Don Brunell - Senate health care proposal

As part of its health-reform package, the U.S. Senate wants to expand access to the nearly bankrupt Medicare program. Currently limited to seniors over 65, the proposal would allow people 55-64 to purchase Medicare coverage.

That’s like rearranging the deck chairs on the Titanic. In fact, the Senate is actively encouraging more passengers to get onboard the sinking ship that is Medicare. Without a huge infusion of cash from our government (us), Medicare goes down like a big rock in a pond.

That’s unfortunate, especially when there are affordable, risk-free private sector solutions to what ails our health-care system – but more about that later.

The proposal to expand Medicare is an attempt to appease moderate Democrats who oppose the so-called “public option” – a government-run insurance program. But some fear that, once 55-year-olds are covered, political pressure will build to expand eligibility even further. According to a Washington Post editorial, “The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”

The major problem is that the Medicare program is unsustainable; in fact it is projected to go bankrupt in seven years. The 2009 Social Security and Medicare Trustees Report shows that Medicare has unfunded liabilities – costs exceeding income – of $86 trillion dollars. Expanding Medicare as the centerpiece of health-care reform seems a questionable strategy at best.

For example, Medicare doesn’t pay the full cost of medical services. It reimburses doctors and hospitals only 83 percent of the true costs, forcing them to shift the unpaid costs onto people with private insurance. Putting more people in the program will only worsen that cost shift, further stressing strapped medical providers and increasing private insurance premiums. For that reason, the proposal came under intense fire from the American Hospital Association and American Medical Association (AMA) as soon as it was announced.

In addition, the AMA, which supports national health reform, reports that Medicare denies claims at double the average rate of private insurance companies. And “60 Minutes” correspondent Steve Kroft reports that “Medicare fraud – estimated now to total about $60 billion a year – has become one of, if not the most profitable, crimes in America.” This is not a good foundation upon which to base health-care reform.

Lastly, there is great concern about the cost of enrolling millions of additional people in a program that is heavily subsidized by the taxpayers. Current Medicare beneficiaries pay $96.40 per month, with the taxpayers picking up the rest of the premium cost.

So, if expanding Medicare isn’t a solution, what is the answer?

If the goal truly is to improve access to affordable health care – rather than a government takeover of 16 percent of our economy – there are several affordable, risk-free, market-based ways to accomplish that goal.

*Allow people to purchase health care across state lines. Families will have more choices, and insurance companies would compete nationwide for customers.

*Give families and individuals the same tax exemptions for health insurance premiums as employers.

*Rather than create a mammoth federal program, simply provide vouchers to help people purchase private health insurance.

*Encourage the 14 million uninsured people who qualify for existing government health programs to enroll in those programs.

*Lawsuit reform would save billions of dollars now spent on frivolous lawsuits and defensive medicine, the practice of ordering unnecessary tests just to protect against a possible lawsuit.

Thankfully, some Senate Democrats are signaling they may reconsider the proposal to expand Medicare as part of health-care reform. Rather than enroll more people in a faltering government program, Congress should focus on private-sector solutions that give Americans more choices, more independence and more control over their own health care.

(Don C. Brunell is president of the Association of Washington Business)