Dorcas R. Hardy and Bart Fleming: The U.S. healthcare system is in need of genuine reform, but the plan prescribed by Congress needs a label, "This plan is hazardous to your health and your finances."
The U.S. healthcare system is in need of genuine reform, but the medicine being prescribed by Congress needs a clear label, "This plan is hazardous to your health and your finances."
This is true for every segment of society, but especially true for seniors. For them, the added warning of "even fatal" would be appropriate. The caution is not mere hyperbole. It is based on the president's vision for the future of health care, and on what is in legislation being considered by Congress.
The plan is not a reform of our present system of health care. Using the "public option," the intent of its sponsors is the eventual inclusion of all Americans, including those on Medicare, into a new and entirely different system run by the government. Even if the public option were dropped, inevitable cost pressures created by the remaining provisions would force rationing. Furthermore, this health care "reform" plan could even bring about the end of the Medicare program as we know it. Here's why.
Health care reform would deliver a powerful one-two punch that would significantly raise costs. Think about the effect of adding health care coverage for 40 million uninsured people without increasing the supply of primary-care doctors. The most basic law of economics, supply and demand, will drive up the cost of primary care. Additionally, Medicare enrollees will grow by 30 percent over the next decade as baby boomers become eligible. Currently, 40 percent of every health care dollar goes to paying for care for the over-65 population.
Proposals in the Senate and the House call for dramatically higher taxes, along with nearly half a trillion dollars in cuts to existing health care programs. A substantial part of those cuts will come from Medicare and will necessarily mean reductions in services to seniors. This so-called reform eventually will cause rationing of health care to fall on all segments of the population. But it will fall most heavily on seniors.
Rationing, on a limited scale, already takes place in the U.S. If you are a member of an HMO, you may have experienced a denial of coverage for certain surgical procedures and even for some diagnostic services such as a CAT scan or an MRI. Oregon is refusing to pay for some expensive cancer treatments, but will pay for physician-assisted suicide.
All you have to do is look at rationing in Canada and the United Kingdom to understand what it might look like in the U.S. In Great Britain, it is referred to as age-rationing. Lifesaving medical protocols are withheld based on a calculation of the likely useful years remaining in a person's life, adjusted by the cost of the treatment. Most of us are aware that Canadians can face long waits for some surgical procedures.
Given the above, there are reasonable grounds for our concern about a "slippery slope" aspect of the provision that requires "end of life counseling" every five years for all seniors, even for those who are perfectly healthy.
It is important to understand that cuts to Medicare will present a political problem for Congress and the president. Moving medical coverage of seniors from Medicare into a universal plan would allow the government to hide budget cuts, targeted at senior care, in a much larger appropriation for universal care.
What happens in Congress this fall will not only affect health care in the U.S.; it will determine the kind of society in which our children and grandchildren will live. The financial risks and the potential social and ethical costs are enormous. Seniors and their families must tell Congress, right now, to scrap this government takeover of our health care system and to go back to the drawing board.
Washington public policy consultant Dorcas R. Hardy is a former U.S. commissioner of Social Security and chaired the 2005 White House Conference on Aging. Bart Fleming of Chandler previously served as executive associate administrator and acting deputy administrator of the Centers for Medicare and Medicaid Services. He also served as Arizona state treasurer from 1973 to 1978. Together, they have more than 50 years of experience in public policy, addressing aging and health care issues affecting America's seniors.