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In the last few shows, we’ve discussed health insurance and ways to receive medical care for less money overall. Today’s topic dives into the Medicare program.
Medicare accounts for 20 percent of healthcare expenditures and is 13 percent of total federal spending. Medicare is the second largest program in the federal budget ($767 billion), second only to the Social Security program ($1.151 trillion).
In 2021, Medicare provided benefits to 19 percent of the population. By 2030, one in five Americans will be older than 65. The expenditures will most certainly rise due to increased enrollment, rising Medicare prices, and increased use of care as people with chronic conditions live longer. Accordingly, it is imperative that policymakers arrive at viable changes to the program that do not sacrifice seniors at the altar of cost savings. (You all know I’m a fan of cash – but most people currently are not prepared to go that route. Health Savings Accounts take time to grow.)
Medicare is funded mainly from general revenues (43 percent), payroll taxes (36 percent), and beneficiary premiums (15 percent). And the well is running dry. We have gone from 41.9 workers per retiree to 2.8 workers paying into the fund. In 2020 Medicare’s trustees reported that the trust fund, which pays for hospital and other inpatient care (Part A), would start to run out of money in 2026.
People say we can’t agree on anything these days. They say we are too divided. (In my view, most of us want the same goals but have different ideas on how to achieve them.) One thing we all want is for seniors to not struggle in retirement after working hard for so many years. Another is that we don’t want to kill off our seniors with rationing of medical care. Treatment decisions regarding withdrawing or limiting medical care must be open and transparent and follow the patient’s wishes.
The rationing going on with seniors on Medicare is more subtle and behind the scenes. More and more seniors shifted to the Medicare Advantage managed care program with its fixed allotments to medical professionals and restricted prescription medications. Moreover, the Affordable Care Act decreased payments to this program by $156 billion. Will the program make up the difference by cutting services?
My guest today will discuss Medicare’s general rules, pitfalls for patients, and his ideas on how to improve it.
Mr. Steve Cohen is a partner with the Pollock | Cohen LLP law firm in New York. His practice epitomizes the intersection of law, policy, and journalism – with the realities of politics. For 35 years before going to law school, Steve was a successful publishing executive — including at Time and Scholastic Magazines. He authored seven books — including three best-sellers — and more than 250 articles and editorials. Steve attended the United States Naval Academy at Annapolis and graduated from Brown University and New York Law School, cum laude. He co-chaired Hillary Clinton’s White House Task Force on early childhood literacy, the Prescription for Reading.
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