how to solve medicare problems and solutions

1. Bring Down the Costs of Prescription Drugs. Medicare should benefit from the same discounts for prescription drugs as Medicaid. ...
2. Stop Paying Private Medicare Plans Anything More Than Traditional Medicare. ...
3. Lower, Don’t Raise, the Age of Medicare Eligibility. Some proposals to reduce the national deficit would increase the age of eligibility for Medicare from 65 to 67, or even ...
4. Let the Affordable Care Act Do Its Job. The Affordable Care Act includes many measures to control costs as well as models for reform that will increase the solvency ...

How can we fix Medicare?

1. Raise Medicare taxes The easiest, and probably least liked, method of fixing Medicare would be to dramatically... 2. Institute means-testing Another popular solution would be to institute means testing. Image source: Flickr user Day... 3. Use the federal government's might to negotiate A third ...

How do I get help with Medicare questions?

You can call 1-800-MEDICARE and speak with a representative to ask questions about Medicare or get help resolving problems with Medicare. We made a test call to this number and was greeted by a polite Medicare representative after being on hold for about 90 seconds.

How do you manage Medicare's long-term deficits?

Under Medicare's current structure, there are six ways to manage and contain the program's long-term deficits: Increase payroll taxes current workers pay to the HI Trust Fund to support Part A benefits. Increase income taxes paid to the general federal fund to support benefits paid for Parts B and D.

Why is it important to understand Medicare's financial situation?

That's why it's important to understand Medicare's financial situation, so you can be an informed health care planner -- and voter. According to the summary of the 2017 annual report, "Both Social Security and Medicare face long-term financing shortfalls under currently scheduled benefits and financing.

How can Medicare be improved?

Increase traditional Medicare coverage, including for oral health, vision, and audiology services. Improve access to Medigap plans so people with pre-existing conditions are not locked out. Add an out-of-pocket cap on Part D expenses and strengthen low-income assistance.

What are some of the biggest challenges with Medicare today?

Top concerns for Medicare beneficiaries: Part B, appeals and affordable medications. The top concerns of Medicare enrollees include navigating Part B, appealing Medicare Advantage (MA) denials and affording meds, according to an annual report from the Medicare Rights Center.

What three problems are created by the Medicare system?

Although there are many more, let me mention just three big problems with the current Medicare system: The current Medicare system makes fraud easy. The bookkeeping is broken. The problem resolution system is lousy.

How can Medicare be sustainable?

For the short-term, the Task Force proposed these measures:Gradually raise Medicare Part B premiums from 25 to 35 percent of total program costs (over five years);Use Medicare's buying power to increase rebates from pharmaceutical companies;Modernize Medicare's benefits package, including the copayment structure; and.More items...•

What is the problem we are facing with Medicare?

Financing care for future generations is perhaps the greatest challenge facing Medicare, due to sustained increases in health care costs, the aging of the U.S. population, and the declining ratio of workers to beneficiaries.

What is the problem facing Medicare?

As the Medicare system itself faces financial troubles, Medicare beneficiaries also face higher costs. Today, beneficiaries pay nearly 30 percent of their health care costs from their own pockets. In 1995, those costs averaged $2,563 per person to pay for premiums, services and products not covered by Medicare.

How successful is the Medicare program?

Medicare's successes over the past 35 years include doubling the number of persons age 65 or over with health insurance, increasing access to mainstream health care services, and substantially reducing the financial burdens faced by older Americans.

What would happen without Medicare?

Payroll taxes would fall 10 percent, wages would go up 11 percent and output per capita would jump 14.5 percent. Capital per capita would soar nearly 38 percent as consumers accumulated more assets, an almost ninefold increase compared to eliminating Medicare alone.

How has Medicare impacted the healthcare system?

Medicare and Medicaid have greatly reduced the number of uninsured Americans and have become the standard bearers for quality and innovation in American health care. Fifty years later, no other program has changed the lives of Americans more than Medicare and Medicaid.

Why Medicare is not sustainable?

A shrinking taxpayer base, swelling beneficiary numbers and growing healthcare costs all threaten Medicare's long-term viability, according to the HHS, and the agency warned the program would need to increase its revenue or drastically reduce benefits to balance its budget.

What should the US do to reform Medicare?

Congress should reform Medicare graduate medical education payments by converting the payments into direct grants to institutions sponsoring residency training programs; allowing ambulatory care settings such as physician groups to receive funding for sponsoring residencies; and cutting the total amount of spending by ...

How can I reduce my Medicare spending?

Expand Bundled Payments and Promote New Payment Models – $5 billion to $50 billion. ... Reduce Preventable Readmissions and Unnecessary Complications – Up to $10 billion. ... Reduce Payments to Post-Acute Providers – $25 billion to $75 billion.More items...•

What would a drug benefit in Medicare do?

