “lockbox” and would be used to pay for all the health care needs when that worker retired. Like trusting “marks” Americans agreed, but 45 years later, the con is up. Congress doesn’t have the money to pay for the Medicare promise. In fact, the Ponzi scheme is $38 trillion deep in debt with no way to cover the cost without either rationing care or stealing more money from the paychecks of Americans.

Over the years, there were many opportunities to fix Medicare, but every move Congress made lead to worsening of the problem. Now they are at the final solution for all government run health care: ration care. President Obama’s nominee to run Medicare and Medicaid, Dr. Donald Berwick, has stated proudly that rationing is the only way to manage the program. He will work to implement the rationing program created in the recent Obamacare legislation. This while more people are entering Medicare as $500 billion is taken out of the program to give to a new generation of “marks” — patients to be covered by Obamacare who will have their rude awakening in about ten years. The saddest part is that with all elderly, poor and disabled Americans are trapped in this Medicare cage, the door has been locked and there is no escape — without a prison break.

Americans are trapped in this cage with their doctors who also bought the con-artist line that they would do well to take government money to care for patients. Reality is starting to collide into the utopian dreams of Congress as it refuses to pay doctors the actual cost of the care of the patient. Congress, after promising to pay the doctors bills for Medicare patients, is on its third round of delaying a “doctor’s fix” for Medicare this year. Doctors are facing a 40% cut in payments of their bills by 2014 with 21% to happen in June — although another temporary fix will push the next cut to 2012. This matters because when payment drops below a certain level, doctors stop seeing those patients affected. The best example is Medicaid that pays about 50-60% of Medicare rates for patients to see a doctor. As a result, doctors don’t see Medicaid patients and they flood the ER at the last minute – sicker than needed.

Reality is setting in and Congress can’t pay the Medicare bill. Doctors will leave the system — they will walk out of the cage. Unfortunately, the patients will be trapped there. Why? Because when the doctor leaves Medicare, the government won’t give a penny of the Medicare money back to workers to see that doctor. Even if a doctor were to charge not a dime more than the Medicare rate, Medicare won’t pay. In other words, the benefits Americans were expecting when they needed health care won’t be there. The Medicare benefits don’t belong to you and they never did — they belong to the Con artist — Congress. If you see a doctor you choose, they have no control over you and no ability to ration care. So they won’t pay. This is the example of the socialized medicine chant: “Everybody in, Nobody out”. Congress needs patients and their doctors in the cage together. Fortunately, former House Majority leader Dick Armey won a federal case lately that would let Americans keep their Social Security benefits if they leave Medicare. The Supreme court review of this case will tell America a lot about the role of the Federal government in our lives. Hopefully the liberty movement will prompt Congress to change the long term Medicare program so that people under 55 can keep the money in their wallets rather than giving it to the government to blow on a bridge to nowhere or excessive government worker benefits and other spending.

The solution to this Medicare problem created by Congress is as simple as finance 101. Let Medicare pay what it can afford. Let the patient pay the rest based on an agreement with the doctor they want to see — a private contract. If a doctor costs $100, let Medicare pay its $80 and let the patient pay the extra $20. Don’t tell the patient they must lose the money they gave to Medicare their entire working life then require them to pay their full doctor’s bills too. That is the worst “sting” in the world.

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