Celebrate Medicare's 45th by fixing it for future

Letters To The Editor
Palm Beach Post
Friday, July 30, 2010

Americans should celebrate this 45th anniversary of Medicare.

During just nine months in 1965, without the aid of computers, every elderly American got the option to enroll in Medicare. Most did. Medicare lifted elderly citizens out of poverty while lowering levels of sickness and death. Today, Medicare subsidizes most profits of the private insurance industry, indirectly and directly, by removing the oldest, sickest and most disabled Americans from the risk pool, paying private insurers more to cover some Medicare-eligible Americans and by providing taxpayer money to private companies to offer rationed drug formularies to some Medicare patients. Medicare also subsidizes large private businesses by removing the burden of health care legacy costs of retired employees.

The health care delivery practices of doctors, hospitals, clinics and therapists have progressed in the last five decades. Medicare has remained entrenched in its 1960s structure. Medicare remains the only insurer in the world forbidden by law to bid competitively on a medicine formulary. Americans therefore pay the highest prices for medicines in the world. With no funding available, Medicare cannot develop and integrate a single electronic records and billing system for its contracted physicians, hospitals, therapists, pharmacies and clinics. Without this, real-time tracking of fraud is impossible.

Congress can ensure a healthy, solvent future for Medicare by broadening its risk and premium pool to include young and healthier Americans, allowing Medicare to bid on a drug formulary, ending redundant Medicare Part D and Medicare Advantage subsidies and financing development of an electronic system to track medical outcomes and billing fraud and therefore allow competition among doctors, hospitals and drug companies based on quality of care.

West Palm Beach

Editor's note: Dr. Howard A. Green is a member of Physicians for a National Health Plan.