Tuesday, May 18, 2010

Prediction: Next Stage of Socialized Medical Care

I've talked about this before, somewhat, but I'm not sure if I've ever laid-out a specific prediction on the future of medical care in the US, now that it has been partially socialized by the Obama administration. One could argue that these changes were inevitable with or without the latest "reform", and that they stem from the Medicare system in general, but more socialization certainly doesn't help.

From Texas: more doctors opting out of Medicare. Now, no big surprise here: Medicare is somewhat unfair to practitioners, underpays for procedures, has horrible inefficiencies, a spotty payment history, and is generally a pain compared to other insurance programs. To some extent providers accept Medicare for the same reason businesses take credit cards: it opens up markets and allows more sales opportunities. However, as the Medicare costs go up and the system continues to degrade, look for more practitioners to drop it as a coverage option, leaving few actual resources for those with Medicare.

However, this will not go over well in Congress, especially since more people than ever are going to be on government health care. In response, Congress will mandate that some practitioners take Medicare, probably all over a certain size. This will launch a fight between the medical industry and Congress, and cause more hospitals to go under and/or restructure to avoid falling under the mandate. We may also see some bailouts in the form of subsidization, to delay the problem at the expense of the taxpayers, while the underlying problem continues to get worse. In the meantime, the medical profession will become even less attractive from a cost/potential perspective, and we could see even more of a shortage of practitioners.

Eventually indefinite subsidization and accounting shell games will no longer be able to hide the true cost of Medicare, and the problems will come to a head. At this point, it's hard to say what will happen; liberals will blame conservatives and visa-versa, but in terms of real action, it's anyone's guess. Politicians will try to forestall this point until we as a country have more dire things to worry about (eg: hyperinflation), which, at the rate Obama and the liberals in Congress are expanding the deficit, may come sooner rather than later, and they may succeed. If they do, it'll get lost in the revolts which inevitably follow an effective national default; if they do not, the rest of the options may all be untenable, and it could well be the final straw.


  1. All I know, when I turned 65 I HAD to go on Medicare. In the 2+ years I've had it, I've had no one come to my door to offer me a different plan for my healthcare. I don't know any one my age or older that has a different plan. We do get to choose our 2ndary insurance, but in the end, they all pay the same. It is not very smart to pay a lot for it, because of that fact.

    This year, and next, we got no increase for SS, but our MC and supplemental went up. Our RX program went up too. (It is a good thing my hubby is still able to work!)

    FYI: For those still working. If you drop out of the workforce, and then years later, take a job that pays less, just because you want to help out, remember, SS takes the average of the last 17 quarters you work. Your average could drop like a rock,and thus your SS payments will drop too. Just sayin'.....

  2. I wonder what tools the government has to make providers take Medicare patients. Maybe it’s b/c of licensing. I’m a licensed engineer, but most of my work does not require licensure. So it’s hard for me to imagine the government saying if I’m going to design circuit boards I must design at least a portion of them at a rate of the gov’t’s choosing.

    I do not think things will turn to worms as you suggest. My prediction is that if the gov’t adopts this policy and applies it to people on a gov’t-regulated insurance, standards of what constitutes “normal” care will fall commensurately with the amount of money paid to providers. As this trend moves forward, more and more people will enter transactions outside of the gov’t system. Providers will offer gov’t-level care and executive-level care. Demand for executive care will keep suppliers providing medical care.

    The result is the poor will have a formalized system of socialized medicine rather than the informal one we have today and are in the process of overhauling. People who are not poor will make a decision on a case-by-case basis, weighing treatment cost against the severity of the illness, whether they want to use the cheaper gov’t option or get executive care. Nothing radical has changed, and politicians can claim they solved a problem.

  3. Re: Tools the government will use...

    I would predict it'll happen more or less exactly like that: the government will be forced to simply mandate that more medical care providers accept Medicare. If we still have a socialist-leaning Congress, it'll probably be targeted at larger providers (especially since with all the increased documentation and overhead costs, and out-of-control liability costs, large providers will be almost the only providers left). It has happened before to other industries under the umbrella of "crisis", real or otherwise (eg: consider all the industries co-opted during WW2), and this will be similar. The government will claim it needed to take extraordinary measures to preserve the system in the country, the leaders are not interested in running the various businesses, the government needed to act in-part because of the greedy large corporations putting profits in front of the needs of the people... any of this sound familiar (hint: it should)?