Medicare Solvency

News outlets are splashing around stories about the Medicare trust funds solvency the last few days; it is a very serious problem and must be addressed quickly for our country to sustain this critical program. As someone who does business with Medicare I live in the weeds of this program every day, far away from the high minded banter you often hear espoused by pundits who don’t understand the challenges at the ground level.
There are a few things that must be done to maintain the solvency and integrity of the Medicare program so it is available and functional for future beneficiaries;
1. Eliminate fraud waste and abuse, in all areas of the program. Up-coding, adding services not performed and an outright fabrication of claims are all costing the program billions every year. President Obama has announced additional investments for the policing of the Medicare program; let’s hope those money’s are re-invested and those found guilty of defrauding the program are punished.
2. Slow the rate of growth and reduce overall expenditures across categories, while investing in those categories which create a net reduction in overall expenditures. This is pretty simple to anyone who has run a business or a household; spend money in those areas that will create savings for the entire business or household. Homecare continues to be the most efficient means for delivering care and preventing institutional based care, as such we should be investigating ways to deliver homecare more efficiently and effectively so we can leave our hospital systems and critical care systems free to do what they do best, provide advanced level care for the critically ill.
3. Health and wellness; if people continue to abuse their bodies all their lives they will arrive on the doorstep of the Medicare program at age 65 with a host of disease states and health issues which are tremendously expensive for the program to treat. As a country we must do a better job in the prevention of obesity and a reduction in the level of smoking, two of the key contributors to rising healthcare costs within the domestic healthcare system.
The problem is a complex one and there are numerous entrenched interests aligning themselves to support and defeat various clauses in any reform discussion. I maintain that the conversation MUST be focused on reforming our healthcare delivery and wellness system, not on providing additional coverage to pay for an already fractured system. Until we can solve the issues of skyrocketing costs, it is a fool’s errand to try and insure more people into the system. By adding more paying customers to a broken model we are simply further incentivizing the players in that system; there must be disruptive change in the way we deliver care and what is charged for that care.
Of course I believe, as a business owner and a taxpayer that we must further invest in alternative site care, because hospital charges are substantially higher and growing at an unsustainable rate. We need to work to keep people out of hospitals, in the home, and provide the services, equipment and support to them so they don’t lean in and utilize the higher cost healthcare models.
The reform train is still barreling down the tracks – I still can’t tell who is driving or who is on-board, but I am anxious to see the results as they trickle out of the next 45 days.