May 26, 2011
In today’s edition of MedPage Today, the author of “Medicare to Run Dry in 2024” addresses the newest prediction of the collapse of Medicare. Prior predictions had Medicare running out of money in 2029; but, due to a rapidly aging population and lowered tax revenues associated with the poor U.S. economy, the projected date has been advanced.
Last week, I had the privilege of participating in a Town Hall meeting addressing healthcare in the U.S. with Congressman Joe Walsh. It was the first time I have been in the presence of a Congressional leader when I didn’t feel dirty! An audience member asked Congressman Walsh why he referred to Medicare as an entitlement. I thought that was a great question. Don’t we make monthly payments into Medicare over many years? Shouldn’t Medicare have been the equivalent of an annuity, savings account, or maybe life insurance policy? After all, without Medicare, most retirees could not afford the healthcare they need to stay alive. It dawned on me that Congress refers to Medicare as an entitlement because they have felt entitled to mismanage and raid our funds for years!
Those who have read this column know that among my worst fears is that we are barreling towards a “Soylent Green” future (http://livewellthy.org/search.aspx?q=soylent green&sc=tcon&dt=3m&al=). The movie I often quote is staged in the year 2020, four short years prior to the projected bankruptcy of Medicare. In the movie, seniors went into the death chamber at a prescribed time for the good of society. Sound absurd? Let’s look at some facts.
By some people’s estimates, 80% of what Medicare will spend on an individual is spent in the last three months of life. Of that 80%, the lion’s share is spent in the last month of life! If Medicare is projected to go broke in 2024 and if 80% of Medicare’s funds are being spent in the last three months of life, then cutting out the last three months of life should significantly increase Medicare’s solvency. Correct?
Do I really believe the government will send elders to the death chamber? NO! Instead, Medicare, the insurance companies. and A.C.O.s (Accountable Care Organizations) will institute medicine by protocol (http://livewellthy.org/2011/04/27/round-peg-in-a-square-hole.aspx), the next best thing. Protocol will define who gets what therapy. Protocols will be based on “evidence” and the government will decide on what the “evidence” is. Care will be rationed! It’s already occurring (http://livewellthy.org/2011/04/15/prior-authorization–in-the-beginning.aspx). The end result: those last three months will be shortened and the financial crisis averted.
Congressman Walsh asked the physicians in the room what we thought of the Canadian system. I was the third doc to speak. My colleagues slammed the Canadians for their rationing and delays in care. I thanked the Canadians. Canadians come to my office for care they can’t get in their country and they pay me cash.
Where will we go for medical care? Bienvenidos a Mexico!