Wednesday, November 4, 2015

Issue 714 Medicare B,C,D: Not a right! November 4, 2015

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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