Medicare: A Dangerously Good Deal

It's not surprising that we can't pass a bill to address long-term budget deficits. Effectively all of the growth in projected long-term budget spending is health care costs tied to Medicare benefits. And -- surprise! -- voters really like Medicare benefits. According to a 2010 poll by the Tax Policy Center, three-quarters of Americans think entitlements like Medicare will create major economic problems over the next 25 years. But two-thirds oppose reducing benefits, and more than half oppose raising taxes.

Here's why: Medicare isn't just a good deal for retirees. It's an outstanding deal.

According to the Urban Institute (link opens PDF), a couple with average wages retiring at age 65 in 2010 would have paid $88,000 in dedicated Medicare taxes over the course of their lifetimes (including their employers' share) but can expect to receive $387,000 in Medicare benefits. A 65-year-old couple retiring in 2020 will have paid $111,000 in Medicare taxes and can expect to receive $427,000 in benefits. These figures are adjusted for inflation and discounted to present value using a 2% real rate of return. It's likely that the returns earned on Medicare taxes will exceed what an average investor earns in the stock market (at the expense of someone else, of course) over the course of their lives.

Medicare taxes for most workers are currently 2.9% of income, where they've been since 1986. But median wages during that time grew by an average of 2.8% per year, while medical costs grew by an average of 5.5% per year. In order to have kept an equal ratio of Medicare taxes to Medicare expenditures over the last three decades, either taxes would need to have doubled or expenditure growth would need to have been cut in half. But remember the Tax Policy Center poll: Voters by and large refuse both options. This is why we have deficits. It's one thing to talk about the immorality of kicking the can down the road to future generations, but it's another to actually stop kicking. Cans feel really good to kick.

That sentiment will probably grow in the future. In 1970, 10% of the U.S. population was age 65 or older. Today that's 14%, and by 2030 nearly 20% of the economy will be eligible for Medicare. How do you think these people are going to vote? Will they easily give up their investment-of-a-lifetime Medicare benefits? I doubt it.

There are a few likely ways this will end. Raising the age at which you become eligible for benefits is one of the more palatable options, but it doesn't do much to the deficit, as a disproportionate amount of health care costs are incurred when people are in their 70s and 80s. Growth in health care costs is coming in below what budget analysts expected. If that trend holds, most of the runaway-spending budget forecasts could be proven too pessimistic. More likely, Medicare growth will come at the expense of other government programs -- nondefense discretionary spending is already on track to hit a 50-year low as a share of GDP.

But here's what we know: The budget isn't hard to fix because politicians are evil or because one political party "doesn't get it." It's hard because what drives long-term deficits are programs that offer voters deals they can't refuse. Just pay a little now, and we'll give you a lot tomorrow -- who can turn that down? It's a dangerously good deal.

Making the right financial decisions today makes a world of difference in your golden years, but with most people chronically under-saving for retirement, it's clear that not enough is being done. Don't make the same mistakes as the masses. I urge you to learn about "The Shocking Can't-Miss Truth about Your Retirement." Click here for your free report.


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  • Report this Comment On February 13, 2013, at 9:00 PM, Darwood11 wrote:

    Medicare is one of several government props for the service economy. Where would be be without this subsidy to the entire medical community?

    Thanks to the politicians, this program can keep seniors alive and well, perhaps not kicking, but here on earth well into a time in which they have reached a vegetative state.

    Isn't government mandated medical care wonderful?

    Of course, there is a price to pay with this pact with the devil. Yes, we may live longer, but is the quality of that life better? Or have we merely entering purgatory?

  • Report this Comment On February 14, 2013, at 1:07 AM, BiotechMarc wrote:

    Voters literally cannot refuse; there is no way of opting out of the system, unless you include the generous offer to pay medicare taxes your entire life and then not enroll in the medicare program, allowing your contributions to go elsewhere.

    Besides, looking at this in isolation doesn't really mean much. How much would the same examples pay in SS taxes over the course of their lifetime and what would be the value of their benefits? And please let's not forget the employer's contribution here, as so many do. My understanding is that it is a break-even proposition. Factor SS and medicare together and what rate of return would be needed to convert a lifetime of FICA contributions to cover combined benefits?

  • Report this Comment On February 14, 2013, at 11:20 AM, slpmn wrote:

    Simple question - What is the alternative?

    It is a fact that the vast majority of retirees could not afford medical care on their own. They're either going to need their kids to pay for it or they're going to need the government to pay for it. Unfortunately, the vast majority of retirees' children cannot afford to cover their parents healthcare. That leaves one option. So - they're going to get government subsidized care.