A drug benefit in traditional Medicare would protect beneficiaries against expensive and sometimes inappropriate marketing practices.

How does the Affordable Care Act affect the deficit?

The Affordable Care Act includes many measures to control costs as well as models for reform that will increase the solvency of the Medicare program and lower the deficit while protecting Medicare's guaranteed benefits. The Congressional Budget Office estimates that repealing or defunding ACA would add billions to the deficit while ignoring the real issue of rising overall health care costs, which contribute heavily to the growing national debt. ACA includes strong measures to allow CMS to combat fraud, waste, and abuse that will bring down costs, as well as a variety of pilot and demonstration projects that aim to bring better care and quality to beneficiaries. Allowing the ACA to do its job will improve care and hold down costs for taxpayers.

What is the ACA?

ACA includes strong measures to allow CMS to combat fraud, waste, and abuse that will bring down costs, as well as a variety of pilot and demonstration projects that aim to bring better care and quality to beneficiaries . Allowing the ACA to do its job will improve care and hold down costs for taxpayers.

What was the ACA payment rate?

Prior to the Affordable Care Act (ACA), payments to private Medicare Advantage (MA) plans averaged as much as 114% of the rate the traditional Medicare program spent on a comparable individual. The ACA attempted to rein in these overpayments and bring MA costs more in line with costs under traditional Medicare. Despite these changes, though, various factors prevent more equitable and accurate payment to MA plans, resulting in inflated and wasteful payments. [5]

How old do you have to be to get Medicare?

Lower, Don’t Raise, the Age of Medicare Eligibility. Some proposals to reduce the national deficit would increase the age of eligibility for Medicare from 65 to 67, or even higher. This would "save money" for the federal government by shifting costs to beneficiaries, employers and states.

Is Medicare a private voucher?

Once again the House of Representatives’ leadership are proposing to change Medicare into a private voucher system. Their proposals would have severe repercussions for Medicare beneficiaries and their families. [1] Sound solutions that would preserve Medicare coverage while reducing costs are still not being seriously addressed. With the President on record as recommending that we lower Medicare's drug costs, perhaps now is the time.

Should Medicare include a drug benefit?

Include a Drug Benefit in Traditional Medicare. Offering a drug benefit in traditional Medicare would give beneficiaries a choice they do not have now, encourage people to stay in traditional Medicare, and save money for taxpayers.

How to manage Medicare deficits?

Under Medicare's current structure, there are six ways to manage and contain the program's long-term deficits: Increase payroll taxes current workers pay to the HI Trust Fund to support Part A benefits. Increase income taxes paid to the general federal fund to support benefits paid for Parts B and D. Increase premiums retirees and beneficiaries pay ...

How is Medicare funded?

In addition to taxes collected from workers, Medicare is funded through two separate trust funds: The Hospital Insurance (HI) Trust Fund. This fund supports Medicare Part A, which pays for hospitalizations, home health services following hospital stays, care at skilled nursing facility and hospice care for the aged and disabled.

What happens if the HI Trust Fund is depleted?

If Congress allows the HI Trust Fund to become depleted, then Medicare Part A benefits will need to be reduced accordingly. The 75-year actuarial deficit of the HI Trust fund amounts to 0.64 percent of the payroll of covered workers, or 0.3 percent of GDP through 2091.

Is Medicare a financial pillar of Social Security?

Yet together they form the twin pillars of financial security for retirees.

Is there a shortfall in Medicare and Social Security?

According to the summary of the 2017 annual report, "Both Social Security and Medicare face long-term financing shortfalls under currently scheduled benefits and financing. Lawmakers have a broad continuum of policy options that would close or reduce the long-term financing shortfall of both programs.". In addition to taxes collected ...

How much is Medicare taxed?

Medicare is currently taken out as part of your payroll taxes along with Social Security at a rate of 2.9% of your modified adjusted gross income. Like Social Security, this tax is typically split down the middle between you and your employer, with each side paying 1.45%.

How much Medicare did the average person pay in 2010?

As of 2010 (but based on 2012 dollars), the average man and woman were paying $61,000 in Medicare taxes over their lifetimes. Yet, men and women were receiving $180,000 and $207,000, respectively, worth of lifetime benefits (women have a longer life expectancy than men). This gap between taxes paid and benefits received is only expected ...

How much did Medicare spend in 2014?

First, Medicare Part D (drug plans) spending was "only" $78 billion in 2014, meaning even with staunch negotiations the program might only save between 2% and 5% of its total annual expenditures, by my estimate. That's not going to give the Medicare program much of an extension beyond 2030. The other issue is simply innovation.

