Medicare as a model? Heaven forfend!

The simplest matters generate vast bureaucracy

The day-job’s at an end – suddenly and abruptly. Suffice to say that the combination of working corporate, and reporting early for extra hours at holiday-times, proved to be my undoing. Back to the drawing-board, but at least there’s a small cushion and no overdue bills outstanding. Perhaps it’s a good time to comment on some more things I learned in that venue, about how the current ethos of “entitlement” will surely be our undoing, unless it is reversed very soon. Full disclosure: The gig I just left, not entirely of my own will, involved processing Medicare forms, and the experience has only strengthened my already-adamant opposition to any ideas being circulated about expanding that benighted program as a model for nationalized health insurance!

As noted in previous columns, the practices of medical professionals and their administrative staff, in complying with the intricacies and absurdities of the Medicare reimbursement system, are apparently driven far more by redundancy and inefficiency than by what would normally be considered good business procedures (were it not for the incentive from the IRS systems to waste resources in printing, mailing and such). Meanwhile, the impetus toward what Arnold Kling at the Cato Institute calls “premium medicine” often leads them to look at a patient’s ailment as a chance to try out all their new expensive diagnostic toys (CAT scans, MRIs, biopsies, etc.), rather than just identifying and treating the illness or malady as simply as possible, and sending the person back into the world.


However, the actions and choices of these practitioner/healers pale in the face of how the Medicare-covered patients themselves (aka, the “beneficiaries”) generally function. (Note: There are exceptions, but from this editor’s experiences, they are rare and notable mostly for their contrast with the norm. We are apparently smack in the midst of several generations of Americans who’ve taken it so for granted that their “retirement years” would be attended by a staff of obsequious underlings that it’s a wonder when any one of them steps up to offer a “refund” of a service granted in error, let alone accepts a ruling against the slightest expense incurred out-of-pocket without multiple levels of appeal first.

The process of getting “flu shots” is only the most obvious example of this; the roughly $25-30 being charged for the shot (and the administrative paperwork accompanying it) is contested by pretty much everyone eligible for Medicare – no matter how much time and paperwork it takes to get the check. The idea that perhaps such a relatively small amount, being shelled out in the name of “prevention” (as they are urged to do at every turn by at least the allopathic wing of the “healing profession”), should automatically be reimbursable … Well, it sure does run counter to the common sense about taking care of yourself that most of these folks grew up believing.

(Meanwhile, according to the latest studies, there may not even be a correlation between getting a flu-shot and avoiding serious illness, as has been claimed so matter-of-factly by those same allopaths and the bureaucrats who backstop them. As the story puts it, “Over the past 25 years, the proportion of those aged 65 years or more who receive flu shots has climbed from 15% to 65% in the US. … Yet current estimates of winter death causes suggest that flu-related mortality has actually risen since 1980.” In other words, what many folks in the “natural healing” world have long suspected ¬– that these widescale inoculations, allegedly a safety-barrier against influenza deaths in the elderly, are not saving any more lives than we do by encouraging healthier immune systems and better care of ourselves in general – may in fact be what is happening here.)

But we digress … Whether or not getting a flu shot improves your chance of survival, in the event that “the crud” makes its usually annual visit among us, is secondary to whether or not you believe it will. If you do, and you choose to get one, expecting it will be paid for by the taxpayers seems a bit presumptuous to these eyes. But that is the paradigm on which the whole Medicare system is founded.

On some levels it might seem to make sense, since after all those who are now receiving these services could in some sense say they have “already paid for them,” as F.I.C.A. payroll-tax deductions over the life of the Medicare program. However, as we all know, this was never a process of “pay as you go” whereby a person’s “FICA-bite” was being set aside to pay for THEIR later care, or even socked away and invested, to create a pool for that person and all of his/her contemporaries to draw from in their declining years. Instead, the money stolen in the 1960s, 70s, 80s and 90s was all being spent as soon as it was expropriated, on that (much smaller in numbers) generation of “seniors.” What’s going out now has no relation to those funds, but is based on what the children and grandchildren of today’s long-living tribal elders are losing from each dollar earned.

Yet the attitude is there, as this editor saw all too close during his stint opening the many letters and forms. If there is a medical situation – a visit to a doctor, nurse, emergency room, clinic or other “covered” healer – it is generally the expectation of the “beneficiary” that all expenses for that malady, along with every test run and diagnosis associated with it, should be paid for by Medicare, either to the healthcare practitioners or their institutions, without question. And in the somewhat rarer case where the healer has stepped out of such a payment process, and simply charged the treated person directly for the procedure, then Medicare should immediately reimburse said “beneficiary” with no questions asked.

The flu shots are only the most obvious example. Weight-loss surgery, new eyeglasses, .. you name it, someone thinks someone else should be paying for it, and they usually have at least a doctor or two, if not a legal beagle, backing up their contentions.

Imagine for just a moment an entire population making such demands on healthcare, for every little thing involved in keeping them “healthy” (By whose definition? Who knows? It should be “covered” anyway!), while taking little or no responsibility for maintaining their wellness themselves. (Imagine further that we are now about to deal with this with a whole generation of “Boomers,” who have spent their entire life expecting the world to treat them as “special people” entitled to the finest of everything – and now they expect someone else to pay for whatever strikes them as necessary … Does anyone wish to challenge the contention that the “Medicare model” is the LAST thing we should be looking at as healthcare “reform” paradigm?

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Australia: Cardiology meltdown at major Queensland public hospital

A leading Queensiand cardiologist is on the brink of resigning out of frustration with the state's failing health system. An investigation into problems in cardiac services at Brisbane's Prince Charles Hospital has been launched by the Crime and Misconduct Commission. The specialist cardiologist, who declined to be named, had initially raised concerns with hospital managers but they failed to respond to her complaint. Details of the complaint have not been revealed, but are believed to concern management conflicts stemming from bed and staff shortages.

It is not the first time senior doctors at the Prince Charles cardiac department have been forced to quit. In 2000, heart surgeon Dr Julie Morton resigned, citing workplace environment as the problem, and in 2004 Dr Con Aroney also left the cardiology department. Only last year, renowned heart and lung transplant surgeon Dr John Dunning was so appalled by the state of Queensland Health that he returned to Britain.

Dr Don Kane, president of the Salaried Doctors Queensland union, said Queensland Health had failed to fix on going problems. Managers at the Prince Charles Hospital refused to comment.

The above article by Hannah Davies appeared in the Brisbane "Sunday Mail" on November 25, 2007