How will a depleted Medicare program affect most of us?
By Ernie Williamson / The Bulletin
About this time every year, the government issues its sobering report on Medicare’s future.
Years ago as a newspaper editor, I felt compelled to publish these dire warnings. Personally, however, I didn’t worry much about Medicare’s fate. After all, I was younger, healthier and Medicare’s insolvency seemed a long way off. Surely, our esteemed lawmakers would find a financial fix.
Well, the latest Medicare prognosis is out. It says Medicare’s hospital insurance fund is expected to be depleted in 2026.
Insolvency would mean doctors, hospitals and nursing homes would not receive their full compensation from the program, and patients could face more of the financial burden.
For me, as a retiree with spinal cord damage that has put me in a wheelchair, Medicare has been a blessing. It certainly has saved me from financial ruin and maybe even saved my life.
It has paid for medical specialists, physical therapy, leg braces, drugs, hospital visits and MRIs. Because I have a history of shoulder pain that is aggravated by using the wheelchair, Medicare even paid for an assist device that powers the wheelchair when needed. I can think of nothing that has been disallowed.
All this comes at a cost, of course. Because of my spinal cord injury I not only have Medicare Part A (covers hospitalization) but also Part B (covers doctors visits and other outpatient care),
Part D (covers drugs) and a private supplemental plan that picks up where Medicare leaves off. I pay premiums on everything but Part A.
Handling my insurance needs this way has allowed me to stay with the specialists of my choice and not worry about copayments and deductibles every time I visit the doctor … and I need to see a lot of doctors. I end up paying more for insurance, but my yearly costs are pretty much fixed.
But what is good for me may not be good for others. There are other options. For many people, private Medicare Advantage plans may be the better way to go.
They are generally cheaper, but they charge for copays and deductibles, and enrollees must stick with the plan’s network of providers, or pay a penalty.
No matter which Medicare option you choose upon retirement, it is clear there are developments that are worrisome.
Also, Medicare, in a major test case, is wrestling with what to do about new types of cancer treatments called CAR T cell therapy. The “personalized” treatments have been proven to be remarkably effective but are extremely expensive and will put added strain on Medicare’s finances.
The cost of two new CAR T cell treatments can easily exceed $750,000 each, including the cost of the therapy, the doctor and hospitalization.
Cancer patients, doctors and drug companies are urging the Trump administration to approve broad coverage. Not surprisingly, insurance companies are pushing for more restrictions.
Finally, it is estimated it would take a payroll tax increase of 0.91 percentage points to fully address Medicare’s shortfall, or a 19% cut in spending.
With the problem that was once far down the road now just around the corner, it is mandatory that both parties put fixing Medicare on the front burner.
Unfortunately, lawmakers appear more interested in hurting the other guy than healing Medicare.
Even if you are not retirement age, pay attention this upcoming election. Your time will come … faster than you think.
(Ernie Williamson welcomes reader input. Please contact Ernie at email@example.com)