    The real issue is how do you meaningfully reduce the cost of that care. I have two modest proposals, neither of which are likely to be implemented, but I think they go to the core of the problem:

    1) Ration care. Set up the "death" panels that make independent decisions on whether grandma gets a new hip at 90, or grandpa gets a new knee at 85. I don't know the exact figures, but some huge percentage of medicare goes to cover expenses in the last few years of life. Financially, does that make sense? Of course, opponents of government subsidized healthcare are also oponents of common sense measures to reduce the costs, demonizing the very tools proposed to reduce them. Hence the term "death panel".

    2) Force hospitals and clinics to reduce overhead costs. I hate to sound really old, but "when I was a kid" hospitals and clinics were uniformly spartan and generic looking. There was little to no investment made in creature comforts, it was all about getting the job done. "Nowadays", new hospitals look like upscale hotels. Dentists office lobbies look like coffee shops. It's all done in the name of competing for customers, which we love in the free market system, but we pay for it in the form of higher taxes and insurance premiums. You don't want to share a room when you're recovering from your appendectomy, or feel a little uncomfortable visiting grandma when there's another family five feet away? Well, then don't complain about how much your insurance costs or how much gets spent on medicare.

  • Report this Comment On February 14, 2013, at 11:40 AM, damilkman wrote:

    Is it possible that health care costs like tuition keep going up faster then inflation because the market is constantly distorted? If Medicade did not pay out perhaps hospitals would be forced to figure out how to make their services affordable, else no one will come. Ditto with tuition. If the government stopped guaranteeing student loans the colleges that keep raising tuition would have empty classrooms. Again they can adjust or go out of business.

    I do agree on the requirement for a needs panel. If everyone gets the best service and procedures regardless of what they put in. There is hundreds of billions wasted on needless procedures and drugs that everyone wants because they saw an advertisement in the Readers Digest. Medicare should cover a certain baseline of health not be a supermarket of whatever pleases us.

  • Report this Comment On February 14, 2013, at 11:53 AM, slpmn wrote:

    I think "damilkman" brings up a good point. How much of the problem is created (or at least exacerbated) by the government subsidies themselves? Just last week, I was talking to a Rochester, MN businessman, who has very good local connections, about the rumored impact of Obamacare on the Mayo Clinc, which employs about 30,000 people in that city. Now, I'm nearly ignorant of the details buried in that legislation, but apparently, there are provisions that will reduce the reimbursement rates that hospitals receive for services. Mayo Clinic, as what I would call a "premium" provider of healthcare (they literally serve Saudi Arabian shieks among other world dignitaries) has a high overhead structure, and they will likely have to make some cuts to keep profits up. From the perspective of the Rochester economy, that's not a positive, but from the perspective of a taxpayer, that is exactly the kind of thing I would like to see more of. Because I do think there is a lot of truth to the notion that one reason medical care is so expensive is because it is an extremely deep pocketed entity that pays most of the bills.

  • Report this Comment On February 14, 2013, at 12:32 PM, TMFMorgan wrote:

    <<Voters literally cannot refuse>>

    Sure they can. They can vote for candidates who vow to end Medicare tomorrow.

    But they don't.

  • Report this Comment On February 14, 2013, at 12:49 PM, smartmuffin wrote:

    Robbery is always a good deal for the robber.

  • Report this Comment On February 14, 2013, at 5:15 PM, SMFT wrote:

    <<What is the alternative?>>

    A market-based solution. I.E. - if you retired wealthy - guess what? You get good health care. And. live a longer life. That is the reward for being successful.

    If you didn't manage to become wealthy, then you don't get the benefits of it.

    Where in the Constitution, or any other substantial legal treatise, does it say that the government is obliged to pay for a long life for everyone?

    As stated above by others, Medicare is there to cover the bare minimum, and should not cover non-essential treatments.

    Hip replacements for 90 year olds! What a rip-off.

  • Report this Comment On February 14, 2013, at 7:54 PM, overley wrote:

    Nice article. Just dreaming, but tort reform and medical courts so huge amounts of money are not spent on defensive medicine would help curb costs also, but will never happen as long trial lawyers make obsene amounts of money to pay off the pols. We could be upfront about not spending money on those will almost no chance of surviving, and let them die with dignity. If you want that care, you have to buy an insurance policy on your own to pay for it.

