My Prescription for Medicare

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by Richard Crews
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(1) Don't provide Medicare for people who don't need it. Anyone who makes more than $100,000 a year and has a net worth over $2 million can afford to pay for their own medical expenses. Dropping their coverage would save Medicare several tens of billions of dollars a year.

(2) Contract with VISA, MasterCard, and American Express to root out and prevent fraud and abuse. The major credit card companies run claims-transaction systems that are very similar to that of Medicare, but they do it with less than 1/100 of the rate of losses from fraud and abuse (fraud and abuse cost Medicare over 10% of its expenses; the credit card companies run at about 0.1%). This would save Medicare several tens of billions of dollars a year.

(3) Allow Medicare to negotiate with drug companies and foreign drug sources for the best possible drug prices. The Veterans Administration and many private health insurance companies already do this with no loss in quality or value to patients. This would save Medicare several tens of billions of dollars a year.

(4) Cap malpractice awards at $1 million. An episode of medical malpractice that causes disability, disfigurement, or death is a terrible, terrible thing. Careless perpetrators should be punished; victims should be compensated. But there is no difference between a one-million-dollar error and a ten- or twenty-million-dollar error. The only difference is the malpractice insurance premiums paid by doctors, which they must pass along to their patients in increased fees. So the cost of such large awards is not paid by the doctors or hospitals--it is paid by the patients and, therefore, by Medicare and other health insurance companies. Moreover, much of an award is not paid to the victim--lawyers routinely charge 30% or 40% of the award amount. Capping malpractice awards would save Medicare several tens of billions of dollars a year.

(5) There are several other money-saving fixes that could be made, but these four alone would move Medicare securely from red to black ink for many decades to come.
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