Common Sense on Medicare

In NEJM there is a brief note regarding Medicare and corrections which can and should be made to it. They state:

Medicare was always intended not just to increase access to care but to protect the elderly from financial ruin.

We agree and we had proposed that with our various plans.  Although I do not agree with all the proposals there should be some core propositions which must be addressed:

1. Move age eligibility upwards to 70 as life span increases.

2. Increase Medicare from 3% to 4% over some time frame.

3. Make it for catastrophic coverage, it should help the truly needy.

4. Have some payments from the participants.

5. Provide essential coverage not total coverage.

6. Scale back or scale up costs for those with higher incomes.

There must be a dialog here. Catastrophic coverage is essential, we want to make certain that people are not left destitute. However total coverage must be addressed. We currently pay for too much. Means testing will become essential and age adjustments are critical as well. It is readily solved, if we want to.