Former Senator Breaux (D-La.) says: End Medicare

Medicare is big in the news today, and yesterday, and last year, and well, for two decades now, as something that is unsustainable. My Advocate brings news of a Democrat who proposed the “Ryan” plan a decade ago, the one the Democrats are saying will kill grandma. The problem was noted back in Reagan’s administration, and it was said that actuarial trends – that is, the numbers of people receiving versus the number of people contributing, and the promises made for benefits, would eventually swamp the system with expenses that cannot be covered with the income the program takes in. Those numbers are real. There’s no way to have 100 Trillion in unfunded liabilities, as they like to call it, and keep on going. And either the system must change, or the taxes will go up beyond rationality, and the benefits will be denied because there’s simply no cash to give to the doctors or anyone else. Or the government’s coffers will be filled with an inflated currency that will really wreck the place.

So now it’s said there’s this “evil” Republican plan, and lot s of political posturing and accusation, for the fun of it, and to try to get elected of course. Or, if your a Republican, this brilliant idea, or if your Newt Gingrich “Right wing social engineering.” I’m not sure what social engineering is except to tax the money out of people, take it to Washington for a brief visit before being given back as largesse with strings attached and 30% missing for the Federal Overhead Charge to pay for the bureaucracies – which don’t seem to change no matter if Republicans or Democrats are in office, but instead just grow with the next program dreamed up by some D or R so that he’s done his part for his constituents. The bureaucracies never seem to be much changed at all though, so much for all that talk of the difference between the two parties – for if nothing changes, the difference is?

Yet, in 1999, Senator John Breaux, a Democrat of my fair state, proposed nearly the identical thing as Ryan’s plan – after heading a commission Ah, the famed commissions of lore, which produce what’s politely termed “door stops” – big thick policy proposals to realign the bureaucracies and then are put right there on the floor with all the other big thick policy proposals that have surfaced by Democrats and Republicans in commission after commission that say: Medicare and Medicaid are simply unworkable economic models. And they need to be re-thought, and ended as we know it, but somehow the system has to be changed gingerly so that no one is upset or something. Meanwhile, nothing is done and the disaster approaches with gathering strength. Maybe Ryan got it from Breaux’s work by actually picking up a door stop and reading it. And Ryan seems to be quite well read on the subject.

And now we have ObamaCare which takes $500 billion from Medicare and gives it to ObamaCare – which is almost what the Ryan plan does too, and it’s what the Breaux Plan did, and all the other plans – it takes money from one part of government and gives it to another in a different system of giving us back our money, and I’m thinking, if that’s “ending” anything, it’s not changing much either. And supposedly ObamaCare is health care for all, but doesn’t affect Medicare or Medicaid much, except to throw a big wet blanket of bureaucracies upon it all for the sake of “efficiency” for the experts will come out of the woodwork to make the new system efficient indeed.

But under the Breaux-Ryan plan we’d get “vouchers” instead of “benefits” if we’re under 55, and it’ll stay just the same if we’re over 55 – yes, well, I guess that’s different. And we can choose our doctors from approved Medicare lists and perhaps we’d be able to choose our doctors from approved voucher accepting doctor lists. And instead of Medicare just paying the money out from its pocket to the hospitals and doctors with you getting a notice in the mail to tell you of the spending, you’ll get a voucher in the mail and go spend it on the doctor you choose – which is the same guy either way. Either way, though, you’re still getting a piece of paper in the mail to tell you that the government is giving you your “money,” and how much of it, to spend on doctors that are approved for you to spend on. Meanwhile, the big building in DC with thousands of employees pushing the paper will remain intact but the forms will be renamed.

But, ah, the system will be changed. Well, no, not at all. It’s still either taxing people to get the money to give back, or it’s requiring you to spend your money – which is like a tax because the money is removed from your hands to a government directed purpose – or it’ll be borrowing the money through deficit spending – which is a big part of it already – we’re borrowing $1.7 Trillion a year to provide all this “health care” which is really a lot of bureaucracy. Everyone says that, everyone knows it, everyone jokes about it, and no one proposes getting rid of the bureaucracies. That would be too much, I suppose.

