Thursday, July 13, 2017

You Can Have Your Medicare and Eat it Too

      "Doctor, I can't hear so good. Please send me for an MRI and a C-T scan."
      "Well, Mrs. Schwartz, why don't you let me clean the wax out of your ears first and see it that takes care of the problem."
      "Doctor, it could be a brain tumor. Don't worry 'The Medicare' will pay for everything. And also, maybe I should have a PSA just in case."
      "But you're a woman. You don't have a prostate. Why do you want a PSA test?"
      "You never know. And besides, 'The Medicare' will pay, right?"
      The bottom line is that there are only two ways to control medical costs. The first is to have a system with patients paying part of the costs so that they have an incentive to control them (called having 'skin in the game') and the second is the dreaded 'R' word, rationing. 
      Let doctors set their fees and let patients choose the ones they want to use. Then, some doctors will accept Medicare as payment in full. Some will charge a little more. Some will charge a lot more. And the system will not go bankrupt because government will pay whatever it will pay and then GET OUT OF THE WAY.
      No, doctors will not be able to charge anything they want. There are too many doctors around to choose from. It's called competition. If your doctor charges a ridiculous fee, you'll pick another. And you'll be able to buy whatever kind of supplemental insurance you want. Works the same way with food, clothing, housing...everything. 
       "Doctor, I can't hear so good. Please send me for an MRI and a C-T scan."
       "Ok, Mrs. Schwartz, if that's what you want. But it will probably cost you over $1,000."

       "Hmm, on second thought, doctor, maybe you could just clean out the wax and, if I still have the problem, I'll call your office tomorrow for a referral."