Happy Birthday, Medicare

Medicare turns 44 today. The program provided health care to America's elderly, and represented a major change in health care. Oddly, these are the people opponents of health reform prey on, because they say that the government will take things away from them.

Nate Silver at 538.com discusses how Republican opponents are so out of touch on health care. The tension has gotten me annoyed too over the past few days.

They say Medicare has destroyed medicine. It pays too little and costs the government too much and leads to rationing. Almost all of these matters are false. Medicare rates, while not generous can and do effectively handle reimbursements if one is willing to handle a lower margin, but institutions have done okay on that, and still continue to take a hefty load of Medicare patients. Rationing just does not happen. In fact, one of the problems is that it is a fee-for-service with a set rate of coinsurance for anything. It does not matter if the expensive is as effective, worse, or only marginally better than the much cheaper alternative, it tends to reimburse at the same rate. The point of cost is a problem, but if you are against a rational rationing system then you have the current irrational system I just described, and these lead to poorer outcomes.

Yet, Medicare is also wildly popular as Silver points out. It works well for consumers. Doctors and providers grumble often, but it is also not worse than not having any patients at all above the age of 65.

So what is going on here? I think it's a bit of double speak. Then again, if you look at the last quote of this Washington Post story on Jim DeMint, you see that many people just forget how valuable and important the government is. As the man says in the end "keep your government hands off my Medicare." Sadly, such disinformation like the Republicans discussion on Medicare, can work when the populace has such views.