Medicare & You: Will It Be There When You Need It

If you are in your near retirement years, I am sure you are getting ready for Medicare to take over your health care. Will it be there? By 2030 there will be about 100 million persons receiving Medicare. This is twice as many as 2008. This comes at a time when the growing demand for doctors is at a critical point. Their numbers are dwindling, especially those that accept Medicare payments for services.

Medicare is a health program that is publicly funded by the government to care for persons over 65 who have been legal residents for five years.It is a single payor program. Medicare eligibility starts at 65 years of age. If you are a person with disability, end stage kidney disease (i.e. requiring dialysis or kidney transplant), or Lou Gehrig's disease you will get benefits before age 65.

For the past few years Medicare payments to doctors have been cut by as much as 21% in 2010, while Medicare premium payments by patients have risen (along with the cost of health care!)an average of 10% per year. In addition, Medicare taxes are being prepaid through every working persons' paycheck - 2.9% of your wages to be exact (more if you make over $200,000). It would make sense that doctors and health care providers would receive increases instead of sharp cuts (pun intended). Instead doctors are quitting and looking for second careers unrelated to clinical medicine. Hospitals are closing (the small reserves for hospitals may exhausted by 2017). Clinics are downsizing and closing.

Predictions abound that Medicare will be bankrupt by 2020 to 2030, . "The latest report on the solvency of the Social Security and Medicare trust funds reveals that these entitlement programs will likely run out of money sooner than expected." (reference: Brookings Institute, 2009) Medicare alone was 13% of the federal budget (almost $400 billion) in 2009. It is projected to be near the same in 2010 with a higher cost near $500 billion! The amount spent on Medicare is likely to exceed the payroll taxes collected from your hard earned wages. Astounding data! In spite of the fact that doctors must now accept what Medicare pays them versus what they charge (traditional from 1960 to 1980), this program will be in the red.

Health care rationing may become part of the plan to cut costs and be sure all get health care. Those over 60 and those with multiple chronic conditions many of which occur just because you get old like arthritis, high blood pressure, decreased vision with cataracts, decreased hearing will be put in the long line near the end. As we live longer more health care is needed especially if we inherited the family genes for certain things like diabetes, cancer, and heart disease. Add this to the "old age" diseases and you have the equation of a Medicare patient. Of course old age is much kinder to some than others, but it happens to everyone.

Where will you go for health and medical needs when you reach 65? Medicare was supposed to be there. You worked and paid for it. So you must look after it. First and foremost, you must realize that your health is everything. Loss of function of an arm or leg, your speech or vision almost renders you dependent until you "overcome" it, if you do.

Health maintenance and wellness are vital. You must be your best health advocate by taking the time to prevent as much as possible. Routine checkups by you and your healthcare providers are very important. Early detection will prove a lifesaver if some illness is discovered. This will help you get through the Medicare years. You will be able to see your premium payments and hard work pay off, just with less Medicare and more of your money out of your pocket.

Bottom line: cut Medicare benefits or increase payroll taxes? This is truly a "beast and burden" that needs taming.

by J. L. Richardson, M.D.

Dr. Richardson is a family medicine physician, independent medical record reviewer, and author of Patient Handbook to Medical Care: Your Personal Health Guide. This book provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates.