Posted By: austin c @ 09/05/2008 8:31:37 PM
Comment: The Medicare only cover seniors above 65 which involves only a part of the total population of U.S. Except for Part D for drug which does not cover all the seniors, I think Medicare is a great thing to be available , the cost of medical service is controlled by the government. For general population, we should look forward for the national health insurance, which is currently praticed by many developed nations with per capita medical expense much less than in U.S. which currently has no national health insurance. the key of its success is to cut down the charges of the medical services, which has been done in Medicare with some success.
That lower cost of medical care in third world countries is because those countries don't have the burden associated with ingenuity. In other words, we have one of the highest health care costs, because this market is paying off all of the innovations.
Other countries benefit from American innovation, yet don't have to expense it. Indonesia didn't invent the X-Ray and therefore does have to pay it's cost.
Look at Japan, their cost of living is skyrocketed compared to ours because their market has to bear the burden of their innovation.
Same thing in medical costs here.
The big issue is poor research and the number of people that use brand-names instead of generics. Medicine companies are forced to provide a generic if one isn't on the market already. This was intended to curtail medical costs. Yet government insurance programs are inforcing this as much as privately owned insurance. My private insurance always forces me to buy generics if they are available and proven to work the same.
The one guy with the disability. If the medicine is the same then you're suffering from a sugar pill effect. There's no way the inactive ingrediants can make the difference. However, if there's a true medical difference in the two, then you are the anomoly, and we should give you the medicine that works.
For most people, however, the generic works just fine.
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Should Medicare have price controls, then? Obama has said they would save billions.
The government can't be in the position of paying any price that a manufacturer names, so in the cases where a drug has no competition, there ought to be some kind of ability to set prices. But price controls could also spook venture capital and drive it out of the drug industry.
What about McCain's reforms? Let's start with means testing—he recently proposed a small increase in premiums for prescription-drug coverage for those making more than $160,000 a year.
Well, there's some means testing in Medicare already. The bigger problem is that the high-income group is a very small percentage of the elderly. There aren't enough of them to make much of a dent if the goal is to save money. And it's hard to even say what their incomes are, because the elderly are mostly living off their assets, like their homes. Means testing on that basis is very difficult.
McCain also says that "Medicare should not pay for preventable medical errors or mismanagement." Is that another reform that's already been put in place?
It was just announced in the last year that Medicare will no longer pay for hospital errors. This is also a tricky proposal, and I would not expect a lot of savings from it. Medical errors can be hard to detect, at least at a level of certainty to justify non-payment. And saying you won't pay for errors has a potentially perverse effect. If you're trying to mitigate errors, you want everything out in the open so you know what is causing the problems.
If you're a doctor and you know admitting to error means you won't get paid—
You may instead try to get away with not reporting it.
There's at least one Medicare reform neither candidate has proposed: raising the age of eligibility.
There's an obvious political reason to avoid that, and a couple of substantive ones as well. Raising the age of eligibility doesn't save as much money as one might think, because those first years under Medicare are the cheaper ones when people are in their best health. Also, one of the important subgroups of the uninsured are the so-called near-elderly, who are around age 60. By raising the eligibility age for Medicare, you potentially increase the size of that uninsured group.
People have been calling for serious Medicare reform for decades. It hasn't happened. Is there reason to think the next four years will be any different?
Not really. The historical record suggests that if it looks possible to make some modest changes and put the big ones off to another Congress, that's what Washington will do. But at some point, of course, that will no longer be possible.
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