Need to Know: Can Medicare be fixed?

This episode originally aired on February 8, 2013.

This week on Need to Know, Anchor Ray Suarez hosts a panel of experts to explore how to save Medicare.

>Explore the past, present and future of Medicare

Here’s a look at the panelists for this week:

Peter Suderman

Peter Suderman is a senior editor at Reason magazine and Reason.com, where he writes regularly on health care, the federal budget, tech policy, and pop culture. Paul N. Van de Water is a Senior Fellow at the Center on Budget and Policy Priorities, where he specializes in Medicare, Social Security, and health coverage issues. Judith Stein is the Executive Director of the Center for Medicare Advocacy. Ms. Stein has focused on legal representation of the elderly since beginning her legal career in 1975.

Before joining Reason, Suderman worked as a writer and editor at National Review, the Competitive Enterprise Institute, FreedomWorks, Doublethink, and Culture11. His writing has appeared in the Wall Street Journal, the New York Post, Newsweek.com, theAtlantic.com, the Washington Examiner, The New Atlantis, The American Conservative, the Orange County Register, and numerous other publications.

There’s a debate right now going on in Washington about what we should do…. You can let panels of government experts sort of decide what kind of payments we’re going to make, what we’re going to  pay for care — and do this  in a very centralized way.  The other thing that you can do is you can devolve some of these decisions to patients and doctors and individuals a little more control over their health care decisions and their health care dollars.

— Peter Suderman

Paul N. Van de Water

Before he  joined the Center on Budget and Policy Priorities, Van de Water was Vice President for Health Policy at the National Academy of Social Insurance. From 2001 to 2005 Van de Water served as Assistant Deputy Commissioner for Policy at the Social Security Administration, where he managed the agency’s policy analysis, research, and statistical activities. From 1999 to 2001, he was Associate Commissioner for Research, Evaluation, and Statistics at Social Security.

Van de Water worked for over 18 years at the Congressional Budget Office. From 1994 to 1999 he was Assistant Director for Budget Analysis. In that capacity he supervised the agency’s budget projections, analyses of the President’s budget, cost estimates of legislative proposals, and estimates of the cost of federal mandates on state and local governments. As Deputy Assistant Director for Budget Analysis from 1992 to 1994, he coordinated CBO’s analysis of the Clinton Administration’s health plan and other proposals to reform the financing and delivery of health care.

It’s not simply a question of knowing what health care services cost.  More important is knowing what health care services do, what benefits they may provide.  And that’s what’s very hard to determine.  Moreover, when you go to a doctor because you have a complaint, you’re not buying a particular service. You are starting out on a course of treatment, a course of service which is unpredictable at the start, both to you and to your physician.  So in most cases, it’s really not feasible to get a price quote for solving a particular health care problem.

— Paul N. Van de Water

Judith Stein

Judith Stein founded the Center for Medicare Advocacy, Inc. in 1986.  Ms. Stein has focused on legal representation of the elderly since beginning her legal career in 1975. From 1977 until 1986, Ms. Stein was the Co-Director of Legal Assistance to Medicare Patients (LAMP) where she managed the first Medicare advocacy program in the country.

She has extensive experience in developing and administering Medicare advocacy projects, representing Medicare beneficiaries, producing educational materials, teaching and consulting. She has been lead or co-counsel in numerous federal class action and individual cases challenging improper Medicare policies and denials.

We have to figure out what we’re going to do, honestly, about the fact that we’re living longer….And we actually can stay well if we allow Medicare and our health insurance programs to provide proper care for people, and try and marshal the overall health care costs without blaming the program which…has helped drive down the poverty of older people and people with disabilities.

— Judith Stein

 
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Comments

  • http://www.facebook.com/people/David-Auner/100002042338402 David Auner

    Ray, not too long ago the best CABG results were at Methodist in Houston (cheapest)- the worst in Las Vegas( the most expensive.)

  • http://www.facebook.com/people/David-Auner/100002042338402 David Auner

    Medicare patients have a hard time getting primary care doctors here in Missouri. Medicaid patients just use the ER – their only option.

  • Rick

    Let’s control health care costs by putting a cap on the dollar amount of an award a lawyer can be paid and have plaintiffs pay all court costs if the defendant wins.