  • Report this Comment On February 14, 2013, at 8:31 PM, Nephromeister wrote:

    It is almost never discussed by the pundits and politicians but a huge driver of medical costs is patients' lack of personal responsibility. Patients that call the ambulance to go to the ER for a cold, so they don't have to pay for a taxi. Patients hospitalized repeatedly for uncontrolled hypertension because they do not take their medications, EVEN WHEN PROVIDED FOR FREE. Patients who have severe vascular disease and require expensive heart caths and bypass surgery yet continue to smoke. Medicare pays roughly $70,000 annually per patient to provide life sustaining dialysis, yet it is common for patients to skip treatments or cut them short, leading to sickness and hospitalizations, driving up costs. Personal responsibility can be a slippery slope, but perhaps this would be a place to start "rationing" care, increasing costs for those who abuse the system and conserving dollars for those who take some responsibility for their health.

  • Report this Comment On February 14, 2013, at 8:48 PM, Samantne wrote:

    A better option would be genuinely good HEALTH care, versus SICK care (which is what we mostly have now). I'm fortunate to be 70 and med-free ... but I also watch what I eat and exercise regularly, and haven't had a cigarette in 50 years or so. My usage of health care, so far, has been limited pretty much to one broken bone (wrist), two babies, and a bunch o' sinus infections. Long may it wave! The best way to lower health care costs is to get us all healthier, and keep us there.

  • Report this Comment On February 14, 2013, at 8:59 PM, Dyengii wrote:

    The vast majority of Medicare expenses are incurred in the last few months of life. Raising the age limit will not help. Raising premiums will not help.

    Sadly, only "death panels" will help. Or people coming to the understanding that sometimes those last few weeks of life, bought at enormous expense, both monetarily and emotionally, are rarely worth it.

  • Report this Comment On February 15, 2013, at 12:45 AM, smartmuffin wrote:

    "Sadly, only "death panels" will help. Or people coming to the understanding that sometimes those last few weeks of life, bought at enormous expense, both monetarily and emotionally, are rarely worth it."

    If they (or their families) had to bear this expense personally, I imagine it might be a hell of a lot easier to convince them.

    Imagine that. Just don't bother thinking about what the logical conclusions of this would be...

  • Report this Comment On February 15, 2013, at 1:32 AM, leswar21 wrote:

    Speaking as someone in the healthcare field working primarily with older folks dealing with their chronic and terminal diseases, the problem is not the 90 year old getting the hip replacement (if they are getting the hip replaced, overall, they are fairly healthy). The problem is the intense use of medicare dollars in the last few years or months of life.

    The cynical and dishonest use of the phrase " death panels" only serves to hide their real purpose, part of which is simple education and communication between doctors and their patients. With the use of more programs like hospice, home health AIM programs ( advanced Illness management) more people would stay out of ERs and ICUs where the largest percentage of Medicare dollars are spent.

  • Report this Comment On February 15, 2013, at 10:25 AM, devoish wrote:

    Darwood11,

    I absolutely agree with you, that no matter how much or how little we spend, we need to offer the best "quality of life" we can to those we provide for. Even if that means spending more on healthcare.

    Damilkman,

    Your macroeconomic argument that money being available to spend on healthcare is what is driving up costs is a pretty good one and could happen somewhere. But it is also possible that the cost of providing good quality healthcare is simply expensive.

    For example, Blue Cross/Blue shield was not always an insurance company deriving its profit from marking up the cost of providing care.

    Back in the day, the good Dr would treat you for a chicken or two in exchange for a cocaine laced treatment of CocaCola and then you went to the hospital to die. One day we discovered germs and suddenly through simple cleanliness hospitals were able to provide care without causing infections and people went to the hospital to live. But that caused genuine and real expenses, not subsidised ones. We needed a cement floor to keep clean, not dirt or wood. We needed to replace gloves. we needed to have more people working to actually do the disinfecting and suddenly we needed to chickens for the builder and the nurse, and the cleaning people too. And the truth of the time was that very few had that many chickens or dollars to spare. So the hospitals offered the option of prepaying for health care at their hospital and most town people paid a chicken a month to keep the hospital workers fed and happy in exchange for knowing the Dr would treat them if they were injured. Granted there was only one Dr and not much "choice" but it was better than what had been before.

    Eventually someone had to be paid to keep track of accounts and that was ok too.

    The system has broken down now that we have evolved to having insurance companies as their own profit center, existing to mark up the services provided by the real healthcare providers and deny services to customers when they can.

