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Friday, August 21, 2009

Medicare for Everyone

In a column in this morning's Union Leader, Dr. Thomas Clairmont finds a simple solution to the health care debate. Just put everyone on Medicare.
For about 4.5 percent of income, matched by your employer, you would receive a lifetime policy with no co-payments, no deductibles, no out-of-pocket expenses and, most important, no pre-existing conditions exclusions. Your policy would cover your choice of physician and appointments with them, hospital care, diagnostic imaging, laboratory tests, prescriptions, vision care, preventive care, dental care, chiropractic care, emergency care and ambulance transportation, podiatry, speech, physical and occupational therapy, mental health care, substance abuse care, health education, hospice care, adult day care, skilled nursing care, long-term care and dialysis. This policy would be portable, continuous and never could be canceled regardless of your employment status.

Please note that passage of this plan covers everyone with the same basic policy. Medicaid would be eliminated; Medicare would be considerably improved. Medical bankruptcy would be eliminated, and the President’s goals of universal, affordable, choice and cost controls would be met. the dreaded doughnut hole in Medicare D would be an unpleasant memory.
Where to begin? How about the "for just 4.5 percent of income, matched by your employer..." That's a nine-percent tax, just for health care.

Dr. Clairmont then goes through the well-worn argument that Medicare is so much more efficient that private health care. After all, the administrative costs are so much lower. Well, Medicare has lower administrative costs because it doesn't have to pay for administrative costs. Medicare doesn't have to repave the hospital parking lot every few years. It doesn't have to fix the leaking roof on the doctor's office. It doesn't have to work around vacation days for the cafeteria workers and receptionists. Medicare underpays doctors for their services, who lose money treating these patients. Medicaid underpays so severely that many physicians have decided to stop accepting Medicaid patients in order to stay in business.

Medicare and Medicaid, valuable and helpful programs to be sure, exist solely because we subsidize them not only through our taxes but also through higher prices in the private health care sector. And despite these huge subsidies, both Medicare and Medicaid are headed towards bankruptcy.

There are plenty of good ideas for fixing the accessibility and affordability of health care in America. Piling everyone into a sinking ship isn't one of them.

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