  • Elizabeth Harkay

    I have another solution:
    Allow people 55 and older to join Medicare…it would be a bonanza of extra money into the system because most people 55-65 are very healthy. It would allow people (age 62) to retire earlier, and more young people could therefore be gainfully employed paying into the system.

  • Marc

    Expand Medicare to cover all Americans and tax accordingly. Other countries do it very successfully. so can we. When there is only one payer for services, the payer determines the price of services. Now you can send the insurance companies packing. They provide nothing to the patient except paperwork, denial of services, and overhead.

  • A. S. Griffith

    I watched the program on Saving Medicare. During the broadcast the statement was made that Doctors like the way that Medicare pays them and does not argue with them about costs as private insurers do. When I moved to Edmond, OK I had a hard time finding a doctor who would take a new Medicare patient. The doctor I finally found did take Medicare. After about 2 years he advised his patients that he was opting out of Medicare because of the paper work and the time it took to get paid. Since I had already established a relationship with this doctor, I stayed with him. Fortunately I have the money to pay out of pocket for my care and by limiting my visits to twice a year I am making it. However, I disagree with the gentleman who made the above statement about how doctors like the way that Medicare pays.

  • Judith Logue

    I get so tired of the threat that doctors won’t treat medicare patients. This is the biggest market for their services. How are they going to treat? Youngsters? Wish they would just stop this dumb argument. Not enough doctors? Really????

  • IHE

    One aspect of Medicare spending that I never hear anything about in these discussions is the fact that doctors’ training is paid for with Medicare funds. The payments are made to universities with medical center residency programs. The universities are paid a certain amount for training interns, residents, and fellows in their programs. The universities, in turn, pay stipends, significantly less than than the amounts paid by Medicare BTW, to the program participants (Docs).(The medicare payments were approximately $67,000 dollars per FTE, or full-time-equivalent, in 1999.) Perhaps interns and residents should be obliged to repay Medicare by agreeing to accept Medicare patients.

  • Ron A

    All the panelists seem to agree the goal is to lower the national cost of medical care in general as well as the cost of Medicare in particular. Since we know medicare is a more efficient form of medical care than the private insurance version of medical care, it’s too bad the following question didn’t arise:
    What would the cost effect be if the entire country, all age groups, were covered by medicare as has been suggested?? Wouldn’t the inclusion of younger, healthier patients offset the cost of the older “less healthy” patients as is the underlying premise dictated by the insurance industry within the “obama-Care” program??

    Coupled with the more efficient admin model, it seems like a “no-brainer” that is thwarted and precluded only by special interest.

  • http://www.facebook.com/diana.mcclure.94 Diana McClure

    Unlike the panel on show about Doctor reduction-it has been reduced in our area of Ky and 4-6 month wait on appointments or no appt. at all in many locations for medicare or uninsured

  • Marc

    What a great idea! Then America could join the other rich, industrialized, intelligent countries like Germany, Denmark, France, the UK, Switzerland, Japan, Taiwan, Norway, etc. who have figured this out decades ago and are ALL higher on the WHO list of health rankings. America is outdated. If you don’t adapt, you become irrelevant and fail. Failure is not an option.

  • Michael C. Utah

    Hey, do you watch PBS? I do. Why reinvent the
    wheel? Copy a system from any other “first world” economy, Canada,Great
    Brittan,Japan or Germany etc. We’ll pay a lot less and get a lot more.Privet
    insurance is just too inefficient. mcantor@hotmail.com

  • DuckSoup

    If “market competition” were the answer to rising health care costs, then other advanced countries would be using it, successfully, to rein in medical spending. But these countries are doing the opposite – interfering heavily in healthcare markets – and achieving 50% savings compared to the U.S. The fact is, as two of the panelists emphasized, medical markets don’t function like other markets, and competition doesn’t work.

    The libertarian panelist claimed that Medicare is “inefficient,” citing a report showing that the program spends about $48 billion more than it needs to per year. Really, the issue with those monies is less inefficiency than fraud and over-treatment. For example, many older Americans are taking dozens of pharmaceuticals at the same time. You can’t convince me that all these drugs are necessary. The gov’t needs to deploy more resources to clamp down on this activity, resources that will easily pay for themselves.

