Oddly, it was only after President Obama’s speech to the joint session of Congress that it dawned on me for the very first time that without Medicare these past years, I would by now be either bankrupt or dead.
There are two reasons I’d never before thought of that. The lesser of the two is that when it comes to my personal health, I am terrific at denial. I do seek treatment for my illnesses and conditions as they occur, but I then very promptly forget about them. I find it somewhat staggering to go through the list of ailments for which I have been treated and for which Medicare has paid; after all, aches and pains aside, I consider myself a reasonably healthy specimen.
But on my desk is the printed record of the many tens of thousands of dollars I’ve cost the system, and the record suggests that I not only deny, but also distort. It provides not merely a catalogue but also a judgment: “Healthy?” it incredulously seems to ask. “You lie,” it (silently) answers. No South Carolina-type heckling, just a straightforward and apparently objective assessment.
But of course, there’s the rub. Between my ailments and my healthiness there stands Medicare and all that it makes possible. I have never had to consider whether going to the doctor might wreak havoc with my budget. I have never had to ration my own medical care. No specialist has turned me away, nor has my primary-care physician ever rushed me through. I have been treated respectfully, diligently and effectively every time, and Medicare has enabled all that. Medicare, as it were, enables both my health and my pattern of denial.
The more important reason I’d never thought about all that before is that one slips into the Medicare system quite seamlessly. One morning you wake up and you have a really good and comprehensive medical insurance program, all already paid for, and you’ve done nothing save had a 65th birthday. Now you can change employers without any health insurance hassle, because Medicare is not employment-based; it is yours as a matter of right and as a matter of law. Prior condition? Not relevant. Frequency and complexity of treatment? Not relevant.
And if you can afford to spring for the moderately priced Medicare supplement, offered by private insurance companies, then no deductibles, no co-payments; not relevant. (Sadly, it is necessary to point out that Medicare Part D, the prescription drug benefit, is anything but straightforward and that the cost of prescription drugs can be a serious burden. But there seems to be general agreement that if health care reform survives, Part D will be among its reforms.)
The much-discussed growth in the cost of Medicare services and the consequent unsustainability of Medicare is in no small measure a function of Medicare’s age restriction. It covers beneficiaries who need more frequent and more intensive services. But were Medicare to cover everyone, the per-person cost would be quite dramatically reduced; younger people require less costly medical services than older people. Moreover, the total cost of health care would be dramatically reduced because the administrative costs of Medicare are very substantially less than the administrative costs of private health insurance. And with more care being delivered, health outcomes would improve.
One recent study, for example, shows that with regard to diabetes and cardiovascular disease, the 55-64 age cohort is in worse shape that the 65-plus cohort. That’s not because those conditions improve with age; it’s because the older cohort is on Medicare and is therefore more likely to get better treatment.
People who believe that a public program inevitably means regimentation should talk to their friends and relatives covered by Medicare; they will learn that Medicare fully preserves our right to choose our own doctor.
Shockingly, very many Americans are simply not aware, even now, that Medicare is a government program. Nowhere on the statement I periodically receive informing me of the medical care I’ve used and what Medicare paid for that care is there any indication that Medicare is a government program. Suddenly, inexplicably, our government, though entitled to boast, has turned shy.
President Obama is determined, he says, to be the last American president to wrestle with the health care system. He won’t be. The proposed Obama reforms will help, but they will leave considerable room for improvement by his successors.
One may hope, on this eve of a new year — may yours be sweet and healthy — that Obama’s concluding peroration on social justice and the role of government will oft be repeated and long be remembered. If it is, then I am reasonably confident that we will one day build a health care system in which there is Medicare for all, and I do not believe it will take a civil war (or an extension of our current very uncivil war) to get us there. It will take, as most important social reforms do, sweat, toil and tears.
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Mr. Fein, First, without Tort Reform or Open Insurance Competition in all States there is no reform, Why won't this hero of Social Justice embrace these two areas that everyone agrees will reduce the cost of health Care.
Why nust it be mandatory, Don't I have the right to say something about my health care.
"Social Justice" an intriguing two words. Just who specifically gets this social justice. It can't be me when it deprives me of my right of free choice. Can it be the 67% of Americans that are happy with their health care. I think not, can it be the elderly that are screaming "leave medicare alone" I don't think so. My 2 most notable people that used that term were Karl Marx and Adolph Hitler, Boy! we Jews did well under those 2 regimes. We were socially justiced right out of their systems.
My father, who came from Russia taught ne 2 things: (1) Don;t trast Russians and (2) If somebody offers to do something for you, look very carefully at his motives.
The role of government in a free society is to create an atmosphere that engenders open competion and regulate (not control) the system for excesses, Barack Obama has done neither.
Doesn't it seem unsual that with a 9.7% unemployment rate, not one penny from the stimulus has gone to small business, that generates 80$ of the jobs in this country. People in this country do not want handouts they want jobs. Watch the evening news listen to what is happenig in this country. I watch CNN and Fox, just to make sure I get both sides of an issue. I do not trust ABC, CBS, or NBC they all have political agendas.
I do not ask you think the way I do, or accept my word. I do ask you to make sure you get all sides of an argument before you make a decision
L'Shana Tovah
A family from Montreal was at Rosh Hashanna lunch at my house, as was my neighbor who grew up in Toronto. Both said that Canada suffers from a physician shortage and that it is very hard to switch doctors because most physicians don't take new patients. Also, our Montreal friends said that when their child was sick he couldn't see his regular doctor but had to go to a walk-in clinic and wait 3 hours.
First off, I would like to say that the health reform debate should not be primarily about personal/hearsay anecdotes about the pro's and con's of socialized medicine vs. free market healthcare delivery. We all have heart-warming stories and horror stories from both systems. I am Canadian and lived for a number of years in the US. I am also a homecare social worker (so I work within the Medicare system in Canada). What I respect so much about socialized medicine is the way in which it acts as a social leveller. For the most part, socialized medicine prevents the extremes of the haves and have-nots in greater society. The other thing I would like to say: what works in Canada in terms of socialized medicine may have to be re-designed to fit the US and the particular history and make-up of its people.
I had a real bad case of acne, brought on by pregnancy. I demanded accutane to get rid of my acne once and for all. No American dermatologist would give me accutane because of the birth defects issue. I went to Iran and got accutane, and then aborted my fetus at 38 weeks. US healthcare is retrograde and should be abolished
I am an American living for the past few years in London. I pay weekly National Health Insurance contributions and also pay monthly private medical insurance premiums. One system need not exclude the other and both can work together, using the same specialists. After W W II the whole Western civilized world moved towards national health systems without scrapping the private option. The USA needs to catch up and stop using emotive words like socialism or communism. No American citizen or worker should be deprived of basic medical care. What other advanced nation relates health care to level of income?
According to a study published in The Johns Hopkins Magazine about 30% of US medical expense is for administration and unnecessary tests and procedures, and in spite of all the tests a large number of patients are still given the wrong diagnoses. Western European countries spend much less per head than the USA and have a higher success rate. Clearly we need to study the options -- and to cover all citizens and legal residents for basic medical bills