Hillary Clinton, Medicare, and Me

“Medicare Could Go Broke” says the headline from last week (see here.)

Medicare will go broke by 2019, seven years earlier than predicted a year ago, and could begin squeezing the rest of the federal budget as soon as 2011, according to a report released Tuesday by the trustees of Medicare and Social Security. The annual report blamed the deterioration in Medicare’s long-term financial outlook on lower-than-expected revenue from workers’ payroll taxes, higher spending on health care and the prescription drug benefit Congress passed last year….

“This is bad news for seniors and for retiring baby boomers,” said Sen. Dick Durbin, D-Ill. “President Clinton added 30 years of solvency to Medicare, but under President Bush, we’ve lost 10 years.”…On paper, Medicare is backed by a “trust fund” that is supported by Medicare premiums and payroll taxes. But in fact, the trust fund is regularly tapped by the federal government to pay its general expenses and filled instead with IOUs the government issues to itself. Once the program’s annual costs exceed its income — which Tuesday’s report said will happen in 2011 — the extra money to cover Medicare’s growing expenses will have to come from raising taxes, cutting other spending or increasing the federal deficit.

(Sort of ironic seeing Dick Durbin, who supports Obama, referring to Bill Clinton’s efforts to preserve Medicare, isn’t it?)

Medicare’s status may be of little interest to younger voters, but it sure caught my attention, particularly since the effects of underfunding doctors’ payments have begun hitting home. The staff at my family doctor’s office believe that the push is on to destroy Medicare. One has to wonder how doctor’s can stay in a system that won’t even guarantee a payment rate for a whole year? Because that’s what has happened this year…their reimbursement schedules are only fixed for the first 6 months of 2008! What happens then?? (see here.)

Last year I had to go to a doctor who didn’t participate and who required that sign a pledge not to file a claim, because she didn’t want Medicare to come after her and push her into becoming a provider. Just last week, I needed to find a specialist and was able to get an appointment with a doctor who doesn’t accept assignment (meaning I have to pay more that Medicare allows) — in OCTOBER!! The one other doctor in town in this specialty is NOT accepting any more Medicare patients! To top it off, because I had “insurance,” he refused to take payment in cash!! Imagine, refusing self-pay, most likely because he also didn’t want to tangle with the Medicare system. After expressing my fear and confusion, the nurse took pity on me and told me to go to a surgeon who does participate and luckily for me, I had already seen him once before for a consult and was “in the hopper” as an existing patient. Because, you see, if you are an EXISTING patient you’re lucky and may be able to see the doctor; if you’re not already on his patient rolls, you’re probably out of luck these days. And, lucky for me, the surgeon was able to refer me out to a doctor who will do a biopsy. Perhaps this is a new doctor in town who needs to add patients to his roll and is therefore willing to take Medicare. LUCKY ME, I’ve made his list! But for a few days, I was extremely worried about finding a doctor and very angry!

So, it’s with great interest that I read Hillary Clinton’s mention of Medicare on March 25 when she responded to McCain’s remarks on Social Security (see here.)

The Social Security trustees just issued a report, actually while I was speaking, and there has been some improvement in the outlook for Social Security according to some, to the Social Security trustees. So I think that it reinforces what I have said for a long time, which is we have some long term challenges. It is not a crisis. We can fix what’s needing to be changed in Social Security. Our real challenge is Medicare which is much more in crisis and deserves closer attention.”