Saturday, October 17, 2009

medicare for all

I promise, even I am getting tired of this subject. So, just once more, with feeling.

We really need HEALTH CARE for everyone in this country. And we need it now.

We need it because this is a fight against death. Not the death that comes for the old and hurting, as a welcome friend. But the death that lurches in and plucks the 11 year old boy suffering with nothing more than an abscessed tooth that will not be treated because the dentist does not "take" medicaid patients; the death that snatches the 17 year old girl who needs a kidney transplant that has been denied by some nameless, faceless insurance clerk. We need it because HEALTH CARE fights for life: the life of each and every citizen that wants it and can hold it.

This is how it should work:

Build a national care system by expanding on the existing Medicare program... This restructuring would involve gradual changes in the age of eligibility for the Medicare system...

(1) Enroll children under 5 years of age, pregnant women and those with lifelong illnesses by the end of 2010.

(2)In 2011, those between 55 and 65 would be enrolled...

(3)In 2012 those from 5 to 15 and those from 45 to 55 would be included.

(4)Those between 15 and 25 as well as those from 40 to 45 would be added in 2013.

(5)Finally, by the end of 2014, by adding the remaining population between 25 and 40 the entire U.S. population would be covered...

There would be Medicare for all in a single-payer system. There would be no limitations based on pre-existing conditions... The changes proposed under the Medicare Expansion program would be relatively easy to make from an administrative standpoint since age is easily verified and the basic system is in place and functioning... [from "Health Care Reform by Medicare Expansion" by Eric W. Fonkalsrud, M.D., and Michael D. Intriligator, Ph.D.]

The medicare rate (of withholding and self-employment tax) could be increased--and adjusted for dependents--to help cover the costs. Any subsidies for low wage earners could be given back through expanding the Earned Income Tax Credit--which can, even now, be received as an advance against withholding for wage earners.

And we have to get a handle on the cost of Medicare fee-for-service, as it is now practiced, in which doctors and hospitals are paid for each suture, fancy diagnostic test and pat on the arm.

We need salaried doctors, too. I know, catch your breath, breathe. Yes, this is socialized medicine. But there ain't no such thing as a "free market" in medical care. There is a free market in food. You can eat beans instead of dining at Emeril's. But you can't tell the surgeon, "No thanks, I can't afford a triple by-pass today. I'll just have this wart removed."

So, we change the way we train doctors. We--the government (that's you and me, my gentle snowflakes) pay for the full cost of the medical education of the young doctors-to-be. And then we treat them as humans during internship. (Not, as in the current system, where interns are virtual medi-slaves.) And then, in return for the public paying for their medical education, each young doctor pledges a ten-year commitment to work for the new Medicare For All system at a reasonable salary. (Sure wish I could take credit for this idea, but I stole it whole-hog from Ted Kennedy! ) Similar arrangements should be made for all other health professionals.

Now, what about the cost of medications? Medicare Part D must be changed to allow for negotiations between Medicare (that's the Government--remember, you and me, my gentle snowflakes) and big Pharma over the price paid for drugs.

After all this, if for no other reason than the utter terror that the Government--you and me--will nationalize them, the hospitals will get in line and support Medicare for All.

Costs will be controlled, contained, made manageable.

There it is: Let the CBO score that!


No comments:

Post a Comment