Medicare's pending collapse due to lack of courage

Last week we learned again that Medicare is going bankrupt. The latest figures indicate the demise will be in 2017, a couple of years earlier than we were told in 2008.

Annually the trustees of the Medicare Trust Fund are legally bound to report the status of the federal health-care program for seniors. Predictably and dutifully they gather like a quorum of prophets and pronounce the doomful end of Medicare. And every year they are ignored. Congress and whatever administration is in power at the time don their perfunctory sackcloths and dab a little ash here and there. They gnash their teeth in front of C-SPAN and point blamefully to the opposite side of the aisle in an empty House or Senate chamber then rush back to their offices, take off the mourning garb, and it is back to business as usual. Courage is not a prerequisite for public office.

It is pretty simple math. If anyone spends more than they have, eventually they go bust. Health-care expenditures far exceed the revenue. Medicare is part of its own problem. People are living longer because of medical science and lifestyle changes, and the longer they live the more they consume health dollars. Please note I am not in favor of the elderly or the infirm hiking out to the desert just to save the younger generation a few bucks.

We as a nation spend way more on health care than any other country. Now, we could say that is acceptable if we are living longer and happier. The problem is that we are not. While we are aging, we are not necessarily aging well. We pay more but buy less health. True, we buy more services, but in the end they do not buy us the longest lifespan or healthier days before we die.

It is particularly telling to see the difference in the cost of care and clinical outcomes. Medicaid spends far more dollars in Miami than in Utah for the same conditions but with worse outcomes. It is also incredible how different the procedures are from state to state and even town to town. One thing is true: where there are surgeons, there will be operations.

Since I am part of the aging population, there is a personal interest that this problem gets solved. The boomers are here. We brought Elvis, Woodstock, and rock 'n' roll. We were tough in the Cold War, triumphant in the race to the moon, gallant in the civil rights movement and victorious over the fall of the Berlin Wall. We have survived Vietnam, Haight Ashbury and bell bottoms. Now we want the health care promised to us by our political leaders.