    However, if we really want to reduce healthcare costs, we need to stop letting business interests poison us, and we need to make healthcare more about achieving true health than treating symptoms. The corporate food system is a disaster. There is no good reason the majority of the population should be eating a processed food diet, laden with all sorts of chemicals and constituents altered beyond recognition by our evolved bodies. To cite one example, the gov’t has virtually waged war on farmers who chose to provide raw dairy products to their communities. The fact is, pasteurization destroys much of the food value and makes dairy products extraordinarily hard to digest. The gov’t pretends it’s worried about TB, ruminant fever and other potential hazards of raw milk products, but these hazards are easily minimized with modern handling and testing measures. The real reason for the crackdown is to force dairies to become mere suppliers to the corporate food system, wherein processors and especially retailers make the real money. Often, a retailer will make more profit on a gallon of milk than the gross price received by the dairy. This is ridiculous. Of course, there are many other examples of how corporate food is hurting our health, form HFCS to trans-fatty acids, to GMOs, to phytic-acid laden cereals, to arsenic-polluted rice, to artery-clogging corn-fed beef, to e-coli outbreaks, and on-and-on.

  • David Harrington

    Why didn’t you mention the option of lowering the age for medicare instead of raising it? If the age is raised, the ratio of sick to well people in the program will go up, making it cost more. Lower the age to say 50, with many more well than sick people included, and the ratio goes down. This is simple logic. But maybe Mr. Suderman wants Medicare to fail.

  • http://www.facebook.com/profile.php?id=830875031 Jeffrey Knee

    The insurance business model must change. Both public and private. Instead of prepaying premiums, we should post-pay based on extended family networks, sliding scales and on care outcome quality.
    Throw out premiums, tax subsidies, and employer pools. As well as poverty-based entitlements. Instead, use state family law to require extended families taking charge of needy kin, and enforce it across state lines using IRS oversight.
    Entitlements originated decades ago when extended families all lived in the same areas; they all suffered a weather or employment calamity. We needed a national tax funded safety net. Those days are over. We now have relatives across the country, but the gain is on adding personal oversight. The govt cannot compel you to change health and reproduction habits like your relatives can –especially if they’re liable to pay for the results.
    In return, cut all taxes 50%. The entitlement burden would switch from the political branches to the courts, and IRS enforcing surtaxes and fines for negligent family members (but they’d gain powers over needy kin, who would lose rights until straightened out).
    Education and crime: cut taxes and then target surtaxes and fines on the relatives if a student fails, drops out, gets pregnant, goes to jail — again, to stop enabling bad habits and instead compel families to help each other and stop dumping their needy on overtaxed middle class.

  • David A Bailey

    Most medicare dollars are spent on patients in their last years of life. A long time sick 0ld person who is bedridden without hope of recovery. This is wastefui and beyond reality. America; we are all going to die at some point in life and there is no reason to spend hard earned resources on any of us when the chances of recovery are nil/nada and none. No matter how long you pray and wring your hands, life is not forever and old age is the appropriate time to time.
    In my case, I am a healthy, 75 year old man who takes care of himself and have no complaints; yet my doctor brings up “stress testing” when I see him. I have not cooperated because I have determined that it is an attempt to overtreat me and bill Medicare and my supplemental insurance. The waste should be drained from the system by the government and each individual patient. It is paramount that we do this and stop whining about the cost of medicare.

  • Geezer

    I would like an answer on the medical costs for treating illegal immigrants in Emergency Centers on the weekends. This was not mentioned in the show..
    With approximately 20 million in the USA, and not paying into SS System, but using Emergency Facilities on weekends for free, does anyone have records of this cost?

  • Katie

    I agree with Marc. We can fix Medicare by expanding it and allowing the program to bargain drug costs, global budget for hospitals, and if we eliminate the private insurers from the mix, we can keep overhead way down for both the providers and the insurers. Who will lose out? The CEOs and shareholders making money of people who are sick. I am perfectly fine with those odds.

  • Common _ Sense

    The comparison of the “Ryan” voucher and President Obama’s Medicare as is an apples to oranges comparison. One tries to address the cost while the other ignors the cost! It is like asking who they like better the tooth fairy or the dentist! The American people need to understand that the tooth fairy is not real!