    And now there is Obamacare which is an attempt to preserve the insurance companies and mandate expanded coverage to more people.

    Overly,

    In the many States where it exists in State law, tort reform has not really lived up to the expectation of reducing costs to the point where good quality healthcare becomes affordable at minimum wage incomes.

    I think I have a different perspective on solving that aspect of the costs involved. I think if most people knew that when they got sick, that disability insurance would provide a safe, comfortable life and provide needed medical care for injuries suffered, most people would not need to sue. Right now, because they have no alternatives they need the "pain and suffering" dollars to provide medical care. In the States they do not get it, they suffer.

    Nephromeister and Samantwe,

    I like your suggestion and agree you have the right starting point. I am not sure how you will persuade CocaCola or Pepsi to stop telling people how wonderful it is to destroy their health. But it seems to me your idea needs to have some "free speech" limiting steps, such as a higher standard of honesty in advertising than we now have, or a publicity campaign in excess of KO's advertising and marketing budgets to educate people a little more.

    But I like your effort, and I also try.

    leswar21,

    You identified the financial problem as "the intense use of medicare dollars in the last few years or final months of life".

    To me it seems pretty evident that providing the services needed when a patient is in the hospital finding out that they have reached "the last few months of life" is one of the most important reasons to have medicare to begin with.

    You live 84 years, never went to the doctor once, never got injured, shook off a few colds and then one day you see blood in your stool and you cannot keep down a meal. You go to the hospital, and suddenly money is finally being spent on you. Sadly it turns out you have cancer and this money has been spent "in the last few months of your life".

    I am not sure I understand that there actually is an alternative to the scenario I just described.

    There is however a different "truth" about medicare spending. In 2007, "67% of medicare spending was on was on patients with 5 or more chronic conditions." Examples would be cancer, diabetes, lung disease, heart disease, strokes and Alzheimers.

    This "truth" lends credence to the cost saving suggestions expressed by Semantne and Nephromeister.

    Sadly most of these posts seek to decide who should not get healthcare because they have or had low incomes.

    But I have never seen those with the highest incomes actually be productive enough to wipe a cripples butt.

    I watched Jaime Dimon testify that other Americans will have to lower their expectations. He was paid enough while saying those words to hire a nurse for a year.

    I think i know what the problem is, too.

    Best wishes,

    Steven

  • Report this Comment On February 15, 2013, at 10:31 AM, smartmuffin wrote:

    "I absolutely agree with you, that no matter how much or how little we spend, we need to offer the best "quality of life" we can to those we provide for. Even if that means spending more on healthcare."

    Someone who approaches a problem with the viewpoint of "it doesn't matter how much we spend" shouldn't be surprised when the problem ends up leaving you with tens of trillions of dollars in unfunded liabilities.

    Would you spend $1 trillion to lengthen a suffering cancer patient's life by 1 month (let's say that despite the suffering, the patient reports that they desperately want to continue living). If you answer no, then you don't REALLY believe that costs are irrelevant. If your answer is yes, then let's just modify the scenario. Would you spend $10 trillion to lengthen a suffering cancer patient's life by 1 day?

    We need to be realistic here and admit that the basic premise of "government exists to spend as much money as possible to increase people's lifespans under every imaginable circumstance" is fundamentally flawed and unsound.

  • Report this Comment On February 15, 2013, at 11:52 AM, devoish wrote:

    smartmuffin,

    You and I can both imagine an example beyond any real cost of extending someones life by one day or one minute or one month.

    But I would prefer to be intelligent enough to use a real world cost of extending someones life for this exercise.

    Using google to ask for the most expensive hospital stay ever revealed a single person claiming to have seen a bill for $28,900/day. Round that up to $30k and multiply by 30 days, and you get $900,000 to extend someones life for thirty days.

    So just by waking up from your nightmare we have already saved America tens of trillions of dollars in healthcare expense.

    Since it is possible to use real world numbers lets hope yours is not a recurring nightmare that needs treatment as a chronic condition.

    But your point is well taken, and there is a limit to resources and for now we have them, so it is ok to spend a million dollars on those occasions that the last thirty days of someones life do not cost the system the far more common result of less than that amount.

    And once again, it is chronic conditions that cost the most, not end of life care.

    Best wishes,

    Steven

  • Report this Comment On February 15, 2013, at 12:33 PM, erikinthered100 wrote:

    I am an emergency physician without about 20 years of experience. Addressing some of the comments thus far:

    slpmn wrote: "the vast majority of retirees could not afford medical care on their own."

