Expanding and Improving Medicare

Eldon Van Der Wege, MBA and
Thomas Billroth Gottlieb, MD

This paper describes the structure of Medicare funding as defined today. The future expansion and improvement of Medicare is further defined with a funding source already defined by existing federal law.

Read Expanding and Improving Medicare by Eldon Van Der Wege, MBA and Thomas Billroth Gottlieb, MD.  

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  • Robert Messman
    commented 2018-08-10 00:41:54 -0600
    For some reason, the site cut out some of my comments. 1) that businesses shoulder around $700 billion/yr of our health care costs, and 2) That then means that the paper is suggesting that we fund a good portion of the proposal by either borrowing—pushing the national debt up faster and shoving the costs on to future generations -OR printing money. The latter will eventually drive up inflation as well as interest rates. As the national debt grows above its roughly $18 trillion in 2017 and interest rates rise significantly, interest costs alone will force the government to drastically cut back on spending and most likely starve or eliminate expanded Medicare and its deus ex machina financing. If expanded Medicare is not fairly and sustainably financed-with contributions from all those who benefit—it will have a short life.
    Robert Messman
  • Robert Messman
    commented 2018-08-10 00:36:44 -0600
    Good overview of Medicare but then a reckless descent into a unsustainable and unfair proposal to create a New Medicare for the under-65 without the 80% coverage limits and Medigap supplemental coverage of current medicare. Funny how one can praise current Medicare but propose a drastically different and more expensive version for the under 65. Using optional supplemental plans would allow younger citizens to opt for lower premiums while assuming the risk for 20% of their medical costs. All citizens adn businesses would see a drop in the medical portion of car insurance and the medical side of workman’s comp. Plus doctors medical liability insurance would drop because all parties would be paying for Medicare rates for health care which currently can be a quarter to a half of what private insurance pays.
    However, one of the big holes in this proposal is that it frees business from sharing in any of the costs for keeping their workforce healthy. Currently, businesses that provide and subsidize health care for their employees carry a big portion of our current , total national health care costs -possibly as much as $700 billion per year after tax deductions- according to my rough calculations. So if you do not have them help support this expanded Medicare, you lose a big portion of the purported savings in this article—disasterous. That means that the premiums in the form of an individual income tax would have to be almost prohibitively high, unless , as the paper suggests, the Federal General Fund is hit up for a big portion.
    Most other developed countries which spend much less than the US on health care, fund their systems with funds from both workers and businesses—Germany, France, Tiwan, Japan, to name a few. In Germany, the total payroll tax is around 15%, split evenly between workers and businesses. There is no way that ci tizens would shoulder a 10-15% income tax increase, even if the rate was on the lower end because the tax would be extended to all net income instead of just payroll income. So that means that our politicians would cave in and look to fund a good portion of the costs from the General Fund. Next year the Federal Government is expected to run a $trillion deficit so there are no spare funds . That then means that the paper is suggesting that we fund a good portion of the proposal by either borrowing—pushing the national debt up faster and shoving the costs on to future generations -OR printing money. The latter will eventually drive up inflation as well as interest rates. As the national debt grows above its roughly $18 trillion in 2017 and interest rates rise significantly, interest costs alone will force the government to drastically cut back on spending and most likely starve or eliminate expanded Medicare and its deus ex machina financing. If expanded Medicare is not fairly and sustainably financed-with contributions from all those who benefit—it will have a very short life.
    Robert Messman

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