What would happen if drug companies lost their pricing power?

If drug developers lose their pricing power in the U.S., they could take their research, and jobs, overseas. Since U.S. drugmakers are known to subsidize emerging and developing markets with medicines, prescription drug reforms may also reduce access to these medicines overseas. 4. Index Medicare to life expectancies.

What is Bernie Sanders' plan?

Democratic Party candidate Bernie Sanders has suggested creating a universal health plan for Americans of all ages, which would require a 2.2% healthcare premium tax on all individuals and a 6.2% tax on employers. 2. Institute means-testing. Another popular solution would be to institute means testing.

Is it tougher for Medicare to police claims?

The problem is in convincing lawmakers that a model beyond the institutional hospital setting should be reimbursed. It may also be tougher for Medicare officials to police claims if they aren't made within the traditional settings of a hospital.

Is there a cap on Medicare?

There is no earnings cap on the Medicare tax, so raising the earnings cap isn't an option here . If taxes are going to rise, they're likely going to rise for everyone. While increasing taxes could indeed stem a cash shortfall, it also could strain the pocketbooks of tens of millions of working Americans.

How long does it take for Medicare to become insolvent?

But now even those gimmicks have run their course. Estimates suggest the Medicare trust fund will become officially insolvent within five years —and could face a cash flow crunch even sooner.

When did Medicare Part A become a condition of Social Security?

In 1993, an administrative ruling by the Clinton administration—one that did not even go through notice-and-comment rulemaking—forced all individuals to enroll in Medicare Part A as a condition of applying for Social Security. This policy makes little sense, for several reasons.

What does it mean when seniors pay to Medigap?

Every dollar seniors pay to a Medigap insurer allows an organization like AARP to take their share of the cut (a.k.a. “ kickbacks ”) in the process. Fewer dollars running through insurance companies means less overhead and profits for the insurers—and more dollars back in seniors’ pockets.

How much money does Washington spend on Medicare?

According to the Congressional Budget Office, the national debt has roughly tripled since 2007 and is projected to rise such that, by the end of the coming decade, Washington will spend nearly $1 trillion per year just to pay the interest on our bills. Medicare itself has been effectively insolvent for several years.

Does Medicare have a cap on out of pocket costs?

Because the traditional Medicare benefits provided by law do not include a cap on out-of-pocket costs, roughly nine in 10 seniors have some type of “insurance” to provide such a catastrophic cap. Otherwise they could face medical bills totaling tens of thousands of dollars (or more) in the case of a medical emergency.

Can Republicans reform Medicare?

To be clear: Republicans can—and should—explore more comprehensive Medicare reforms, including a premium support program that would place private plans and traditional Medicare on a level playing field to attract and enroll seniors.

Will Biden rightsize entitlements?

In the immediate future, President Joe Biden and his Democrat colleagues in Congress will likely thwart any major attempt to right-size our entitlement programs, until Washington finally re-learns the habit of spending within its means.

Why is Medicare reform important?

There are two broad reasons for reforming Medicare. The first is to reduce costs in the program. This saves money for taxpayers and extends the program's solvency. Typically, this points to changes in benefit structures and payment schedules or to increases in revenue. The second reason for reform is to deliver better value to beneficiaries. Doing so might involve some benefit changes, but it also can include the various experiments being conducted to incentivize higher-value care.

When will Medicare's trust fund be exhausted?

According to the 2016 annual report of the Medicare trustees, Medicare's Hospital Insurance (HI) trust fund, used to pay for inpatient expenditures, will exhaust its funds by 2028.

How many people are covered by Medicare?

In particular, Medicare — our socialized health-insurance scheme for the elderly and disabled — covers 55 million people. That's 17% of the American population, or roughly the population of England. The program accounts for 15% of the federal budget and 3% of our economy.

Why was the retrospective reimbursement system a problem?

The program's retrospective reimbursement system (which essentially amounted to asking hospitals after the fact what their costs were) was a particular problem since it allowed hospitals to raise costs at the taxpayer's expense without much pushback.

Is Medicare a premium support system?

Implementing a premium-support system in Medicare would be challenging in practice, since it would require some major design and funding decisions that would affect costs to taxpayers and beneficiaries. But the overall approach is theoretically simple.

When did socialized health insurance start?

The Progressive Party platform in 1912 endorsed socialized health insurance, and the Bull Moose himself lobbied for sickness benefits as a state program.

Do enrollees pay premiums?

Enrollees, however, pay a premium that factors in the difference between the plan's bid and the nationwide average bid. While enrollees in MA plans pay a higher premium for plans that bid above the benchmark, that is the only instance where enrollees are held accountable for selecting higher-cost plans.