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The US government is in the same boat as the rest of us--trying to make ends meet. Like most of us, we have to calculate how much is sure to come in as opposed to what is likely to help the monthly take. Then we need to figure out how much expenses will be, adding in some for inflation and other unknowns.There are expenses which come before paying hospitalization insurance. Note I say: Hospitalization. In general, after WWII, we could hack a trip to the doctor and another one to the pharmacy if we weren't saddled with hospital expenses. Medicare was thought of in that way. Thus there is Part A and Part B. And in dealing with the hospital, the thinking went that ordinary stays in the hospital were not so formidable as long as they were short--major medical became important.
This bit of early history lets one realize how many extras have been added to a person's effort to be well. In my view some of it has grown to extremes. But, I don't begin to tell the US population what it needs. What I do say is that no one should have the audacity--especially in these tough times--to expect Cadillac treatment during a Model T downturn. (Could that be part of the trouble in discussing cost?)
Rhetoric can be misleading, even about Medicare. Classic Medicare has deductibles and copays, as most everyone knows. The 80% payment to doctors leaves the patient with a 20% obligation. As medical costs increase the premium for a supplemental policy increases. Yet it is a good investment because otherwise the annual deductible, the 20% charge, and the first days of a hospital stay can leave a person owing.
I recognize that those on Medicare--not Medicare Advantage--know all that. However, I feel it necessary to explain this to those who write on the subject. Often I have read that what the country needs is Medicare for everyone. I don't quarrel with that notion. It's just important to know what is involved. ( I notice that some employees are covered by policies where they can't use them because of their share of the cost.)
When the prescription bill was added to Medicare, it could all but wreck the system, in my view. I have a sneaking hunch that's what the Bush administration was aiming for. There again, I have no quarrel with the government's paying for prescriptions. It's just a question of eating up the longevity of the program.
For those of us in the Medicare program, we pretty well know what we have and how to use it. Most of us are not anxious to overuse it. For my part, I prefer to stay away from doctors and hospitals as much as possible. But when needed, it's a blessing to keep the budget intact.
For those about to be eligible, I salute you when you study the if/whereas nature of the laws which may be enacted. Short advice: Ignore the many solicitations you get by phone and mail, and also what your Aunt Tilly has. Remember if you're 65, you're going to be married to Medicare for a possible 25 years.
