Thursday, January 14, 2010

How to Make Old People Die Faster

Let's look at the ingredients in the current noxious health reform brew:
  1. Most of the alleged savings will come in the form of Medicare payment reductions.

  2. Doctors are already refusing to see Medicare patients because they can't make any money off of them, so we should expect it to become much harder for elderly patients to get in to see a doctor in a timely fashion. (Say it again, folks: "Price controls cause shortages, price control cause shortages...")

  3. When you're old and you don't see the doctor promptly, you tend to die.

So, Medicare may really suck in the not-too-distant future. Those of us who can afford to do so may want to get a supplemental insurance policy, if for no other reason than we'd like to be able to get an appointment with a doctor with a good enough reputation to make money.

But here's where it gets interesting: As I understand it (and somebody please correct me if I'm wrong), the private supplemental insurance policies that work with Medicare don't reimburse the doctor at a higher rate; they merely cover the subscriber's out-of-pocket. What you'd really like is a policy that would convince a doctor that he can make a living wage by seeing you.

I don't think that exists, and, given the regulatory climate that will accompany this legislation, long after the Democrats have shot their wad, it's unlikely that such a policy will exist in the future. Therefore, the only options that anybody but the extremely rich elderly will have will be to get shortage-riddled care.

I'm going to be 53 next month. This topic is starting to be somewhat more than academic to me.

1 comment:

David said...

As always, I like the way you setup the problem, and your proposed solution. I think it would work until a law is passed requiring doctors to see Medicare patients. And if anybody doesn't think that'll happen, they must have missed the bill proposed last week to regulate tax preparers.

Separately, how is it that health care costs as a share of the economy are 16% and housing is 5%. I don't understand how we spend three times as much on health care over the course of our lives than we do on housing.