    That is actually not true. I don't know the exact numbers but retirees are the wealthiest segment of this society. Moreover, they have had much of their earnings confiscated to pay into the medicare system so they already have paid for much of the medical care they receive through medicare.

    slpmn also has two proposals which are the definition of central planning - "ration care" and force hospitals to reduce overhead costs." As such, they are an absolutely horrible idea for the overall health care system. Government-provided health care must, in order to be affordable and sustainable, be limited to only that which is necessary. That would mean rationing of some sort - no elective surgeries on the public dime and no frills on the public dime. So, while it's a good idea for government health care, it's inappropriate and immoral to force such spartan health care on the vast majority of people who can pay for their own health care. The vast majority of people should be enabled, through proven free market reforms, in paying for and controlling their own health care. If they wish to have a posh suite at the hospital and can pay for it, they should have every right to do so. Then, they can can recover or die in the least misery possible.

    Damilkman makes a very good point. Government involvement in health care has greatly inflated health care costs. Government policies have created mainly a third party payer system where prices are not transparent. There are endless regulations which suffocate the health care market and stifle supply and innovation which would lower costs. Obamacare only adds to these problems. Government IS the problem not the solution. Without this interference, health care costs would be dramatically lower - some tests and treatments would cost only 10% or less than current prices. Add in another layer of costs due to the out-of-control government-created medical liability racket. The insane free-for-all known as the civil legal system creates huge costs directly and indirectly. The only way government can control costs is by arbitrary rationing by central planners, an approach which has always resulted in inefficiency and extremely low quality of goods and services.

    The free market approach doesn't seem appropriate for every aspect of the health care system. Society has an interest in providing for emergent care regardless of ability to pay and creating a safety net to provide health care for children and also for adults with catastrophic illnesses which make them uninsurable. But outside of that, people have the right to make their own health care decisions without government control or interference.

  • Report this Comment On February 15, 2013, at 12:37 PM, TMFMorgan wrote:

    << That is actually not true. I don't know the exact numbers but retirees are the wealthiest segment of this society>>

    Here are some exact numbers.

    Americans age 65 have a median net worth of $232,000. Fidelity Investments recommends a couple retiring this year will need $240,000 just to cover medical bills during retirement -- and that's on top of Medicare.

  • Report this Comment On February 15, 2013, at 12:41 PM, whereaminow wrote:

    The Urban Institute was created in 1968 in an effort led by LBJ. It provides "intellectual" cover to welfare programs.

    The dollar amounts in the article assigned to benefits might as well be pulled out of a monkey's backside.

    There is no way to know the real cost of health care. The delivery of services has been removed from a patient-provider model with competition and been replaced (not just with ObamaCare) with a monstrous legalized cartel that derives its revenue through theft and maintains its monopoly position with violence.

    No "cost" or "benefit" calculated by a Progressive think tank (or any masquerading Conservative think tank for that matter) has ANY basis in reality.

    It's just a bunch of nonsense to justify the violence they've put in place to assure their own profit and well-being.

    Your well-being, the well-being of poor people, and the well-being of the elderly is the least of their concerns.

    David in Liberty

  • Report this Comment On February 15, 2013, at 1:03 PM, erikinthered100 wrote:

    "Here are some exact numbers.

    Americans age 65 have a median net worth of $232,000. Fidelity Investments recommends a couple retiring this year will need $240,000 just to cover medical bills during retirement -- and that's on top of Medicare."

    This appears to show that the majority of older Americans CAN pay for their medical care but not at current government-inflated prices and without the current complete disregard for costs. Introduce some free market reforms (completely absent from Obamacare) and the vast majority would be able to pay for their medical care. And they would die with greater dignity and comfort than they would in a dilapidated and bankrupt national health care system controlled by bureaucrats. Of course, many would have to make the practical choice of deciding not to spend millions on medical care in their last few days or weeks of life.

  • Report this Comment On February 15, 2013, at 1:04 PM, EdGrey wrote:

    First of all, Medicare is paid out of a separate "pocket," the Social Security trust fund.

    Second, the two big holes in our national pocket are both entities that suck down increasing amounts of money while giving us back less and less, and could even be argued to make things worse overall - the military and healthcare. You could even expand Eisenhower's "military-industrial complex" into "military-industrial-media-healthcare complex."

    If we had a rational military and effective healthcare (including public health and preventive medicine), we could easily return to solvency.