  • Walter F. Picca

    How to save Medicare–found in “The Tax Guardian.com” ; for example, the Franklin Plan, four things individuals can do to cut costs, the right to die, the legalization of euthanasia, raise taxes on those that receive the benefits, etc.–ignored by Ray Suarez and panel

  • Anonymous

    As long as medicine and health care remain a commodity for sale in America, it will continue to increase in cost. Just like the stock market, everyone needs to make a profit, and it has to be higher every year.

    In my city, the doctor will see you for one complaint at a time. Do you have a headache and a stomach ache? That’s two visits. Need an x’ray for that twisted knee and a Rx refil for your blood pressure medicine? That’s two visits.

    When you go to get the x-ray, you pay for the x-ray, the radiologist, and then have to make another appointment with your doctor to get the results of the test and move on to the next step.

    It’s expensive and inefficient with a layer of insurance company profits on top and a side of malpractice attorneys.

  • Carole Bahou

    Every time I hear a discussion in our country about healthcare, I feel as if I am entering an alternate reality. The discussions all seem to ignore two fundamental issues. First, is the basic reality of what it means to be a sick, injured or dying person, and that one is in no position to “shop” for anything when one is in pain, short of breath, bleeding, confused, etc. Neither health nor health care are finite commodities like a grapefruit, but are instead processes with often uncertain outcomes. That is what makes it impossible to know in advance what our care will cost, under our current method of payment. This brings me to the second issue which is the market system, that we refer to as insurance. This system is based on the entrepreneurial model, whose purpose is to maximize reimbursement for the providers, whether than safety and well being for the recipients, And if you don’t believe me, just check the hospital re-admission rates of older patients, which Mr. Suderman somewhat alludes to in his comments. It seems to me if we feel that health care should be basically a business, then we will march down this road, with continued resistance to universal access to health care in the US. If we feel the purpose of medicine should be patient care, then we will need to res-structure how we deliver medicine, such as group practices, and other ancillary care services that can help people avoid unnecessary tests and hospitalizations. And of course, as Dr Angell has stated, in order to control cost we need to change how medicine is practiced in the US. It is a matter of our value system, and how we define cost – in only dollars and cents, or in human suffering that is at the heart of being a sick person. As a footnote, I’m wondering how long Mr.Suderman expects to, or would like to live, and if he really expects to be in total control of that matter, as one controls how many grapefruits to buy in the market place. Perhaps someone can ask him. Thank you…

  • Bruce McConnell

    A favorite newscaster among the fine people
    of Newshour.PBS has been Ray Suarez, until I happened upon “Need to
    Know” this Saturday, February 9, 2013 on local PBS. The program was about
    how to save Medicare and reminded me of the story about the Sicilian family.
    The husband obtained an audience with the Don to ask permission to buy a pint
    of blood for his wife, now hemorrhaging in giving birth to their first child.
    This was no problem for the Don, who took the family’s house. Does not our
    present medical system amount to the same thing?

    The unconscious young expert cheerfully proposed the same blackmail, claiming dire losses of doctors when they abandon Medicare for more money. The more
    seasoned experts corrected his worried enthusiasm, but even they ignored the
    crux of the problem, thanks to Ray’s astute avoidance of the topic: We could
    save the shank of a trillion, 950 billion $ each year, if we used the medical
    service employed by all the developed countries of the world; not just $150 or
    so billion over ten years for cutting costs, but EVERY YEAR! So much for the $trillion used to threaten us by the transparent young Republican when we reach 2020.

    Independent panels tell us that soon, our US economy will be bankrupt merely to maintain our doctor’s deluded lifestyle. Ray knows this as something we “need to know”. We learned nothing we needed from you, Ray.

  • jim papai

    well said..well thought out..and dare we mention the creed of the very rich..truly

    reflective of the human condition and in particular man’s ego

  • Sandy Varndell

    I’m not sure if this idea has been considered but what if medical school training was paid for by the government, with the stipulation that each doctor that took part in the training provided must serve as a Medicare or Medicaid doctor for say, 10 years. perhaps they could specialize in geriatric medicine, and take a reduction in their pay for the time served. Since they wouldn’t have massive student loans to pay back, and possibly lower insurance premiums on their practices, they would win financially. patients would win, too, because there would be a lot of doctors available to see them, instead of not accepting Medicare patients. The Medicare program in general would win as there would be new doctors coming into the system annually and they would be specializing in treating older adults, gain 10 years of experience before they are finished with their service. This is something like the military’s college assistance but in reverse.

