Medicare was signed into law on July 31, 1965, by President Lyndon Johnson. Unlike ObamaCare, Medicare had broad bipartisan support. It is Title 18 of the Social Security Act. The Centers for Medicare and Medicaid Services (CMS), part of the Department of Health and Human Services, is in charge, but the nuts-and-bolts administration is in the hands of regional private carriers.
Medicare is a single payer in that funding comes from the taxpayers, but it is like ObamaCare in preserving a lucrative role for private cronies, the "carriers," who receive and disburse the government money. ObamaCare is like Medicare in that most new enrollees are heavily subsidized by taxpayers – except that Medicare beneficiaries paid into the program through payroll taxes.
There was immediate trouble with an explosion in Medicare costs, resulting in almost immediate violation of the original legislative promise of no interference with physician decision-making, or with their compensation. Yet seniors still face big out-of-pocket costs, so many buy MediGap policies. Part D was added because of the lack of Medicare coverage for drugs.
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Still, Medicare has served seniors well in many ways over these 50 years. Thus, few have complained about the lack of an alternative, or the fact that seniors must enroll in Medicare Part A if they want their Social Security benefits.
The question is: Will Medicare be able to continue to provide the care today's seniors expect? The answer is an unequivocal NO. Here are some of the reasons:
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- About 10,000 baby boomers will turn 65 every day for the next 20 years, causing an explosion in costs and demand for medical services.
- Yet, Obamacare cut $716 billion from the Medicare budget. Cuts in seniors' care are to pay for expanded Medicaid for younger people, including free contraception and taxpayer-funded abortions. Medicare cuts are unevenly distributed across the country. California tops the list of cuts at $61 billion, and Florida faces loss of $44 billion, Texas $43 billion, New York $40 billion, Pennsylvania $28 billion and Ohio $21 billion.
- There is already a shortage of doctors at a time the number of Medicare patients is sharply rising. Doctors are reducing the Medicare patients they can take due to rapidly increasing and costly regulatory burdens and lower payments.
- The Obamacare cuts in Medicare's budget reduce payments to hospitals, home health and hospice services, cancer treatment centers, doctors and other professionals. Patients who relapse soon after being discharged from the hospital might not be re-admitted due to new rules limiting payments if patients are hospitalized within 30 days.
- In January 2017, Medicare coverage decisions will be made by Obamacare's Independent Payment Advisory Board (IPAB). The 15 politically appointed bureaucrats will be independent of congressional oversight or judicial review. Your access to life-saving care will be in their hands, and their job is to cut costs by cutting medical services. You will have NO appeal. Some call the IPAB a "Death Panel."
- Because of Medicare cuts, 30-40 percent of U.S. hospitals will have to close by 2030, according to Medicare's former chief actuary, Richard Foster.
- While the closing of the Part D "doughnut hole" may make seniors feel more secure, we are seeing shortages of critical medicines – even simple things like intravenous solutions. You may not have to pay for it, but you can't get it when you need it.
- Part B of Medicare looks more like a means-tested welfare program.
- The "end-of-life counseling" Medicare now pays for seems to be a voluntarily end-your-life-early approach to save money for both Medicare and Social Security. Isn't it convenient that Medicare is part of Social Security?
- Both Medicare and Obamacare "health plans" use the same managed-care business model: Promise everything "necessary" but deny payment – or sufficient payment. They control the definition of "necessary." Doctors and hospitals can agree with government's definition – or go bankrupt.
Don't fall for politicians' glib reassurance. Use your common sense. Look at the numbers – including those on your tax return showing the higher taxes you now pay as a Medicare beneficiary.
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Happy 50th anniversary. We likely will not see a 60th, at least not one to celebrate.
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