Is Medicare a Good Model for National Health Care?

It is a rhetorical technique to state a debatable issue as if it were fact. It puts opponents at the disadvantage of having to play defense, and those who may be less well informed will have a tendency to assume your statement is true.

I keep hearing proponents of a government option in health care use Medicare as an example of how well it will work. The President did this Wednesday night. So, just how well does Medicare work?

Many doctors will not take new Medicare patients because the program underpays so severely as to make it impossible to earn a living if they see too many patients. Not impossible to earn a good living. Impossible to earn a living. Some Medicare reimbursements are so low that, depending on the doctor's overhead, each patient visit can be a few dollars either side of break even. It requires those of us with the kind of insurance that the administration and some in congress are villainizing to pay our doctors enough for our visits that they are able to afford to see Medicare patients at all.


Medicare is due to start bleeding money faster than it is taking in money in just a few years.


The President thinks there is so much "waste and abuse" in Medicare and Medicaid that cutting it out will fund nearly all of his new plan. If there is that much "waste and abuse" in Medicare, why not cut it out now?

Part of the reason is that in any bureaucracy there will be waste and abuse. The larger the bureaucracy, the more waste and abuse there will be. That is just the nature of the beast. Nothing runs perfectly and the larger and more complex the organization, the less perfectly it will run. It is fantasy to think you will eliminate waste and abuse any more than you can eliminate gravity. In order to get money out of Medicare he is going to have to cut payments in a system that already underpays to the extent that health care is now being rationed to the elderly by virtue of doctors not accepting new patients.

The President promised that a government run plan will be self-funding. That is the way the Postal Service works.

How long did you have to stand in line the last time you went to the post office? Postage rates have been increasing annually for the last few years and still the Postal Service is losing money. Rather than resolving the problems by being more competitive and customer friendly, they are talking about cutting delivery services to 5 days a week and closing some post offices. This is what happens when the government runs something. There are no competitive forces at play to compel creative thinking. It doesn't become a matter of providing better services to the customer. Do we really want to replace what is arguably a good health care system in need of improvement with a government monopoly similar to the Postal Service or Medicare?