Posted on 04/30/2017 2:36:13 PM PDT by ThankYouFreeRepublic
The numbers are hard to ignore.
According to the 2016 report from the Boards of Trustees, Medicare Part A will run out of money in less than 11 years. As a country, the United States is experiencing “deer caught in the headlights syndrome”; We’ve been alerted to a grave impending danger, but we’re frozen into inaction.
Whether we choose to accept it or not, something has to give. The truck is barreling down the road, and if we don’t do something soon, we’ll all be roadkill. Why don’t our leaders act? Because they can’t come up with a solution that doesn’t either cut Medicare benefits or raise taxes, or both, and what politician wants to run on a platform of cutting benefits and / or raising taxes?
I am proposing a third solution, one that will not only eliminate the Medicare funding deficit without raising taxes, but will do so without cutting benefits: Provide Medicare recipients with a voucher for 75% of what Medicare would pay for their procedure in the U.S. and then let them receive their healthcare services anywhere in the world they choose.
What patients don’t spend, they keep.
After studying for years what it’s like to live abroad and now doing it myself at the age of 59, I’ve read what others report and now experienced personally how the quality of healthcare services in many countries abroad is as good or better than the United States, and how the cost is a mere fraction of what it would be in the U.S.— sometimes as much as 80% less.
As an example, I can visit my general practitioner here in Mexico for less than $20 out of pocket, without insurance. A visit to a specialist such as my neurosurgeon will set me back $40, also out of pocket with no insurance. Apart from my personal experiences, on the Best Places in the World to Retire website we have more than 400 expats who have answered close to 1,000 questions about the cost of healthcare in Mexico, Panama and even Nicaragua, with the overwhelming majority reporting that the costs were significantly less than half of what they paid in the U.S.
In a recent study we asked expats living in Panama the cost of healthcare. 44.6% said it was from half to a quarter of the cost in their home country and 29.7% said it was less than a quarter of the cost of their home country. In a soon to be published study covering Mexico, 40.7% said healthcare costs from half to a quarter of their home country, while 31.6% reported costs that was less than a quarter.
Using my voucher solution, Medicare beneficiaries could pay for their healthcare abroad and have money left over for a nice vacation in Puerto Vallarta or perhaps to even fund their a grandchild’s freshman year of college, all while Medicare saves billions.
But low costs are close to meaningless if we don’t receive quality healthcare outcomes. I’ll start again with my personal experience and that of my wife and our friends, which has been that the quality of care is excellent for expats in Mexico.
Consistent with what I read from the expat contributors on our site, I have found that the physicians they use here in Mexico take much more time with each patient, listen much more attentively (all in English, by the way), and are good doctors.
The above referenced surveys also backed this up, with expats reporting that the quality of care abroad was about equal to what they received in the U.S.
In Panama, Hospital Punta Pacifica is a high-end facility managed by Johns Hopkins Medicine International, where we are told the care is less than half the cost of the US.
Even in Nicaragua, Hospital Metropolitano Vivian Pellas received accreditation by the Joint Commission International, a prestigious and difficult to attain indicator of high quality.
In the U.S., we have so mangled our own healthcare system and burdened it with so much gunk and costs, that unless there are major changes, we will soon be experiencing some very significant and very nasty problems. And who expects those changes to take place any time soon?
There may be all sorts of issues and interest groups that would thwart any effort to implement my voucher solution, and of course, there would be details to be worked out.
However, to those who reject it, I have a question: What is your better solution?
Such bullshit.
This solves nothing nor stimulates debate with asinine suggestions.
The current system here is sputtering to a halt because costs are rising from ludicrous to astronomical. As a consequence, deductibles are rising so fast that soon most people even with insurance will not seek medical care except for emergencies. When that point is reached, there's no longer any point to paying for the insurance.
The end result will be a clamor for "single payer," which will seek to dictate cost reductions by lowering reimbursement rates. Then hospitals and physicians' practices will simply close.
If we don't address the costs (principally malpractice and the administrative nightmare of 50+ individual state regulations plus Federal), in a few years almost no one will have medical care.
thanks. something needs to be done.
Maybe a voucher is the answer.
I went to CMS(Centers for Medicare & Medicaid Services) to see about Inpatient Hospital Medicare payments. (not doctors fees)
The last year for statistics is 2014.
The actual costs & dollars paid are staggering.
one example:
Heart Transplant
University of Alabama
average charge $1,172,866.38
average payment $251,876.31
average medicare payment $244,457.92
13 patients.
then add the doctors fees to all that.
there were 1,518 heart transplant discharges throughout the U.S. in 2014.
Charges\payments are greater or lesser depending on the part of country the hospital is in.
Thank you!
Supposedly 34% of all Medicare payments are fraudulent. How about stopping some of those?
So...why do so many Canadians come to the U.S. when they have a serious problem?
Just make the penalties for fraud and other "white collar" crimes the same as for the "blue collar" thefts.
Equal dollar amounts receive equal penalties.
Of course, there needs to be an "add-on" or multiplier for violence or threat thereof.
But, if you walk up to the bank teller window with a note saying "give me all your money", collect $5,000 and receive a sentence (when caught) of 5 years, then defrauding SS, Medicare, your client, embezzlement, etc. of $5,000 needs to receive the same sentence.
Perhaps "white collar" crimes also need a multiplier if the perpetrator is an officer of the law, an elected official or an attorney.
Integrated "white collar" and "blue collar" non-violent prisoner populations.
Mostly they come to the US for the same reason they come to Mexico, Panama, etc.; because they have to wait too long in Canada, even though healthcare there is “free”.
It offshores even more jobs. True; mostly of bureaucrats.
It doesn’t fix the American healthcare system at all. Also true. We don’t have the political will to fix it, so we have to do something else before we all go bankrupt.
It will make American healthcare even more expensive, as the volume drops, but the fixed costs of facilities and management overhead and regulatory compliance remain the same. Unlikely. Competition tends to drive costs down, not up. As another poster mentioned, it will also put pressure on the US healthcare system to become more efficient, as its monopoly is withdrawn.
It sends people to countries where there may not be good controls or the ability to sue if incompetence abounds. Just like it was in the US when we had the best healthcare in the world. Letting people choose what to do is a great control and people do tend to want good doctors for their surgeries, and not just depend on the controls we have in Medicare.
You can’t usually fly to other countries in an emergency. True. This is not for emergencies.
The question is not if this solution is perfect, it is, is it better than what we have.
In my lifetime, when I went to see a GP he had one office assistant, almost always a woman. She wore a white uniform and many thought she was a nurse, but she was an office assistant. She made appointments, took in cash, did some bookkeeping, and was present when a male Dr. examined a woman. The Dr. paid her salary.
Today the same Dr. will have 2 or 3 assistants, a couple of insurance billing specialists, and a full time bookkeeper. The Dr. pays their salaries. Now the insurance companies have 3 or 4 people on staff to reject the bills from the Dr. unless they are exactly correct, and a supervisor for them.
So, today we have 10 straphangers for every Dr. and someone must pay their salaries.
It doesn’t have to be that way...
How you describe how it used to be in the US is how, for the most part it is in places like Mexico and Panama. That’s the main reason the costs are so much lower (like they used to be in the US)
Hi, libertylover.
There are two main reasons so many Canadians come to the US when they have a serious problem:
1. The healthcare system in Canada is state run, so there can be lots of waiting.
2. For some very serious and unusual illnesses, the US still leads the world in treatment options.
The article didn’t say that every healthcare system in the world is better or less expensive than that in the US. It just said that many are, for the vast majority of problems. Please read the article.
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