My jaw hit the floor while reading the Wall Street Journal’s excellent editorial this morning on the tattered state of Medicare. The Journal recounts the latest insanity: The spending cut provision in the debt-ceiling deal. It immunizes the program’s swelling millions of beneficiaries from cuts and cost-sharing. Instead, any purported Medicare slashing from the across-the-board $1.2 trillion in cuts (once the vaunted Super Committee deadlocks) is to be borne — again, purportedly — by providers.
The editors demonstrate that this is a racket (I’d call it a racket within a racket). Medicare reimbursement rates are already so low that providers are squeezed to the breaking point. Beltway politicians always claim, on paper, that they are going to control health-care costs without hurting beneficiaries by such artifices as the “sustainable growth rate” imposed on physicians fees and “productivity adjustments” to inpatient treatment. But at the eleventh hour they reverse themselves by enacting “doc fixes” and the like — just as they knew they would do all along.
None of this is news, of course, but it’s always ugly to review the cold, hard numbers. The jaw-dropping part, though, was to read this passage:
At this point the only thing left to do is end Medicare not “as we know it,” but altogether. On paper, that would zero out $7.67 trillion in obligations from 2012 to 2021 and more than erase the $6.74 trillion in deficits that the Congressional Budget Office projects over the same period.
Even if the Journal’s editors were joking about having to end this unsustainable, multi-trillion dollar fraud scheme, that felt they could say it out loud is progress. Ultimately, they conclude that “the only durable way to control long-run costs without hurting patients is a reform agenda akin to Paul Ryan’s ‘premium support’ plan.” On that, I’m afraid they’re dreaming as much as the budget fairies they rebuke. True, Rep. Ryan’s proposed fix is better than anything out there — indeed, Ryan is singular in acknowledging that we have a disaster on our hands. But any “reform” that leaves the government playing a central health-care role is as unsustainable as Medicare itself. As the editors note, central-planning is what got us here in the first place. They were right, however unserious they were, in saying the thing to do is end Medicare altogether.