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June 12, 2011

FLASHPOINT: Bucshon’s strategy for Medicare reform is like ‘doing nothing’

Dr. Larry Bucshon [8th District U.S. representative] masquerades as a fiscally responsible Republican, like other Republicans seeking to dismantle Medicare. He might be credible if he were willing to examine a multipronged approach that addresses fiscal concern while maintaining the value of health and human life. It is particularly hypocritical, considering Bush raised the debt ceiling every year of his presidency to fund a bogus war. All options should include raising revenue.

The Ryan voucher system may help some people manage premiums for a limited period, but it does nothing to keep insurance providers from raising premiums and deductibles at a later time. Insurance mandates the recovery of all costs. This includes operating costs, increases in equipment and facility costs, advertising, stockholder dividends and administrative costs (including highly inflated salaries of executives). Paying the premium is one thing, paying the hospital bill is another.

The idea that the cuts will not affect people currently on Medicare is disingenuous. This may appeal to our selfish nature (as long as this hurts others and I am OK, no problem). This may calm many seniors, but it is their children who will pay doubly, i.e., reduced benefits and picking up more of the burden of their aging and ailing parents. Any Social Security changes will also impact Medicare. There was a time when families lived close together and even shared homes. Today, families are spread out across the country, and looking out for each other is much more difficult.  

Any company would become insolvent if it operated without considering revenues and competitive pricing while engaging in costly expansion.

There is a justifiable concern related to the distribution of medical care, primarily because the money is in specialization and in larger metropolitan areas. Services tend to follow the money. Dr. Bucshon is right, increased demands on the system are inevitable because of an aging population and increasing obesity among the young. The choice is really between no service for many individuals and different service models affording more access for more people.

This problem is not solved by keeping insurance companies in charge and multiplying their numbers under the guise of more choices. Nor is it solved by focusing on premiums rather than the total costs of treatments and developing ways to maintain and improve the existing health of individuals.

Dr. Bucshon raises the issue of Washington bureaucrats making medical decisions which should be left to the doctors and patients. This ignores the current influences of the insurance bureaucrats whose primary responsibility is to the company and stockholders, not the insured. He also ignores the fact that the doctor-patient relationship has already been invaded by legislation dictating what pregnant women are told or shown.

The Clinton Administration attempted to address Medicare, but was blocked by very strong lobbying. Now, 25 years later, it is being discussed again. Rather than using a national health plan, President Obama retained the private insurance system and added mandates, a Republican idea implemented in the Romney plan in Massachusetts. The proposed plan is not perfect, but many elements are good. Instead of good faith negotiating points of this plan, our Republican legislators have summarily rejected it. They have wasted time and taxpayer money to allow a “crisis” to develop.

Dr. Bucshon is right, doing nothing is not an option. But I  think by shutting the door to the surgical suite and refusing to try corrective surgery, he is “doing nothing.”

— Raymond Quist

Terre Haute

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