There is a Yiddish proverb that pretty much describes my reaction to Paul Krugman’s post on the sustainability of Medicare:
Az di bobe volt gehat beytsim volt zi geven mayn zeyde.
Roughly, “If my grandmother had balls, she’d be my grandfather.”
Dr., Krugman:
What is true is that the U.S. Medicare is expensive compared with, say, Canadian Medicare (yes, that’s what they call their system) or the French health care system (which is complicated, but largely single-payer in its essentials); that’s because Medicare American-style is very open-ended, reluctant to say no to paying for medically dubious procedures, and also fails to make use of its pricing power over drugs and other items.
So Medicare will have to start saying no; it will have to provide incentives to move away from fee for service, and so on and so forth. But such changes would not mean a fundamental change in the way Medicare works.
To limit Medicare spending to the point where it’s sustainable by making it cover less is to change the system so it is no longer “Medicare as we know it”. That’s necessary. We’re just flailing around like a fish on a gaff trying not to admit it.
“To limit Medicare spending to the point where it’s sustainable by making it cover less is to change the system so it is no longer “Medicare as we know itâ€. ”
I suspect he is talking about keeping Medicare as a program that pays the majority of expenses. That should be doable.
Steve
I guess you mostly agree with Krugman, and just find a little fault with still calling it Medicare?
I don’t suppose Medicare is actually a blank check now, or that it has no limitations on coverage or procedures. So I don’t see that moving those limitations “reasonably” is abandoning the principle.
Medicare needs more moderation, but it is not now a free for all.
And it wont happen, not until it absolutely has too. Any president/Congressmen to go along with such a change will be handed his walking papers with the next election.
Only tangentially related, but…
I remember a while back, somebody introduced me to a chart showing the age breakdown of our health care spending to that of other countries. For instance, it had 0-15, 16-30, 31-50, 51-65, 65-over and showed what we spend, what Japan spends, what France spends, and a couple other countries. I *think* it was Dave that linked to it. If so, do you know what chart I am talking about, Dave? If so, do you have a link? I have been looking for it to no avail. Everything is cross-agegroup and separated some other way (such as public/private).