that many people (all union?) have had no medical co-pays. Only through learning about public employee unions bankrupting states and municipalities, did I learn that I not only pay my own co-pays out of pocket, but I also pay the co-pays (and more), of a multitude of public employees who pay nothing or next to nothing for their medical care.

There are public employees who understand that this cannot go on. These people greatly earn my respect. If you could fill a whole school with these “old-fashioned” non-entitlement-mentality teachers and employees, the waiting list of kids to attend that school would be a mile long.

According to CBO, our budget would actually have a surplus in 10 years IF Medicare costs per recipient stay the same. That is right—even with the increased number of recipients we can balance the Federal Budget.

Right now this is not projected to be the case and this leads to deficits in the perhaps 100 Trillion range over next 30 years. But if we enact market reforms, we can innovate ways to not just keep costs from going up but to actually LOWER costs.

Start with the costs of doctor’s offices filling out paperwork. Studies estimate a 1/3 of medical costs are simply paperwork costs. I spoke with an owner of a Pediatric network and he stated his costs were 1/2 his costs. Liberals believe these paperwork costs would be reduced by government but when has government paperwork ever been easier than private sector paperwork?? They point to Medicare as having the lowest administrative cost per recieipient but they ignore that estimates of fraud in Medicare are more than $60 billion per year.

A high deducatable plan might work wonders for Medicare. Many employers find that they are able to reduce employee contributions by more than the high deductible. In my case, our health insurance is $360 less per month than standard deductible for only a max $1500 individual/ $3000 family high deductible. That’s right. I save $3600 per year and at worst I will only have to pay $3000 out of pocket.

Why is the rate so much different? Well, it turns out cliams are much lower with a high deductible plan so insurance companies do not have to pay out as much. Why? Because when people pay for any trip to the doctor, they are more seletive about when they go. By the way, the company also saves money.

Currently Medicare pays on average $15,000 per recipient. What if we payed each recipient a fixed amount each year, say $10,000 per recipient, but they would be responsible for the first 10K of any medical treatment. I bet a lot of money could be saved.

If we means test Social Security, we could cut the payouts by 50% or more.

And, once it is means tested, we can see that is it actually more like Welfare. If we can accept the similarity, we can then drop Social Security completely.

After all, do we really need two systems to cover the same problem?

This will make life much simpler. You either need social support or you don’t.
If you don’t, you live on what you have. Otherwise, after completing the means tests, you can live comfortably on Welfare.
All we have to do is get people to forget about the stereotype.

Your diary fully captures the differences between Social Security, Medicare, and true entitlements and the ramifications that ensue.

The answer is in your diary, and more. The way to get back to free market in health care and insurance is to put the power to decide and the financial responsibility for those decisions in the hands of the patients and the physicians.

See www.paythedoctor.com

And one which deserves wider distribution.

A couple of additional points:

1) “Medicare recipients lack the ability to say (they say it anyway), “give me my money back, and I’ll take care of my own healthcare.”

This is only 1/2 true: one may, in fact, opt out of *receiving* Medicare benefits. There are two problems with this. The fist is, as you noted, one has then thrown away all those Medicare tax dollars. Worse, one then becomes *ineligible* to receive Social Security payments, as well (http://insureblog.blogspot.com/2011/03/poms-and-obamacare.html)

2) “expansion of tax free HSAs”

Not many know that the last go-’round of Medicare legislation (the one that brought us Part D) also included a “slot” for Medicare HSA plans. Unfortunately, not a single carrier expressed any interest in offering such a plan.

3) Quill notes that ObamneyCare© proponents will “point to Medicare as having the lowest administrative cost.”

Yes, they will, but they will be lying: because Medicare is geared toward an elderly demographic, with correspondingly large claims costs, it generates significantly higher expenditures than private insurance plans, thus making administrative costs smaller as a percentage of total costs. This creates the appearance that Medicare is a model of administrative efficiency. What [its claimants see] as a “miracle” is really just a statistical sleight of hand. [cite available upon request]

As I said, GREAT post – Thanks for sharing it!

when you get around it (as if you don’t have enough to do), could you possibly go into the same kind of explanation regarding the implications that 16 million person expansion of Medicaid is likely to have our nation financially, and what kinds of options we have in addressing this program? I read the Harvard economist report in response to the CBO analysis, and it doesn’t sound good.

For one, Ryan exposes GOP dementia of yet additional means-testing such support (i.e., even further punishing those who paid the most during their working lives). He does do so in a big way, but contunual gradula INCREASE in such means-tesring only encourages Progresssives. Conservatives must demonstrate discilpline and demand a REVERSAL of current means-testing (a rough guess is that it raises only about 5% more dollars and would thus require aabout a 5% increaser in non-means-tested premiums. It aggravates the payors and encourages the takers.

Further, I believe the GOP should demonstrate a principled approach and layout a 30-40 year roadmap of getting the federal govt completely out of the health care, pension and welfare businesses, (these are not powers granted to the federal govt by the CONSTITUTION.

I am one of these people that just pay into the Medicare and the Prescription Drug Program FOR NOTHING. I am grateful that I am not sickly. However, I would rather have a voucher, wherein I pay the difference or a deductible or something like that than having the Federal Government and some panel decide whether it is time for me to live or die. I hate this Obamacare…I am already feeling the results of it. Hubby and I will be paying $500 a month for medical insurance. However, we are on fixed incomes, we’ve saved money…but should he go to the hospital…our savings are wiped out and we’re on Medicaid…and which point…they deny him coverage or we can’t find a doctor…what is the use…Dr. Kavorkian to the rescue. We did the right thing all our lives. Now we have to pay for Solyndra…we have to pay for all this spending without Congressional oversight and yet…what do we do. The Republicans had some good ideas concerning healthcare…they were locked out of the rooms. I’d like to see private insurance companies back in the business of insuring people…even older people. I’d like to see people who have taken care of their health be given a break on the premiums. I’ve worked at being healthy…shouldn’t that count for something?????????

My social security benefits come from a contract that the federal Government made with me by force. If they try to get out of the contract while they are giving my money to foreign nations, illegal aliens or people who didn’t contribute to the plan. They are committing treason. They are already betraying the American populations by giving benefits to Aliens who have contributed nothing while our benefits are metered out based on what we contributed. That is treason and betrayal.

No one here has talked about having FICA put into an “untouchable” lock-box separate from the general fund, as part of the reform. It would need to include a provision that prohibits expenditures from the “funds” in excess of what is actually in the coffers. Thus, the programs would need to be monitored for solvency, and adjustments would need to be made, when necessary, to keep the programs solvent.

If these entitlements had been handled that way in the first place, we might not be in this mess now. For those who didnt know; when SS was introduced in 1935, the program was originally going to be voluntary, AND it was going to be in a separate “trust fund”. A real trust fund, NOT the imaginary one that most people STILL think exists.