Senator Schumer Offers to End Medicare As We Know It

Even though it may cause digestive problems and headaches, I sometimes watch David Gregory’s biased questioning of government folks on NBC’s Meet The Press just seeking better understanding of that mindset.  This week he grilled Senator Mitch McConnell, trying to get him to take Senator Ryan’s plan for stopping growth in Medicare spending by converting it to an insurance premium supplement rather than direct payment of medical bills off the table as a reasonable option.  McConnell took the position that negotiations over the budget and entitlements are going on between the White House and Congress and he was not going to shift the debate to one between himself and Mr. Gregory on Meet The Press.

Then Gregory turned his attention to Senator Chuck Schumer of NY, asking him whether Medicare is untouchable from a political standpoint.  Schumer replied, claiming to speak for all democrats,

Every Democrat--from the president, Steny Hoyer, President Clinton, Senate Democrats--we agree that Ryan should be taken off the table, that it's a complete stumbling block.  And is--and I am calling on--we are calling on Senator McConnell not to cling to the Ryan plan as he's doing, which ends Medicare as we know it, but to take it off the table.

 Then the senator showed a moment of weakness and made his own proposal for ending "Medicare as we know it:"

But here's the root of the problem.  The root of the problem is it's a cost-plus system.  When a--when you're sick, the doctor gets paid for each service, each prescription, each pill, each test.  If you were to tell doctors you get a certain amount of money to treat Jim Smith, who has a certain form of diabetes, say $10,000, every study shows that you'd save hundreds of billions of dollars without cutting the benefits to people.  That's what Democrats stand for.  And the reason our Republican colleagues resist is they don't want the present Medicare system to be preserved.

Well, that sounds nice, but it demands a major change in the present Medicare system and offers only two options:  

1. We can enslave all health care providers, telling them that they have to provide appropriate health care for all patients, for the rest of their lives, regardless of the cost, for flat fees per illness or
2. we can limit the benefits of Medicare to the amount established for the care of the particular disease they have and not hold health care providers responsible for anything beyond that. 

Of course only the second option will work because adoption of the first would result in abandonment of the health care professions by all but missionaries (and mission work is becoming politically incorrect).  And the second option is simply rationing, an admission that the current system of paying all bills as submitted, "Medicare as we know it," will not work with the expanding elderly population and rising costs of covering all bases for all patients.

Thanks for the admission, Senator Schumer.

Now, even though Ryan’s plan would be a better approach, lets compromise and get on with Option 2, simultaneously limiting Medicare payouts and eliminating restrictions on doctors and patients who want to offer or receive more or different care that the baseline amount guaranteed by Medicare. That will allow Democrats to continue to run all that health care money through Washington for a haircut and will limit their payouts to some reasonable multiple of the amount coming in.  Surely we can all find something to like in that...unless we have a "certain form of diabetes" and our $10,000 has run out.  (That is where missionary work, or personal responsibility, comes in.)

The entire script for the Meet The Press episode is here.  This is one time that watching the show paid off with a glimpse of what Senate Democrats are really thinking.