Did you know that the Supreme Court case Fleming Vs Nestor says
that you do not have a right to the benefits of Medicare if the government
denies you or changes the law? This is because the ruling stated that if
the Congress can change the law, then you have no right to it. Now this
dealt primarily with Social Security, but unfortunately, Medicare is an add on
to the Social Security legislation. So how do we make it a right, or at
the very least discourage the government from restricting benefits further?
Fix it: Well, the simple answer as I have stated in past
issues on the subject is to merge parts B, C and D with part A. The
reason being is that if part A was to go back to the supreme court it is
possible, depending on the arguments made, that that portion alone can be ruled
a right. This is because of the payroll tax we pay into to help that
portion operate. However, while A is funded by our contributions in the
form of a tax parts B,C and D are all funded through the general revenue of the
United States. In other words, Congress says how much can go into each
one of those components. Now A deals with Hospitals and doctors’ offices.
This is safe, but over budget. Part B deals with outpatient care,
such as rehabilitation and similar services specific to when people leave the
hospital but need some extended care. Part C intends to combine some of A
and B together to make up for any gaps in care via a system that pays doctors
through regular health insurance. Part D was inspired by part C, but does
takes care of medications by supplementing the paid premiums Medicare
recipients will have to make. Basically, the government pays a portion of the
cost to pay for private drug insurance. As such, part D is the only
component that is under budget. Due to A, B and C being over budget
however, it incentives government to make adjustments on what treatments and
drugs are to be covered so as to reduce and maintain costs. It also has
resulted in low reimbursement rates for doctors and thus some of them no longer
accepting Medicare patients. Hence why change is needed. As such,
Part D should be expanded to include all outpatient care of part B and also
doctors care of part A to mimic part C in that respect. Then we eliminate
Parts A, B, and C in favor of Part D as it will take care of all aspects of
senior citizens health care. It however will be funded by the payroll tax
that was funding part A (the part that is our contributions) so as to eliminate
governments incentives to alter or change the care we receive. The reason
why using private insurance that is paid for almost entirely though our
contributions is better is because private insurance has more expansive options
for care. They are better able to detect fraud, and we should be able to
(if the capability is allowed) to jump from insurance to insurance, or use the
one that provides us with the cheapest health insurance with the best coverage
at any given time (with it switching automatically to accommodate needed
treatments that suit our seniors the best). All this can then be ruled on
the basis that we are able to contract with private health insurers which is a
right and get the government out of deciding for us what is to be covered and
what is not to be covered. Basically, the government can still call our
contributions a tax, but they simply become a bank to aid us in paying for our
health insurance in this way. As such, we secure our rights to Medicare.
Conclusion: Yes it is a little complex, but
only part A is funded by our contributions, while part D works the best out of
all the parts of Medicare with respect to budget and treatments. So by
combining everything to work like part D, and funding it like A, would solve
the issue of cost overruns and denial of treatments. Allowing people or
having the system automatically switch Medicare patients from private insurance
to private insurance so that no matter what, their costs will be covered for
whatever treatments they need will also enhance the idea it is a right for it
is a contract with private insurance companies. The government simply
helps us pay for it with our payroll tax contributions. So we can do it,
but as Medicare is so volatile with respect to changes, we may not see needed
changes for a while.
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