Medicare Gets Serious About Rationing

As Medicare prepares to cut physician reimbursement by 10.6% on 15 July, physicians nationwide are preparing to no longer care for Medicare patients. It was reported last week that forty-two percent of Texas physicians have already opted out of Medicare. Many more will surely follow if Congress does not block this major reimbursement cut.

Lowering the Medicare reimbursement of physicians so low they cannot afford to care for Medicare patients has successfully decreased the ability of many patients to access medical care. This is a very clever move by politicians and bureaucrats as it successfully creates another highly effective rationing tool. It prevents many elderly and disabled from even getting in line for care.

Rationing heath care is first achieved by progressively cutting the money paid to the principle providers of the health care, especially the physicians. We have seen this happen with both Medicaid and Medicare. With each cut, some physicians will elect to opt out of the health care plan, as they can no longer afford to provide the services needed by the patients in the plan, pay their employees, and keep their doors open for business.

A physician has many fixed costs associated with running a clinical practice. The major costs are the employee salaries and benefits. There is rent for the office space, costs for heating and cooling, electricity and water and sewage charges, costs for equipment and supplies, and insurance premiums. As an example, if overhead expenses average $40 per patient visit and the physician is reimbursed only $35 for the visit, the physician actually loses money for each Medicare patient seen.

The decreasing numbers of physicians participating in a health care plan make it more difficult for the patients in the plan to make appointments with physicians. In many towns and small cities there are currently few physicians who will accept appointments with Medicaid or Medicare patients.

The poor, elderly, racial minorities, rural residents, and veterans are the first to experience the full brunt of the rationing. They can often not afford to seek other sources of health care.

There has been little courage on the part of Congress to reverse the process. As long as voters do not understand that government is the problem and not the solution, health care quality will continue to deteriorate and costs will continue to rise. The politicians will promise changes with every election in order to gain ever more power and control over the very lives of the people.

Our nation champions free enterprise and personal freedoms. We have fought wars to end socialist tyranny, and we stand firm against North Korea, Cuba, and other communist dictatorships. How is it that we are on a path to socialized medicine when Canada, Britain, and even Russia and China are seeking free market economic solutions to their socialized health care problems?

Money has always been provided for health care and other necessities of life for the poor and disabled. The poor are used political human shields to provide cover for the push toward universal government-provided health care. In fully socialized health care systems such as exists in Canada, it is the poor who usually receive the minimal level of health care.

The solutions for health care financing are quite simple. Health care needs to be returned to the basic economic principles that govern the sale of the other necessities of life, including food and housing. Free markets work and bureaucracy and socialism do not.

Personal responsibility is essential to saving health care and to an ownership society. Medical savings accounts for health care and personal investment accounts for Social Security are major reform steps on the road to an ownership society. As most people do not understand economics and fear change, any reasonable solutions will be difficult to implement.

Our elected officials must find the courage to return health care, retirement, and other personal decisions to the people as the people can best make their own decisions. The ownership of health care and retirement funds are essential steps in the return to a free and economically successful society.

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