The response to his promise is highly emotional and favorable, it seems everyone has a dear relative or friend who succumbed to cancer.
No one wants that for anyone and all are willing to do all humanly possible to find the cure.
Instead of seeking the most cost effective modes of care, preventive service, letting patients drive would probably lead to millions upon millions of cases of people power tripping in the same manner as Terri Schiavo's relatives, with good medical care being trampled underfoot.
Ending private plans has been advanced as a solution for Medicare's fiscal woes as the benificiaries enrolled in these plans generally cost Medicare more to administer than other beneficiaries.
But ending private plans seems politically untenable as it would alienate the powers that be in the medical-insurance complex and would antagonize a significant and vociferous bloc of Medicare recipients.
It might be noted that the Medicare recipients in this category are more than likely to be those who enjoyed high earning careers and gold plated insurance policies before retirement.
In addition to the cost issue, fundamental issues of equity underlay this discussion, which I will not treat at this time.
Instead, let's consider the option of continuing these plans, but reducing their cost to the medicare system.
What would be wrong with increasing the private plans contribution to the administrative cost and reducing their cost to Medicare?
Another method of reducing Medicare costs might be by capitizing its share of the risk.
In a capitization plan the insurer would pay a medical provider a set fee and its beneficiaries would be treated.
If there is a bad flu season and the provider treats a larger number of patients, the provider loses, if the flu season is mild and the provider treats fewer, the insurance company loses. In this case Medicare would be the insurance company.
Capitization can provide access to care and cost containment.
Finally, before the discussion goes on any further, it is important to disentangle long term care from medical, hospital and pharmaceutical coverage and to remind the politicians and the public that the fiscal crisis in Medicare stems less from health care coverage as long term care (LTC).
It may be worthwhile to study methods to separate LTC from medical coverage and to study the health care and LTC financing options in that manner.
As the previous shows discussions about health care coverage are complex, detailed and rather dry and even when the subject is open to common knowledge, emotion, other social issues and values affect the decisions.