  • Report this Comment On February 15, 2013, at 1:08 PM, NYCDOG wrote:

    In Housel's world, Big Gov't is not the cause of this or any problem. The elements of government inefficiencies vs the market place, the cost of an entrenched and bloated Medicare/Medicaid bureaucracy, the staggering cost of compliance for hospitals and physicians alike, the blizzard of paperwork, are just a few of the factors not discussed. The systemic ponzi scheme nature of a vote-buying boondoggle which is -to understate the case-exponentially higher than- inflation adjusted-the Political Class "sold the program" to the gullible voters..NONE of these factors are discussed.

    Allowing health insurers to sell across state lines would provide more competition and savings than any of the "death panel" permutations of Obamacare (once heatedly denied and now blithely tossed around in euphemismsby its supporters)

    For 150 years in this country, the cost of a hospital bed/night was within a % pt or so of a night's stay at the best hotel in the same town. Since the advent of Medicare and Medicaid, it towers above that figure. The Class Warriors have bleated about "robber-barons" for that same time frame. What is it..hospitals lagged 80 years in getting so "greedy"?? Or could it just possibly be something else? Wait til the true and delayed costs of

    Obamacare kick in..goodbye Big Rock Candy Mountain. Hello Greece!

  • Report this Comment On February 15, 2013, at 1:32 PM, whereaminow wrote:

    ---> In Housel's world, Big Gov't is not the cause of this or any problem. <----

    I know he would vehemently denied that, but once again we have an article where he cites a government-funded progressive think tank as an authority without any cross checking.

    Welfare policy groups like this Urban Institute have no interest in ending poverty or helping people. They'd be out of a job if they did actually help. And then they'd have to get real work, instead of leeching off of us to provide these hilarious "benefits" reports that could have been generated by a random number program.

    David in Liberty

  • Report this Comment On February 15, 2013, at 3:38 PM, erikinthered100 wrote:

    Great post, NYCDog!!!

    I see the massive waste and inefficiency in health care due to government control and interference every day.

    Health care would be soooooooo much cheaper with more of a free market and less government. As I stated earlier, many tests and treatments would probably be a tenth of the cost or even less. It would be better and cheaper.

    Instead, we get the monstrosity of Obamacare pushing us closer to a financial catastrophe.

  • Report this Comment On February 15, 2013, at 5:06 PM, smartmuffin wrote:

    I like how Morgan focuses on the Net Worth of the elderly as compared to "projected health care costs" rather than the RELEVANT statistic, which is the Net Worth of the elderly as compared to the net worth of the youth and middle-aged, who are actually paying the medicare tax currently.

    Although the fact that "projected health care costs" are in fact so high essentially confirms my earlier point, that people take a "who cares about the cost" approach to medical care, then somehow end up just shocked when they see the bill. Try this for an experiment. Go to a resturaunt, give the watier your credit card, and explain to him that you don't care AT ALL what the expenses are, you just want to see your quality of life raised. You don't want to see a menu or a price listing. You are just trusting them to recommend and cook the appropriate food, bring it to you, tip themselves the appropriate amount, and then charge you when it's all over. Do you think this will result in an efficient meal? Do you think the bill will be affordable? And yet, this is what we do with medical care every day across the country. Do whatever you want! No expense is too great! Lives are at stake here! And then we wonder why it's so expensive.

    Finally, let's remember that medicare does not magically generate wealth out of nowhere. Any increase in the quality of life it provides to an old person is directly correlated with a corresponding decrease in the quality of life by the young person who was taxed to pay for it. Why is quality of life for an older person more important than quality of life for a younger person? Is length of life the ABSOLUTE in all circumstances? Value is subjective. It is entirely possible that a young person might enjoy tickets to a baseball game more than an old person enjoys another round of dialysis. Who are you to judge?

  • Report this Comment On February 15, 2013, at 8:23 PM, devoish wrote:

    Smartmuffin,

    It could be a false choice you are offering but thanks for offering it. I think we can have both baseball and dialysis.

    But the truth is, some old people that need dialysis do not get dialysis. And some other people that do not need baseball tickets get to buy baseball tickets.

    I judge that to be a misapplication of resources.

    Nowhere in America is healthcare treated the way you describe it. It is restricted and cost controlled by insurers who provide no added value and increase the cost to the customers and decrease the value those customers get.

    Healthcare should be treated as if the patient matters more than the cost or the efficiency. It is not treated that way, but it should be.