  • Helene Barbara

    What a creative, positive and practical idea ! Thank You for sharing it ! I hope someone of influence will consider your suggestion.
    Another problem I have with the Medicare system though is that treatments are given, in general, by traditional doctors, trained in AMA type schools, prescribing drugs to make people healthier. We should look at a person’s life style habits, tell them that they must improve the food they eat, etc., and then NATURE, in all it’s incredible ways, will begin to heal the body in a more Natural way ( herbs, detoxes, good eating habits and some exercize or movement ). With HEALTHIER people the costs for Medicare would also be greatly REDUCED ! I actually believe the American food industry is a big part of the problem !
    In general, we should be spending much more money on prevention than treatment. It is the other way around perhaps because many people are making alot of money keeping things the way they are ! It’s a painful shame !

  • Richard Patterson

    I must not do enough texting, because I don’t know what “CABG” is. I flagged this comment as inappropriate because I don’t understand it. Is SMU “Methodist in Houston?”

  • Anonymous

    Health is not just a technical thing. It is about body, mind and spirit. Health is about a larger context of living. The larger context has traditionally been about culture. The cultural consensus provided by the group then reduces choices and individuality.

    Twenty-first century America is comprised of a multitude of elements that are trying to jump into our awareness with ubiquity. So now we have a thousand voices shouting at us to modify our beliefs and our habits. Sorting out how to be healthy within the milieu requires a significant effort and perseverance. The healthier a person is, the greater his ability to make sound decisions about growing and staying healthy.

    This Need to Know Medicare presentation shows a chart in the beginning about how wealthier, inquisitive people have made greater gains in longevity than others. So, there must be something significant about lifestyle or environmental elements that they have learned or can afford to practice.

    The control of individual pathways of lifestyle is much of our cultural tradition. The power of market forces to drive satisfaction of these lifestyles is also an important remaining element of our culture. But, now we know that lifestyle caused disease is a tremendous factor and a burden on paying for our costs of healthcare, including Medicare.

    We, thus face a dilemma about how to optimize health and its costs is in the midst of individuals being exploited in consumption habits. Markets know so well how to use our brain’s predispositions to degrade health in making profits and that individuals are choosing to do so.

    Our acquired scientific knowledge about nutrition is not being used to keep healthcare costs down. We then seek pharmaceutical solutions to the damage done by improper nutrition. Again, we obtain profit by providing masks and quick, easy fixes that ultimately don’t solve the lifestyle acquired disease.

    In the light of these problems, it seems that our culture is not successful. Ultimately, we must face the ills about how the culture works.

    We know that it is going to be a long hard slog. We have righted wrongs and neglectfulness in the past: slavery, child labor, old age poverty, cigarette smoking, wearing seat belts, etc. We must work on righting the wrongs in the food system and its promotion of ill health. I am sure we will ultimately achieve this and the costs of Medicare will trend toward affordability. But, in the meantime, we will be experiencing miseries that are imminent. It is a bitter pill, but individuals might need the suffering to start making wise decisions about nutrition, and healthy lifestyle. There seems to be no pill for personal responsibility.

    Nature has built in us a trap of desires and the food industry obliges by tossing us into it.

  • http://www.facebook.com/ronnie.williams.5011 Ronnie Williams

    it really get’s me that we say that we are one but it’s not true. to know one self is to be part ,of the whole. if the books told the whole story.we wouldn’t be talking about this. but the books don’t tell the whole story about the America. what’s wrong with my history or yours this is what make up the America history. we say free speach but is it when it dosn’t up set a group that it seem to what to keep the people down and the rich up as long as thier happy. it ok but if we ask why or how comme we wrong. that not the America i love if you for get you will repeat it.

  • Carol Lilly

    To help with prescription drug costs, couldn’t we return R&D for drugs to university settings and leave drug production to pharmaceutical companies solely under contractual arrangements based upon actual physician-determined need, not patient (customer)-driven demand?

