Tuesday, December 2, 2008

Get Your Fix

Seems these days everyone has a fix for what is wrong with health care. The most prominent proposal by politicians and health care pundits is to establish a giant pool for all.

Sounds great but does it work?

One of the largest risk pools is Medicare.

Medicare covers about 45 million "beneficiaries" of which around 7 million are under age 65.

A not so unexpected stat is the number of Medicare beneficiaries with chronic conditions. That figure turns out to be 99% of Medicare expenditures are for 1 or more chronic conditions and 68% of expenditures are for those with 5+ chronic conditions.

Generally, Medicare covers the "sickest of the sickest." So what can we learn from this ever growing group?

Medicare expenditures account for 20% of total health care spending in spite of the fact only about 14% of the population is covered. Medicare funding (through payroll taxes and premiums) consumes 11% of the total federal budget.

But here is where it all falls apart.

Over the years as the cost of health care rages out of control the federal government's response is to shift more of the cost of care to the beneficiaries.

Sound familiar?

Moreover, those who are spending the largest percentage of their income are those who can least afford it.

In 1970 Medicare beneficiaries in the lowest income percentile spent 10% of their income on out of pocket medical care while the top percentile spent 2% of their income.

By 2002 the lowest income group was spending 19% of their income for non-covered health care items while the top income group was spending . . . 2% of their income.

If "Medicare for All" is supposed to be a solution, particularly for those who cannot afford health care and health insurance then how is this disparity to be addressed?

Seems to me the fix for the uninsured is not a fix at all but another Washington boondoggle.

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