Ramblings

Delayed posting written on 10/15: I don't like to post more than one thing per day, but I really wanted to comment on this. As this goes up I should be flying somewhere over the Atlantic.

Medicare Advantage is the reason why I don't take conservative concerns seriously, when it comes to public (government-owned) health insurance and health care costs. Here's Ezra Klein, a Washington Post blogger who I just recently found out is younger than me:

Philip Rucker takes a good, hard look at the scam that is Medicare Advantage. Essentially, it works like this: Congress allowed private HMOs to compete for Medicare patients under the rationale that they could offer better service at lower cost than the government. They couldn't. So Republicans in Congress began boosting their payments, to the point that Medicare Advantage gets paid 114 percent what Medicare gets paid to care for a patient. That leads to some fun perks, like free gym memberships and complimentary aspirin and band-aids, which in turn leads seniors to defend the program because they like their perks. But it also means a lot of unnecessary expense for taxpayers.

So we have a program in which private insurers are only able to compete with public insurance when given a 14% advantage. That is a lot of money. And only 14% of that (or about 2% of the total Medicare Advantage cost) actually goes to increased benefits for seniors. Medicare itself is a program that disproportionately benefits the rich, and Medicare Advantage is even worse in this regard. Why should we continue to pay the insurance companies overpayments for something? Why is it that the "small government" conservatives (and I mean those quotes to be as sarcastic as is textually possible) like Sen. Kyl and Rep. Boehner are defending this clearly non-optimal, wasteful use of tax dollars?

We SHOULD allow seniors to opt out of Medicare and apply those savings to private insurers if they so choose. We SHOULDN'T give them a 14% bonus for doing so. In fact, it should probably be a 5-10% penalty, if the private insurance market were as efficient and awesome as some politicians are claiming they are (note: they are not). Since about a quarter of American seniors are on Medicare Advantage, ending the overpayment and shifting those costs onto improving traditional Medicare. Or expanding eligibility to younger people. Or giving the cash back to the American taxpayer. Or whatever.

So. Private insurers aren't as cost-efficient as the government. Costs are spiraling out of control. Conservatives seem very concerned about the increasing deficit (emphasis on "seem"), but suddenly don't like to eliminate clear examples of waste. Business as usual in D.C.