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Articles by Donald E. L. Johnson

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Today is Wednesday, October 22, 2014


How to cut Medicare, Medicaid entitlement costs, expenditures

Congress and the Obama administration are fighting over how to fix entitlements, especially Medicare and Medicaid. Even Democrats disagree among themselves, according to today's Wall Street Journal. Some Democrats want no cuts, others want cosmetic cuts. Republicans want real reforms, but good luck with that.

Here are some ideas for fixing Medicare and Medicaid that I've made over the years and are even more relevant today: 

1. Take free physician office visits out of ObamCare. They waste physicians' time and create tremendous wait times for sick Medicare/Medicaid beneficiaries, which increases costs.

2. Require patients with minor symptoms to see nurse practitioners and other allied providers before wasting the time of the shrinking number of primary care physicians.

3. Eliminate coverage of the most wasteful primary care and allied providers.

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4. Get hospitals out of the doctor business. Their overhead is too high, and they demotivate physicians with all of their rules, red tape, etc.

5. Breakup so called integrated health care systems that are local monopolies and horribly distort local provider and health insurance markets.

6. Eliminated incentives for physicians/hospitals to practice very expensive defensive medicine.

7. Raise premiums for Medicare beneficiaries by 25% on coverage of primary care and drugs, and allow them to spend what they want on the kind of supplementary care they want.

8. Repeal the laws that keep Medicare beneficiaries from opting out of Medicare, especially the primary care coverage, which is a waste of money most of the time.

9. Invest in real fraud and abuse law enforcement.

10. Hire private insurers whose administrative costs per patient, not per enrollee, are 20% to 30% of the administrative costs of Medicare and Medicaid.

None of these reforms will be attempted because AARP, health workers' unions, HCA, the American Hospital Assn., the Catholic Health Assn. and the Federation of American Hospitals will fight them.

LINKS:

13 ways to cut Medicare costs, by Donald E. L. Johnson, 8. 3.2011

Cutting physicians’ incomes wrong way to cut Medicare costs and expenditures, By Donald E. L. Johnson 8.2.2011

Posted by Donald E. L. Johnson on 11/20/12 at 05:50 AM
Health insuranceFraud and AbuseMedicaidMedicarePermalink
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