The Sure Heart – Reflections Upon the Medicare System

October 28th, 2013

The USA has a very important system of support for Americans who have long believed that we must live beyond our sixty-plus hour work-weeks in order to actually enjoy retirement. It is truly at the heart of any discussion of our work habits. While US citizens are among the hardest working individuals in the western hemisphere, we still applaud those sitting in easy chairs on that front stoop ‘after hours’, so to speak. Most retirees remain active and contribute heavily to the economy in tourism, child care, mentoring new businesses and even engaging in their own new career start-ups.

Social Security leaves those options open. It wasn’t meant to be the only retirement income available to a retiree, but it prevents most from becoming totally dependent upon others. When I was recently in England, the talk was all about starting such a system as the one we’ve had since 1935. The Brits also think a great deal of their older residents, or those who came ‘before’. In Latin, we might call them ‘A-priori’ individuals (for brevity’s sake, I’ll call them the ‘A’s).

Our A’s built upon the foundations dug by their parents and are still continuing to furnish that ‘house’, floor by floor. Social Security allows that to happen with equal regard for workers and employers who act as a team. This tax is a trust representing that valued employer-employee relationship. It goes beyond the basic contract of a work environment, into the realm of a social contract. We want a land that values its elders and relieves the young of fears of destitution in old age. In 1965, Americans chose to add another safety valve to this ‘pipe-dream’ of security in old age, by inventing Medicare Insurance. It is funded out of the benefit checks received by Social Security recipients and also by the interest earned from the trust fund holding the taxes collected by the Social Security Administration (SSA).

Insurance companies are real businesses meant to make a profit. Medicare cannot operate as a typical insurance agency because it doesn’t consider profits and losses as the reason for its existence. Insurance companies exist to earn profit by gambling that more people will pay into a system than collect from it (e.g. flood insurance). So why are people like Senator Sanders of Vermont hoping that ‘universal health care’ might be conjoined to Medicare?

He is correct in citing that Medicare is a very efficient single payer system. However, any insurance fund could use Medicare as a model for its administrative operations. Let’s imagine that the children and grandchildren of today’s workers, (we can call them ‘B’s and ‘C’s), add millions of increasingly ill Americans to our present system of elder care. That would rifle the trust fund of monies solely meant for the A’s support, outside of the ‘A’s own medical needs. We know that nearly half of all Americans will battle cancer; that asthma is responsible for the greatest number of lost school days in children; and that nearly half of all deaths in the USA are attributed to cardiovascular problems. These conditions alone will do more than rock the Medicare boat. They will shoot holes through it faster than an AK47 can churn out its rounds.

Medical care for young and middle-aged workers should be handled through private insurers because these entities are invested in learning why they might sacrifice profits on an abnormal level of sickness. The government should regard the increase in illness among Americans as an incursion upon life, as with any other form of ‘attack’ upon our populace. If we reveal those answers before we are forced to ration heath care to the ‘A’s, then we can avoid our states being overburdened by a deluge of applications for medicaid and other assists (generally available to children now). If workers are ‘the soul of a nation, the ‘A’s are its heart. The security of our ‘A’s has to be guarded through sound judgement in how we ensure all obtain the care they need to remain healthy throughout their lifetimes.

Categories: Letters

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