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?
1. We aren't addressing the Medicare funding issue. 2. The healthcare costs less abroad.
So why not allow solve our Medicare funding issue by allowing people to receive medical care abroad?
I can’t see a country of old timers moving around the world to get health care.
If one spouse goes, the other will have to go.
Who has that kind of money as a retiree?
Will the Feds provide funds for airfare & room and board ?
ain’t happening.
Put another way:. why do we allow people from abroad to get free health care here in usa?
Unless Obamacare is repealed, then this is just applying more mascara on a pig.
I don't know.
I have a 90 year-old aunt who lives in Mexico, but she returns to the US to see her doctors.
Want to run a Medicare surplus? Tax everyone a dollar a year and stop paying for anything. It would be nice if insurance were outlawed at the same time too, so we could all afford medical care here in the US.
I say this as a geezer who has been on Medicare for several years now.
ML/NJ
A lot of people who are retirement age purposely travel as part of their life’s goals; good and more affordable healthcare is a bonus.
US GPs and specialists could accept payments like that if they didn’t have the admin overhead imposed by CMMS rules. Perhaps not exactly that low but certainly a reasonable amount.
All they need to do is pay back the almost $20T they borrowed/stole and things would be fine.
Major surgery overseas can cost significantly less, including airfare and hotel, than here in the states.
A secondary benefit is that it will "light a fire" under the AMA monopoly and the Insurance and Tort lawyer cartels.
(of course, that may be precisely why it will not get past Congress even though it would save a ton of money!)
Competition is good!
Dem voters; that’s why.
And ALL the campaigner donors to Bob Menendez, particularly the ones with involved with Medicaid/Medicare reimbursements...
I think the article has merit. I do think a signification percentage of people would take advantage of it. 20%?
But think of the opportunity for fraud...
as of 2015:
Total Medicare beneficiaries = 55.3
aged = 46.3 million
disable = 9.0 million
author is talking about being an ex-pats.
He lives there.
At what point, cost wise, does one travel for medical care ?
combine vacation travel with medical care ?
probably not.
one or the other.
The author then ends with this straw man:
“However, to those who reject it, I have a question: What is your better solution?”
He doesn’t really give a solution, as he does not explain how to make the headline work.
Exactly right, T-Bird45! It’s all the other stuff other than taking care of patients that costs so much
Wouldn’t it be easier to just Enforce EXISTING Consumar Protection Laws??
The Executive has the power and duty to enforce the law. 15 USC Chapter 1, which is where The Sherman, Clayton and Robinson-Patman acts reside, is an extremely powerful body of law bearing on exactly the sort of conduct the entire medical system engages in daily.
https://market-ticker.org/akcs-www?post=231992
https://market-ticker.org/akcs-www?post=231949
The Bill To Permanently Fix Health Care For All*
There are lots of people who do this right now, but for dental work, which of course, isn’t covered by Medicare. In good free enterprise form, Mexican dental clinics have set up right across the border, and many offer hotel stays as well. The cost is so ridiculously less that the difference between what the government would pay and what the patient would pay would cover more than the costs of going abroad and the patient would even have money left over to spend how he or she pleases. Everyone wins.
The feds don’t have to provide funds for airfare, room and board, etc., or anything else. Free enterprise will take care of that. All they need to do is to write the voucher.
Well said, BwanaNdege. Competition is good. We need to break up the monopoly, which will make everything more effective... or dead. We need to open our minds to find creative solutions. You said it exactly right.
I agree. About 20% is a good estimate. It would also open up some competition and shine a light on the absurd costs here compared to other places.
Regarding fraud, there is of course fraud now, and there would be fraud with this solution, but that could be addressed.
The solution is this:
If, for example, a Medicare patient needs a hip replacement and Medicare would pay $40,000, they cut a check to the patient for 75%, or $30,000. Result= Medicare saves $10,000.
The patient then goes abroad, where a hip replacement would be around $10,000, so he has $20,000 left over. He would use the $20,000 for travel and have quite a bit left over, to say the least.
This would encourage LOTS of people to travel abroad for care, which provide competition and other good secondary effects.
I haven’t checked the numbers, but I believe them to be approximately correct.
Already, there is a thriving medical tourism industry that helps with this, but only for items that are not covered by insurance, such as plastic surgery, dental care, etc. They would scale to meet demand, and medical practices would make it as easy as possible by moving as close to the US border as possible. This has already happened with “Molar City”, an area just over the Arizona / Mexican border that is very popular.
I had a medical emergency in Costa Rica some years back. I woke up in the hospital and was told I likely had had a mini stroke, a TIA. I was in intensive care for three days, two of which had a nurse in my room 24 hours a day. Three or four doctors came to see me, the president of the hospital a nun who might have been 100, came to pray for my well-being. Two C.A.T. scans and other tests as well. The whole thing cost me and my insurance maybe $5000.
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