Critical Condition

NRO’s health-care blog.

Medicare for All or Medicare for None?


As 2009 disappeared into the history books, the Mayo Clinic in Glendale, Ariz., (a suburb of Phoenix) stopped seeing Medicare patients for primary care. To be more precise, the Mayo Clinic stopped submitting claims to the federal government’s Medicare contractors. Medicare beneficiaries can still attend the clinic: They just have to pay cash.

This will be tough for the patients: Medicare won’t reimburse them one penny. Indeed, the law requires the physicians to explain this (in writing) to the patients.

The primary cause of the Mayo Clinic’s dropping Medicare is its fees, which are too low for physicians to pay the rent. Some have argued that the physicians have been “crying wolf” on this for years.

Well, the wolf is at the door, as I wrote in a recent study of Medicare Advantage, the program in which one quarter of Medicare beneficiaries are enrolled. Medicare Advantage is offered by private insurers, and most policies are not subject to the government’s fee-schedule.

Medicare Advantage is going to be destroyed by the forthcoming health “reform,” sentencing seniors to increasingly limited, Canadian-style access to medical services.

The accelerating decline in access to medical services will be much faster for seniors than for those with employer-based benefits. It is simply not politically “do-able” for working-age people to have better access than seniors. So, the government will have to undertake further “reform.”

The current government has no taste for reform that allows patients of all ages to control their health dollars. So, I anticipate that it will legislate “equal access” to medical services by also rationing medical care available to those of us with employer-based benefits.

John R. Graham is director of Health Care Studies at the Pacific Research Institute.


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