Paul Krugman Blog-Yes, Medicare Is Sustainable In Its Current Form

[n2doc]

I keep seeing people say that Medicare in its current form is not sustainable, as if that were an established fact. It’s anything but.

What is Medicare? It’s single-payer coverage for the elderly. Other countries have single-payer systems that are much cheaper than ours — and also much cheaper than private insurance in America. So there’s nothing about the form that makes Medicare unsustainable, unless you think that health care itself is unsustainable.

What is true is that the U.S. Medicare is expensive compared with, say, Canadian Medicare (yes, that’s what they call their system) or the French health care system (which is complicated, but largely single-payer in its essentials); that’s because Medicare American-style is very open-ended, reluctant to say no to paying for medically dubious procedures, and also fails to make use of its pricing power over drugs and other items.

So Medicare will have to start saying no; it will have to provide incentives to move away from fee for service, and so on and so forth. But such changes would not mean a fundamental change in the way Medicare works.

more
http://krugman.blogs.nytimes.com/2011/06/03/yes-medicare-is-sustainable-in-its-current-form/

[unkachuck]

1. "...Medicare will have to start saying no..."

....Et tu, Paul? Medicare can say 'no' when we elderly Americans can confidently say 'no' to illness, sickness and disease....

....or maybe we could limit our appetite to just one corporate war per year, or ten percent return for corporations and wall street; then Medicare could easily survive along with the people it serves....

....for in the end, Medicare means life or death to millions....

[Juche]

2. Medical inflation is 2-3x the rate of general inflation

So something has to give sooner or later. We spend about 18% of GDP on health care vs 8-11% in other wealthy nations. Medical costs doubling every 10 years while wages double every 30 years isn't going to work.

All in all what he is proposing (from what I can tell) is like what they have in the UK or France, a medical system where treatments have to provide a certain level of health return per investment, those with the lowest returns aren't in the public system. We will likely have to do that with public health care, but nations like France and the UK do it and they prefer their systems to ours.

Plus reform it so it is results based, not procedure based.

I hope we get medical costs under control.

[snot]

3. K&Rd.