2019 = Medicare bye bye

I turned on the wayback machine (read: my bookmarks folder) and found a clip from NPR circa 2004, to remind myself what the heck we were thinking back when Bush was the man with a plan.

Listen to this for a moment:

http://www.npr.org/templates/story/story.php?storyId=1791298

So even then we knew Medicare was going the way of the dodo earlier than we thought. If you listen carefully, you'll hear Marilyn Moon, vice president and program director of health at the American Research Institute, explaining how the Medicare Part A "Medicare Plus Choice Plan" did NOT foster competition like Bush thought it was going to do.

There's a nugget of advice in there which I'm betting would still yield substantial savings today: "We need to coordinate much better care for people who have multiple illnesses" which is where she says a large proportion of costs lay, as well as helping people choose only necessary care as opposed to unnecessary care.

Sounds like a no-brainer, but let's get real. When you're sick you want to try anything that works, so the distinction might not be so clear. Of course, this is where self-restraint and listening to your doctor comes in to play.

Over my shoulder there's someone whispering, "I should have the choice to do whatever I want if I think it's going to extend my life as long as I'm paying for it. I can waste my own money if I want." You know, that's sort of true. But when you opt in to the Medicare system by your own choice, you're deciding to follow someone else's criteria for treatment.

Put another way, if you want our rates and our benefits, you've got to play by our rules. Take it or leave it. And taking it doesn't mean you take it up the proverbial nose. You can still lobby your elected representative for change.

Mrs. Moon goes on to say that if you want to maintain the Plus Choice program...if you think it has merit...there's no free lunch. You're going to have to pay for it. As a short recap, this plan allows people to use a private plan that gets re-imbursed by Medicare. And where does Medicare come from? That's right, taxes.

Again, let me state, I'm not a "be a zombie, do whatever the government tells you to do" kind of guy. Inefficiency is bad. Competition is for the most part (but not always) good. But come on people! Think! You can't go to these town halls gripping at your Medicare with razor-honed fingernails and expect that you wont have to pay for it.

We haven't fixed things since 2004, but we can still listen to what the aristoi were offering us as solutions.