The Third Third

Curtailing Medicare Costs

  I cannot imagine that Congress is ever in my lifetime going to get its act together to reform Medicare and effectively control its costs.  As they say,  by way of an excuse for inaction, it’s very complicated.  There’s the who’s covered at what age, and the what’s covered, and the cost assigned to each diagnosis and treatment, and the doctors who “take” Medicare and those who don’t, and the how much you paid in versus the how much they’ll pay out, and they still have that donut thing with prescription drugs too figure out.  We haven’t as a nation even defined Medicare itself -- is it a hard-earned entitlement?  a societal benefit of old age? a social safety net?  a vehicle for the delivery of health care? a government-subsidized health insurance program? a tax, or taxable?  or what?  Or all of the above?  I would think that might make a difference to the deliberations. However, my lack of confidence in the current system (and the current Congress) stems from the excess I have experienced in just my first month of (required) enrollment in the program.  I have posted earlier about my difficulty figuring out what I needed to do, once eligible for Medicare at age 65, to maintain the level of health insurance with which I am comfortable. [See[ post][1].]  It seems there is equal, if not greater confusion in the insurer’s office.  You may recall, Medicare, Part A is free to all Americans age 65 and pays for hospitalization.  Medicare, Part B is optional (but required if you purchase Supplemental Insurance), pays physicians, and costs $99 a month, unless because of a higher income reported to the IRS two years prior to the start of each benefit year, it costs you more.   The Medicare office of the Social Security Administration has recalculated that cost for me at least four different times -- and each time it sends me two separate letters, one which tells me what the increase will be, and the second which reports the total cost per month for Part B, the $99 plus that increase. The amount went up the first three times, by $70, $50, and $20 -- all based on the same 2010 tax return.  Huh?  Then, mirable dictu,  it went down. Twenty dollars, at least according to the next two letters that were posted to me, which I now fully expect to say “Stay tuned.”  The most recent letters, I surmise, were occasioned by SSA now referencing my 2011 tax return rather than 2010.  But still, I’ve been enrolled a mere six weeks and I haven’t paid a single bill and I have an inch-thick file of correspondence that represents a huge waste of time and money.  Think of the people making the calculations, the folks generating the two letters, the paper consumed and the postage required.  Really?!  To tell me something I could learn from a text box on the bill?  Or via email? I realize this is small potatoes -- I’m surmising from the wringing of hands over our current fiscal crisis that anything less than a trillion dollars these days (even the $600 billion to be collected in higher taxes) doesn’t really make much difference.  But still.  There’s a principle involved here, a way of thinking about every-day cost-cutting that, compounded over the years and throughout all government offices, could make a difference and, at the least, would inspire greater citizen confidence in our government and the services our taxes pay for it to provide. [1]:
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