I have been offering my views on various aspects of the Federal Budget that have been in the news. One area that most of our politicians seemingly agree needs to be changed are the so-called entitlemnet programs; specifically Medicare, Medicaid and Social Security.

The future solvency of each of those programs has been questioned, with some opinions believing our time of reckoning will be sooner rather than later.

Right now Rep. Paul Ryan, R. Wis., has put his plan into play in the House of Representatives. It tears the hell out of Medicare as we know it. I previously termed Ryan a “Fraud” for his budget approach that, while putting additional burdens on people of lesser means, and offers more tax cuts to the wealthy, egregiously fails to balance the budget and erase the national debt, at least not for the next 30-50 years, depending on which projection to believe.

But in this post I will simply use my personal life to illustrate what effects Medicare revamping may have.

As a battle over the future form of Medicare looms, perhaps a personal story and one from the national news can shed some light.I just read this tale of a Delaware man who kept getting turned down for a nuclear strees test to determine blocked arteries. The company utilized by Blue Cross there refused to pay for many of these procedures and a study found that at least 15% of those denials were improper, being based on nothing more than saving money.

In late February of 2009, after a few days of being unable to keep meals down and just not feeling right, I went to my family doctor. Among other things an EKG was performed and was off enough that I was scheduled a few days later for a chemical stress test.

When I was called with the results a few days after the test, I was floored when informed I had suffered a heart attack. I saw a heart doctor a few days later who set me up for a catheterization the following week.

That procedure revealed three seriously blocked arteries, too blocked, in fact, to insert stents. I had bypass surgery a week later.

I was covered under Medicare. In no instance for any tests or my surgery or my rehab did I encounter any denials of service. I also have supplemental coverage. Together the two plans covered all but $47 of my costs, the only part I paid out of pocket. My total care including followup would have cost $100,000 or more.

My experience illustrates several points.

1. My government insured care did not involve rationing, long lines, long waits to get appointments, or any other of the charges made during the health care debate.

2. Private insurers commonly erect such barriers because they are always looking at the bottom line.

3. The charge has also been made that under Medicare, doctors feel free to order tests that may be unnecessary, thus not only incurring more costs for that system but also driving up overall medical costs.

My answer to that is that I can’t deny those effects. And there is waste and, unfortunately fraud, in the Medicare program. But if the alternative is to simply limit coverage, people will die. That is morally unacceptable.

4. Paul Ryan wants to eliminate Medicare as we know it for potential future enrollees. Vouchers will be awarded based on a series of factors to permit purchase of private insurance by aging individuals.

Rather than the relatively hassle free process I went through, many seniors will find themselves caught up in a numbers game. Too often medical decisions will be made based not on medical necessity but on cost.

The consequences of implementing these proposed drastic changes in Medicare will be enormous and largely negative.

There are some unhealth elements in the way medicare works. I am all in favor of whatever it takes to better root out fraud and waste and ensure Medicare works as efficiently as possible.
I also believe there are a number of ways that overall health care costs can be brought more under control, as their rise continually surpasses the general rate of inflation. Indeed, cutting these costs would probably do more to effectuate the future solvency of Medicare than all other reforms combined.
Now, whatever Ryan has proposed will not affect me. That is, it will not unless it is revised to touch current seniors rather than those not yet eligible.
My positive experience with Medicare is not unique. But there are undoubtedly seniors who have not been so fortunate. But throwing future seniors into a Medicare system that will essentially do nothing but create more profits for an already bloated private insurance industry while removing many safeguards currently available will not only not solve our budget “crisis” it will harm the lives of those forced to endure it.


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