  • Sandy

    The age someone enters Medicare should not be raised. If it is raised, then only much older and more unhealthy will be the only ones paying the premiums for Medicare and then it will fail or become too expensive for anyone to afford.

    Much like Obamacare needs the complete “Pool” of participants, young and older, health and unhealthy to pay premiums into the insurance pool to keep it affordable for everyone.

    This is all basic insurance concepts. Basic Math. The basic definition of Insurance is the pooling of monies to take care of those who have a claim. Same with auto, home, and health. Do not abandon these basic principals in Medicare. It make no common sense to do so unless failure is the goal.

  • Sandy

    I agree with you David. Completely. the pool of payers into Medicare does not need to decrease. Check out my post.

  • Sandy

    Agree. That is what Obamacare principal is all about, making sure everyone pays something . Both the healthy and the sick. The rich and the poor. The pool of funds take care of those who get sick. Just like the pool of funds pay for the auto insurance accident, the Home that burns down in auto and home insurance.

    Some may not realize that many of the uninsured in the health market are the some what rich and the very wealthy. They intend to pay out of pocket when they are sick and dying. Lets hope they do? (oh no, they do not find a legal way not to pay? shelter their wealth ? But now at least they will have to pay a fine into the pool to help out.

  • Sandy

    Agree totally ! I have been paying for my own Health Insurance now for 4 years, and I am 63. No health problems in that time and I pay $650 a month for one person. No company would sell me Health Insurance because I have a birth defect that was discovered 15 years ago. Never caused a problem and I have no health issues that someone my age usually has….so I had to buy a high risk State Plan, or go without insurance.

    My premium has been pure profit. So far they have had to pay out zero.

    Elizabeth, the Insurance industry does not want Medicare to prosper, they want all the premiums to be paid to them. Remember the Supreme Court declared that Corporations ARE people, so they rule the Congressional votes with PAC money.

  • EndCorporateRule

    It’s hard to know where both to start and to stop in discussing just how inadequate was this roundtable.

    For one thing, I find it amazing that nobody thought to mention that virtually every other industrialized country provides medical coverage for their entire population at about half what we spend to cover a fraction of our population. Is the U.S. situation SO unique that none of these approaches could possibly work here? I doubt it.

    For another, it might have warranted a mention that the biggest problem with the U.S. medical system is that money comes first, not the common good. Hospitals, insurance companies, PHRMA, medical device peddlers and even many doctors are in it for the money. This wouldn’t be so bad in another industry, because market forces would provide discipline, but medical care does not fit with the market model, for many reasons, some of which were stated by panel members and some which were left unmentioned (e.g., adverse selection, moral hazard, the highly technical nature of medical care, time constraints, lack of energy on the part of the seriously ill and their already stressed-out family to do the appropriate research, the extraordinary market power of hospitals in small and mid-sized communities, etc.). We all know that drug companies make a fortune off their products, with profit margins well above just about any other industry. They also are routinely implicated in selling products they know to be harming the public, and in pushing doctors to prescribe them for conditions other than those for which they were approved. We are also familiar with some of the insurance company antics, such as rescinding policies for trivial reasons once subscribers become seriously ill, or arbitrarily refusing treatments in order to achieve quarterly profit margins. What the public is less familiar with is the price-gouging of hospitals, who routinely bill for products and services not delivered (which insurance companies typically don’t catch because they audit a summary, not a detailed bill, and because it’s in their interest to keep medical costs high and pass them on to employers and the public), and absolutely rape those who are uninsured or underinsured, thanks to federal laws which force them to charge every patient the same (grossly inflated) list price, while accepting a tiny fraction (still giving them a decent profit) in reimbursement from those with good insurance.

    Moreover, our medical system is designed to treat symptoms and not root causes, so it does a terrible job with chronic conditions, many of which are related to our hideous diet, designed by Big Food to meet their own profit goals. Ms. Stein related an anecdote about how Medicare has been a life-saver for an M.S. patient she knows, but the medical establishment refuses to see rampant evidence that M.S. and many other autoimmune diseases are related to digestive tract dysfunction caused by diet and medicine (especially broad-spectrum antibiotics). They have also ruthlessly gone after medical pioneers such as Revici, Burzynski, Keller, Pauling and others who have demonstrated that other approaches to cancer are much more efficacious, not to mention kinder and safer, than chemo, radiation and radical surgery.

