Medicare

On May 2, I attended an American Enterprise Institute symposium on Medicare’s financial outlook. That outlook is awful.

I offered the Stroke of a Pen solution of raising the age of eligibility going forward. In Crisis of Abundance, I explain in more detail how to phase out Medicare.

This idea was ridiculed by the panel. For the most part the panel reminded me of an old business cartoon with the caption, “I don’t have a solution, but I really admire your problem.”

However, the most likely alternative to cutting benefits is “cost control,” meaning price controls and/or rationing. The audience and the panel seemed much more receptive to cost control than to cutting benefits. Maybe the AEI is getting ready to play a role in the Hillary Clinton administration.

One of those who emphatically resisted cutting benefits was Mark McClellan, the Medicare czar. He was so gung-ho about Medicare’s quality initiatives that during the Q&A I asked him whether Medicare should take over health care for everyone. Instead of saying, “No,” he gave a political answer about how Medicare’s new initiatives were a “partnership” with the private sector.

Public-private partnerships are problematic, in my view. Power corrupts, absolute power corrupts absolutely, and private-public partnerships absolutely corrupt the private sector.

We have reached the point in health care policy where government is like the ten-year-old boy who starts fires so that he can be lauded as a hero for helping to put them out. Massachusetts gives huge hospital subsidies for “uncompensated care”—the subsidies apparently exceed the cost of care, because one of the obstacles to the Massachusetts reform is that hospitals are worried that they will lose money. Anyway, these subsidies, along with dysfunctional insurance regulations, favor uninsured free riders, causing the fire that needs to be put out with health insurance mandates.

McClellan lauded the Massachusetts reforms.