    Best wishes,

    Steven

  • Report this Comment On February 15, 2013, at 9:20 PM, cwalthers wrote:

    Perhaps it would be nice if older people could be given a cyanide pill to store away when they turn 65 or 70; they could then decide when they've had enough. I wouldn't have a problem with this and would store my pill away for when I felt the need had come...being secular I don't have a problem with the scenario. This would leave the "death panels" with a lot less people to worry about with regard to denying certain treatments. But, of course, the religious aspect of the country would never allow this.

    I will say there are grandparents (my husband and I are grandparents) who fulfill roles in the lives of their children, whereby some of these grandparents are responsible for the maintenance and support of their grandkids, fully or on an as needed basis. If they are fully responsible for the grandkids, for whatever reason, and can no longer function because of a knee that doesn't work or a hip that keeps them down (being otherwise of sound and sharp mind) , putting the grandkids onto the state for care may cost a lot more than the knee or hip replacement. This is just one example. We should remember that "we can all be the other person"! Nothing is very cut and dry in life, but I don't think insurance companies should be in the business of health care...it seems immoral somehow; there are so many other things they can place their bets on for a profit. We should be single payer. I'm 70 and a half, female, and can still do a 10-mile run (jog) at a 10 minute pace, more or less depending on "the day"; my husband can do a fierce bike ride; he's 76. It was a relief to get out from under the manipulation, for me, of the insurance industry at age 65. We are still of use to our children.

  • Report this Comment On February 15, 2013, at 11:31 PM, whereaminow wrote:

    ----> Healthcare should be treated as if the patient matters more than the cost or the efficiency. It is not treated that way, but it should be. <----

    Darn skippy, Steven. And the only way to do that is put the patient in charge. The only economic system where this happens is voluntary cooperation among peaceful individuals exchanging goods and services, i.e. the market.

    Since its first involvement in health care, the only thing the State has been able to accomplish is to put insurers first and patients next-to-last (just ahead of tax slaves). The State created this mess. There is no way around that.

    Time to separate the State and the market, especially where that separation is needed most: medical care.

    David in Liberty

  • Report this Comment On February 16, 2013, at 9:53 AM, devoish wrote:

    Believe me David, I understand everything you have written.

    Free men with guns = un-elected government and has certainly never achieved or been the path to "voluntary cooperation among peaceful individuals".

    The gangs of thugs the NRA imagines they need to protect themselves from are also "free men with guns".

    You have a great skill for describing the worst abuses of privatized authority and abuse of financial power in the history of the USA as something it was not.

    You support "private money". Back in the day that was called "scrip" and used to enslave labor to the company store where they overcharged "workers" into debt slaves.

    Combine that idea with your dream of privatized roads that can only be paid for with some other kind of "scrip" and your slaves cannot even leave their "jobs".

    And you support the right of ownership to protect their contracts and property with their own guns and commit violence against the "voluntarily cooperative".

    America has been there and done that. It was only the shared wealth and success and progress that we experienced through aligning Government support for unions, to balance the rights and potential for abuse of private ownership that we acquired the freedom of adequate pay in a capitalist society.

    The only hope for true freedom in America is support for progressive politics and politicians that will support higher pay in a capitalist society and not pretend that "market forces" have ever been a reliable force for freedom or opportunity when left on their own.

    And yes David, we all know examples of when Government authority has been abused, recently in support of the financial industry or aligned with owners in violence against employees and customers as in the case of today's medical insurers( the financial industry again).

    In the United States, Democratically elected representatives in government and unions are the only entities that have ever cooperatively negotiated against the abuses of those who feel entitled to amass the wealth of other peoples work for themselves.

    Social security does not keep the money it "steals" for itself. You cannot say that about Jamie Dimon or Lloyd Blankfein.

    Best wishes,

    Steven

  • Report this Comment On February 16, 2013, at 10:03 AM, devoish wrote:

    "Darn skippy".

    It is "darn skippy" to know Government is held to reach for a higher standard than the poor service and inadequate care standard that the supporters of efficiency and cost cutting offer as they try to answer to "market forces".

    Best wishes,

    Steven

  • Report this Comment On February 16, 2013, at 10:39 AM, whereaminow wrote:

    LOL

    Peace equals violence

    Cooperation equals coercion

    Freedom equals slavery

    You're right out of a Berkeley comic book.

    But whatever works for you. This health care system you don't like is entirely your massa's creation boy. So stop complaining and go back to making massa some tea, boy.

    I prefer freedom.

    David in Liberty

  • Report this Comment On February 16, 2013, at 1:53 PM, devoish wrote:

    massa? boy?

    stop complaining and go back to my job making massa tea?