  • barefootpaul

    This was one proposal for the ACA (Medicare buy-in) that was shot down by Joe Lieberman even though he had supported it before. Now that he’s gone, it should be introduced again. Premiums paid by those who don’t currently qualify could be adjusted to help ensure sustainability of Medicare for those who do.

  • Lee, Mpls, MN

    I fear we don’t want to talk about the increasing expense of care, including chronic care, combined with the fact that many people now live into their ‘retirement years’ for as long or longer as they worked. Companies no longer provide insurance or their retired workers, therefore increasing costs either need to be paid by Americans (ie: our Medicare/aide premiums) OR we will need to make an economic decision
    and allocate expenditures by likely limiting services. In addition, I believe we need to examine the types/quality of food we eat, the amount of processed and sugar
    additives/chemicals to examine how our over eating etc affects our health. Last comment, IF we believe there is a ‘right’ to medical care, then we will need ‘nationalized’ insurance; perhaps ‘augmented’ by ‘concierge’ medical care for those who can afford such. I believe given the aging of society, and many fewer employers offering affordable insurance, we will see more people going into Emergency rooms; not price effective.

  • Madalyn Lane Redini

    LOWER OR ELIMINATE MEDICARE ELIGIBILITY AGE. Medicare has issues because it covers older, sicker people. Insurance is supposed to be a mix of healthy and non-so healthy people. Medicare should be the public option that was left out of the Affordable Health Care act.

  • Ann

    Like some of the postings here, I need a discussion about Medicare costs to include the percentage of total health care costs to GDP (Gross Domestic Product). Medicare is only a part of the total costs. The total also includes the cost of all private insurances. What would the percentage be if we had “Medcare for all” and what it would be if we only had private insurances? I would suspect that the comparison of the two projections would reveal that republican plans for Medicare would greatly increase the percentage and progressive plans would greatly decrease it.

  • Anonymous

    I agree completely. In fact, Medicare has been sensibly proposed as a mechanism to implement a single-payer health care system for everyone, not just the retired elderly and disabled. The absurd arguments and criticisms of the right-wing ideologue panelist Suderman really disgust me. He really is covertly serving the interests of insurance and pharmaceutical companies, not the public interest. His agenda is to eliminate or weaken Medicare as much as he possibly can, not improve it.

  • Bob in Carmichael

    It’s surprising how the cost of medical care in America can be discussed without mention of how FREE MEDICAL CARE IS PROVIDED IN AT LEAST 16 OTHER COUNTRIES. If you saw Michael Moore’s movie, “Sicko”, you would be impressed with the quality of medical care in OTHER countries. One savings in America that I am aware of is our government negotiating with the pharmaceutical industry for the cost of drugs. However, in 2004, our Congress voted down the bill that would have the government negotiating prices of drugs for those on Medicare, and the NO vote was supported by the AARP. Another failed opportunity to control the cost of medical care was when Congress failed to include a single-payer program on Obama’s Affordable Health Plan. Then there are the outrageous insurance premium increases every year in percentages sometimes over 30%. In Sicko, it became evident that other countries consider health care a moral issue. In America, the pharmaceutical, medical, and insurance industries appear to be more concerned about profits, than what is the moral, ethical thing to do.

  • http://posologist.blogspot.com/ Jeff Healitt

    Is anyone else suspicious that PBS is caving in to corporate interests, especially the Libertarian billionaires interests? After watching this program I’m left with some serious questions about PBS’s integrity.

    Why are we even having a discussion about cutting costs to Medicare when other cuts to Government spending (like military spending, corporate welfare, and corporate crime and offshoring) could reduce our budget/debt much more drastically, while leaving the publics’ safety nets alone? Whose idea was it to bring up a discussion about this topic, and why is “fixing it” more imperative than fixing these other costs are are causing deficit problems right now?

    Why is Need to Know including this young (specifically-mentioned) Libertarian “editor” who works for the (Billionaire) Koch-owed Reason Foundation even included in the discussion? Neither Mr. Van de Water’s or Ms. Stein’s political leanings weren’t mentioned. Why not include some communist, socialist, or anarchist editors in this discussion?

