I consider Medicare D odious. One more government bureaucracy with arcane rules providing a service for a lot of people when only a minority needs it, at huge expense. What’s not to like, eh? Like No Child Left Behind, it always struck me as exactly the sort of government fixit that George W. Bush learned at Bush 41’s knee: better and cheaper than what the Democrats were trying to sell - and trying to solve a problem that actually does exist - but still more bad than good.
It occurs to me however, that a tipping point in the opposition to Obamacare has come from seniors, who often follow closely the scary parts of legislation that affects them. Had Medicare D not been in place, that might not have played out the same way. Add medication insecurity to the intense AARP advocacy to support Kennedycare, seniors might have gone the other way.
There’s no way to play out the counterfactual, but it is at least plausible that Medicare D provided the necessary hedge of protection against complete government takeover. I’m changing the grade on that from F to “Incomplete” while I think about it.
6 comments:
They're not really going to call it KennedyCare are they?
Most seniors (correctly, IMO) sense that their Medicare benefits will be eroded to make way for benefits for younger people.
From that point of view, stating that you don't want the government messing with Medicare makes sense.
I'm in the midst of updating Med D Application IDs and UBOIs for the 9/30 deadline on filing, so they are definitely at F for me right now...
In memory of Ted Kennedy, and to point out just how much the Big Shots pushing government-controlled medical care actually care about the health and welfare of ordinary citizens, it should be called CHAPPAQUIDDICARE. (h/t Dr. Sanity)
I thought GWB handled the issue well. As medical care shifted to more drug treatment than surgery/hospitalization, Medicare needed to have some drug provision. The solution is to radically change Medicare as a whole which GWB at least started to do with SS.
You are correct that the Dems would have used the lack of drug coverage to get the whole shebang
dmoelling makes a point that's too seldom heard in debates over medical care. Medicare Part A, the original, paleo-Medicare, provided hospitalization coverage. So did major medical policies, back in the day. This was because back in the day, hospitalization and the associated costs were THE biggie that might push you into bankruptcy or having to sell everything. Doctor's visits were relatively cheap, lab tests were not that often used outside a hospital setting, and there weren't all that many expensive drugs.
It's very different now. A lot of medical care cost is from management of chronic illnesses, largely with expensive drugs. (Example: AIDS.) Hospital coverage doesn't address these expenses, obviously, but they can threaten bankruptcy, etc. Insurance coverage, including major medical where you're allowed to buy it, had adjusted these changes for the most part, but Medicare had not.
I'm not sure whether Medicare Part D is the answer, but there was a question, assuming you want Medicare to pay for large medical expenses of seniors.
Whatever the judgment on Medicare D -- and I largely agree with you -- it wasn't proposed and adopted on the merits. It was political legislation designed to ensure Bush's re-election. And, evaluated on that basis, it worked.
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