    Thats unusually clear for you.

    Believe me David, I understand everything you have written.

    Best wishes,

    Steven

  • Report this Comment On February 16, 2013, at 7:44 PM, smartmuffin wrote:

    "But the truth is, some old people that need dialysis do not get dialysis. And some other people that do not need baseball tickets get to buy baseball tickets.

    I judge that to be a misapplication of resources."

    Well, the good news is that your opinion is not legally binding. The bad news, of course, is that the political establishment agrees with you, and theirs is.

    Who are you to decide who needs baseball and who doesn't?

  • Report this Comment On February 16, 2013, at 7:54 PM, whereaminow wrote:

    The NRA and scrip.

    Wow. You just make stuff up at this point. I do wonder if people reading your comments think you're as crazy I do. But then, I remember that everyone does think you're crazy, and I am at ease.

    Sadly, as smartmuffin pointed out, the government agrees with the biggest lunatic in the room.

    The NRA is a lobbying group that exists on behalf of gun makers. It lobbies the government. Without government, the NRA does not exist. It wants to work with the government, and does so. That's why I don't support the NRA.

    As for scrip, you've just derailed at this point. The scrip you speak of, unbacked debt-based paper money, is the government's ultimate dream and has turned us all into "company town slaves" or whatever muckraking nonsense you've read about the period of time 100 years before you were born. People preferred hard money back in those days, and by and large that is what they got. Examples of debt based paper money are exceptions not the norm. Hence, the need to use violence to impose scrip on the wider population. Government did that. Not the market.

    If you don't believe me, just open your wallet.

    You have derailed dude. Maybe you eat too many whole grains. I don't know. Whatever it is, you're a perfect example of the lunatic ideas that the rest of us have to accept at gunpoint.

    I'd like to opt out from Deviosh. Sadly, your massas have told me their will be no such disobedience. Hooray BitCoin!

    David in Liberty

  • Report this Comment On February 16, 2013, at 8:01 PM, whereaminow wrote:

    I'm sorry. I just can't let this go. It's too funny.

    Deviosh, you don't let "debt based scrip"?

    But you think government money works great?

    Seriously, open your wallet.

    I'm gonna be laughing about this one all night.

    David in Liberty

  • Report this Comment On February 17, 2013, at 12:30 AM, whereaminow wrote:

    Devo,

    I made this for you

    http://memegenerator.net/instance/34977794

    :)

    David in Liberty

  • Report this Comment On February 19, 2013, at 5:31 PM, muffins222 wrote:

    It saddens me to read these comments. Let's do something about illegal aliens who get free healthcare, education, perhaps even programs to feed their kids and health insurance. What about Medicade. How about if we could put some recipients to work, many are not completely helpless. Food stamps- some people on food stamps eat better than we do. What about the poor using the ERs for sore throats, or other minor things - after all it is free to many who put nothing or very little into taxes.What about medicaid FRAUD. PORK spending, is it a subject that is taboo- noone wants to stand up for taxpayer rights?

    .The government spent all of the money from Social Security Fund every time there was an overage and left IOUs. That is even though it was never supposed to be taken out except for SS. What about old people who have some money SAVED over their lives. How about food, clothing, toiletries, house, mortgage or rent, insurance, long term care insurance, a car, gas, home expenses, maybe a little money for entertainment, and many other expenses? Do you really think a few hundred thousand will cover everything for 2 people for 15 or 20 years? If you do you are either not an accountant or not a retiree expert.

    It is so sad that we cannot raise the age since every young person is supposed to live many more years than us seniors. Why don't all the young people write their congressman? It is indeed easier to fight seniors who do not defend themselves. I think if everyone thought hard they could think of many ways to help grandmothers, grandfathers and parents instead of rationing their healthcare.

  • Report this Comment On February 25, 2013, at 11:25 AM, devoish wrote:

    muffins222,

    It saddens me that you believe what you just wrote.

    The best solution to Government debt, SSI deficits, etc would have been to raise the US minimum wage in 1968 along with income growth and then low wage workers could have had enough income to pay taxes and keep SSI and medicare financially sound for themselves.

    Obviously Americans needed protection from free trade agreements that allowed slave labor in foreign countries to compete against the gains they had made battling against their own impoverishment by enriched properties owners.

    Now they also need protection from a financial industry that raises their cost of living through hedges and pretending that "price discovery" is a valuable service as opposed to being the legalized theft that it is.

    Best wishes,

    Steven

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