    Is PBS trying to give this fringe political wing credibility because of monetary support? I’d sure hate to see “public” television sell out just for money.

  • Bert Thompson

    Peter Suderman is deliberately not answering Ray Suarez’ questions, but making his own, politically motivated, irrelevant talking points — a horrible guest. Ray Suarez is making no effort to counter his assertions and, in fact, is handing him leading, softball questions. This is a terrible show and you have LOST ME AS A VIEWER.

  • Karl Munzlinger

    There seems to be a lot of concern as to how to pay for Social Security and Medicare to meet the needs of our aging population. To give you an idea of how old I am, I can remember waiting behind a cart loaded with ice while an iceman chipped off a block. Once finished he would hand out slivers of ice to the kids waiting before delivering the block to a nearby apartment. On returning he would collect the flatiron like weight restraining the horse and then go clip clopping down the streets of Manhattan. So I’ve seen a lot of change, economic ups and downs, and after all this time, I’ve come to make sense of it. The game changers were the automobile, the telephone, and passenger aircraft. We had all that in the 50’s with only one member of the household required to work for it. In thee 60’s the American Dream of a three bedroom rambler in the suburbs caught on and I bought into it. Inflation reared it’s head and disrupted the 70’s after the banks revised their home loan lending policies to include women’s salaries and home prices soared. With two incomes now required to purchase and pay for a home, women were now locked into the work force. It resulted in a tremendous change in our economic system and it happened in less than twenty years.
    Now I’d like to introduce you to the concept of ‘funny money’. The amount of money you make and the amount of taxes you pay doesn’t determine your standard of living. It is what you can buy with what you have left. Through the miracle of inflation, the next generation could pay over half of their incomes in taxes and as long as their purchasing power relative to those retired was kept the same they would be no worse off. What’s more, unemployment can be regulated by lowering the retirement age as Social Security and Medicare will be funded by ‘funny money’.
    Have a nice day.

  • teabag

    i know of one reason to raise the eligibility age for medicare: non-discrimination! when i went on social security disability (ssd) i was forced to wait two years before i was eligible for medicare coverage. in effect, the government was telling me “yes, we agree that you’re too sick to work, so now you have to wait two years before you can afford medical care.” (mind you, i was on ssd because i had been working and paying into the system all my adult life. if i had never been employed, i would have gone on ssi and had immediate full medicaid coverage. however, i couldn’t get medicaid, as my ssd payments made me too “rich” to qualify for it. so i was on my own.) that provision is still in effect, but no one ever mentions it! since it’s illegal to discriminate against people with disabilities, maybe nobody wants us to know that the federal government is doing just that. or maybe the social security administration just figures if they hang sick people out to dry, a lot of them will die before the two years are up, and they won’t need medicare. either way, it’s probably saved a lot of money, so why don’t we try applying the same rules to everyone instead of discriminating? retirees would have to wait two years after they become too sick to work anymore, or after they’re forced to retire because of age, and only then could they get medicare coverage. then the same rules would apply to all. it might not be nice, but it would finally be fair and legal.

  • Elan

    I’ve been on Medicare for 15 years. I paid my working contribution for over 50 years, and now retired I pay — $199 deducted from my monthly $1400 soc sec. Some people think it’s a free benefit — it isn’t. Along with that deduction I have to pay Medicare Supplement $166 and $18.50 for Rx plan. Why do we have to join medical/dental plans????? I remember just going to the doctor of MY choice, getting a Rx and taking it to a close-by drugstore for filling at average cost of $12. What’s happening to us???? Why are we sending billions to other countries, subsidizing corporations who have low tax rates and huge profits, and allowing our government employees to increase their pay whenever they choose — but we’re going to zap soc sec and medicare???? Don’t we vote to have our government care the best to keep us well and our country sustained and pay with our taxes to hire them to do just that? I think we have a pervasive disease called greed/corruption and we’re not finding a cure. Maybe the mysterious billions we contribute for cancer research will help. Thanks so much for being PBS — such a treasure for us all.

  • Luis F. Sotomayor

    Coronary Artery Bypass Grafting