Medicare and Medicaid

Americans, especially Liberals but including large segments of Conservatives, remain content with Social Security and somewhat fanatical about preservation of Medicare and Medicaid. This is likely due to the innate awareness of All that the later Programs are unsustainable. Costs of health care will continue to rise, and the reason lies in the fact Voters demand Government payment of health care costs. Economists will state that fully-funded Demand leads to higher Supply Prices (because of Demand Curve shift to the Right). Doctors and Health Care professionals have been enjoying higher than average Wage increases since the passage of Medicare and Medicaid, and will continue to do so as long as the Programs operate. Corporate and Business interests in the Health Care industry likewise enjoy above-average Profits.

These Programs exhibit a worse effect of the Health Care industry. The payment system of Medicare has led to promotion of Specializations in Health Care; to the point, General Practicioners(Family Doctors) have shifted from the Norm, to a short-supply Specialization in themselves. The rationale expresses simple economics: Medicare payments pay Specialists much higher Fees than GPs; a single Year of additional Specialist training can lead to a lifetime of Fees some 15-50% higher than GP remuneration. This drive to Specialization is heightened by the fact GPs endure higher rates of malpractice suits than do Specialists(the Author can find no effective Study in this area).

Uncertainty of Medical payments in the higher range of Specialist Fees will reduce both of the Above trends(by shift of the Demand Curve to the Left). Medicare and Medicaid must be adapted for Basic Medical Care, with the Concept of Catastrophic Care abandoned. The shift to Basic Medical Care will underwrite Emergency Room operations, provide necessary surgical and corrective procedures to maintain Labor performance, handle Child Care, and provide Hospice and Pain-killing services. Catastrophic Care can be safely left to Private-funding specialized insurance and Charity. lgl