This is all about “getting costs under control” – yes, but what are the costs? The doctors get the same amount of money for whatever they do, and the lab charges the same amount, and the x-ray machines cost the same – and the government directs a good portion of it – which, weirdly raises costs – due to the one thing that always causes government costs to rise – the bureaucracies. And so, supposedly, because the “government” is buying health care, it gets to direct the price, and the supply and the quantity, and even whom gets to use it, which mucks up that side of the equation. But they can’t affect the demand. And because the demand is by citizens for their tax money they really can’t be denied now, can they? They’re “entitled.” Which means they use health care far more than otherwise they might. And so whether the money is given as direct payment from Medicare to the doctor, or whether it goes through a voucher in your hands – it’s still taxes taken and doled out, and power given to regulate the prices and supplies of things and thus it ends up not working very well at all. And with vouchers they’ll still need the same amount of money to spend – both on the bureaucracies and on the health care – why, costs wouldn’t be altered whatsoever.

And the way out of it, if you want to require everyone to have “insurance” and “pay their fair share” and “health care as a right” – well, then there’s two ways to go about doing that – and removing vast sheds of bureaucrats from the national mix. It’s far more “radical” and “rational” too, than any commission would ever come up with – for commissions are meant to preserve the bureaucracies, not solve problems, and even create new bureaucracies for oversight and compliance and equality, of course.

One is to simply set up government run hospitals that are paid for with a tax, whether property, sales, income, etc, and paid for equally by all citizens, with the graduated rate supposedly needed to make it fair by having the rich pay more for the same service, and to support the poor, whom seem to be with us always – especially if you keep raising the official poverty rate to keep it at a steady 25% of the people. This of course is required by the poor bureaucracies, to “solve” the problem.

Then hire the doctors, nurses, technicians etc, and pay them a salary, and then whomever shows up at the front door, you treat them for what ails them. And don’t worry at all about “insurance” or “income eligibility” or have anyone fill out a form to see if they’re entitled to anything whatsoever. Clinics could also be like this. Then all citizens would have the “right” to health care as much as they have the “right” to roads and parks. There’s nothing really wrong about this sort of thing at all – so long as there’s no “eligibility” nonsense going on – and the endless bureaucrats needed to make sure the right form was filled in for what you are “entitled” too. And then you wouldn’t need Medicare or Medicaid at all – you’d get your health care right there, at the government hospital.

But there also still will be private run hospitals, and religious hospitals, and they could charge what they charge, and people could either pay for it. And specialist hospitals for the big or weird problems. And even have insurance such as any private insurance company might offer. There should be no prohibitions or limitations on the private sector, and not even much guidance. But because it’s so much paid for by government now then the government is getting this heavy hand in it – but providing no more health care than what exists. The government ain’t building hospitals or providing doctors that’s for sure – it’s taxing to give you the money to do your own thing, supposedly, with approval.

But another way, and which would deal with Social Security, which is the other big boondoggle that will feel the financial pain brought about by the way it’s set up and then the actuarial demographics of what actually lives and breaths among the people. And this way is to do something radically simple, and elegant, and should meet everyone’s concerns:

Require everyone to save $100 a month in a plain interest bearing account with FDIC protection for their entire working lives. And thus, in 40 years, you’ll have more than $500,000 – to $1,000,000 – depending on the interest rate – right there in your own bank to pay for all the health care and retirement you might require or desire. Why, even the “poor” would become awfully “rich.” Even the poor working class guy pays $100 a month to Social Security, even if he pays no income taxes. Just let the guy keep his own money – and not have to prove eligibility to anyone nor get permission to get a set amount each month that bears no relation to what was deposited in the system over the course of time, but only based on the last six quarters of one’s working life, or whatever it is.

I suppose, one could put a limit on withdrawals for the first thirty years – the healthiest by far. Or make expenditures on doctors and health care the only thing allowed for the money to be spent on. Oh, I’m sure it’ll require some monitoring to make sure people don’t spend the money on booze and vacations, and cars and new TVs, for sure. Many people will be tempted, without doubt. But still, they’re already paying $100 a month at least into the system now which they can’t touch until they’re 62, so to channel that $100 to their own personal bank account can’t be that hard to imagine they can’t touch until they’re 62. .

And too, with government provided hospitals then you would get that normal care during the non-withdrawal years. You would still have charities, and insurance, and private hospitals, and nothing much is different.

The debate in DC is about which party gets the spoils of running the current system, and the system hasn’t changed one iota since 1965. And that’s what most of the newspaper article was about, which brought me the news of Breaux’s comments. And obviously, those who study it come to the same conclusions whether Democrat or Republican – and then no one does anything because “it’s toxic” to talk about reality or something. But somehow, the thing is coming to an end anyway, for one day there will be no more money at all, and that’s it. Then what? The Democrats and Republicans will let us know, I’m sure.


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