Making the Elderly Suffer for Bad Health Care Policy

I don't know what's happened to the NY Times editorial board but they seem to have taken leave of their senses today. Today's editorial discusses the various versions of Medicare "premium support" (aka vouchers) and comes out in favor of them, with some caveats. Here's their great idea:


The best proposal for premium support is one that gives beneficiaries choice while protecting them from any added costs if competition does not keep prices down. Enrollees would be given a set amount of money to buy a plan comparable to what Medicare now provides. If they chose a plan that cost less, they could pocket the difference. If they wanted better benefits, they would have to pay the added premium themselves. But if market competition failed to restrain costs, the federal government would increase the support given. So far, this idea has found no support among leading politicians, who apparently have less confidence in market forces than they claim.

Gosh, ya think? Is it possible that even craven politicians can understand what would happen with that plan? Do you think the insurance companies might have some skewed incentives at all? (Gosh, if prices go up the government will pay more! Great!)

This is the elderly we're talking about here. The only people who would want to take the cheaper plan are those who really need the money. It wouldn't be healthy people, it would be poor people. It's highly likely that these poor people would not get the care they need for chronic conditions or preventive care because their policies wouldn't cover such things, thus entering the system sicker and requiring more expensive care. That's how "cheap" policies work.

I don't understand what world these people live in. Do these people honestly believe that the elderly, most of whom are already sick in one way or another or are destined to become so (after all, it's a rare person who stays perfectly healthy and then dies peacefully in his sleep at age 92) should be forced into a more complicated system than that which already exists? It's as if they are being accused of irresponsibly running up big bills and must be taught a lesson in prudence before they die.

I would love to know where this penchant for making the health care system even more complicated and unworkable comes from? And why does everyone have to be a "consumer?" We are citizens and human beings and when we get old we get sick, period. Making elderly people shop around in order to live is utter nonsense when we know that the only reason to do so is to keep our "privatized" system reaping profits every step of the way.

It's the abstraction in all these debates that drives me crazy. People, not statistics. Patients, not consumers. Yes, health care costs are high and are absorbing more and more of our GDP, but the sick people are not the problem. Getting sick can happen to anyone and getting old is something that will happen to everybody (if they're lucky). Treating being human as a problem is the problem.

Hullabaloo / By Digby

Posted at December 5, 2011, 3:20am

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