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Medicare and Affordable Care Act: A Little Socialism Making America Healthier

Dr. Newquist notes a convergence of good news about Medicare (which just turned fifty years old yesterday and did not usher in the socialist devolution Ronald Reagan feared) and access to health care. Hospitals are reducing deaths, hospitalizations, and costs for Medicare patients, just in time to absorb the increasing demands of aging Baby Boomers. Since full implementation of the Affordable Care Act, millions more Americans have health insurance, have a personal physician, report easy access to health care, and can afford health care.

The Affordable Care Act also appears to be helping Medicare live longer:

Ever since the passage of the Affordable Care Act, per-enrollee Medicare costs have decreased a little and are rising more slowly than overall health-care costs, and somehow or another the Medicare trustees have added 13 years to the program’s solvency.

In fact, let’s go mildly wonky here. This is worth knowing. Before the ACA passed, projections of Medicare bankruptcy were pegged, as noted, at 2017. Then shortly after the ACA became law, that was pushed to 2024. Then in 2013, it was nudged to 2026. Now it’s at 2030. See a pattern here? The main reason is simple. Overall spending is lower. You might remember Mitt Romney’s famous attacks on Obama for cutting $716 billion from Medicare, which took some cheek given that a) Republicans’ own projected cuts under Paul Ryan’s budget were far more severe and b) Ryan and other Republicans used the same budgetary assumptions Obama used for all their Medicare “reform” plans [Michael Tomasky, “Expand Medicare, You Damn Idiots,” The Daily Beast, 2015.07.31].

Meanwhile, Jeb Bush wants to phase out Medicare, and pretty much every GOP Presidential candidate wants to repeal the Affordable Care Act.

Dr. Newquist finds this GOP resistance to good results maddening:

While significant strides are being aade in improving healthcare in the U.S., the GOP expresses its intention to destroy the vehicles of that improvement. The question they never answer is, why? They bring up big government, but they never address the hard facts about  healthcare in the nation or acknowledge the improvements being made. And they never suggest a plan to imake healthcare accessible to more people….

…[W]ill the GOP have the integrity to acknowledge the progress being made? Or even care? [David Newquist, “Get Rid of Medicare and ACA; They’re Getting out of Hand,” Northern Valley Beacon, 2015.07.29]

In a way, Reagan was right: Medicare and the Affordable Care Act brings socialism to America’s health care system. Both programs are examples of Americans working together as a community to solve social problems with public resources. But rather than being short steps to depriving us of the freedom to choose our jobs and all the rest of our liberties, Medicare and the Affordable Care Act are giving Americans more health security and thus more liberty. Medicare and the ACA are socialism working… and that drives Republicans nuts.


  1. MD 2015-07-31 08:43

    Now that we have made it to 50 with Medicare, it is time that we consider some reforms to the system. Medicare has been part of the exponential rise in health care costs as the Medicare reimbursement formula requires an entity to bill high in order to reimburse at an acceptable rate. The problem with this is Medicare says that you have to charge Medicare the same rate that you charge other patients, which has led to the price inflation, especially if you are paying out of pocket or are not part of a HMO/PPO (which is how we are losing choice). While some of this has improved since they implemented Diagnosis Related Groups, there is absolutely no price transparency in health care, so when you enter into the system, you have no idea what the price tag is going to be when you walk out of the hospital (leading many to simply not receive care).
    There is data available from Medicare to back it up.
    So long story short, yes Medicare is good and it should not go anywhere, but we need to come up with a better reimbursement strategy to cut the veil.

  2. Porter Lansing 2015-07-31 09:16

    Well said, MD. Many of one political party have an intense aversion to change of any kind. Of course Medicare needs to change/upgrade. Everything needs to grow. If you’re staying the same you’re not growing. If you’re not growing, you’re dying. Nothing can thrive by staying the same.

  3. mike from iowa 2015-07-31 09:21

    From Daily Kos-

    Republican demagoguery of Medicare began well before President Johnson signed it into law in 1965. “I was there, fighting the fight, voting against Medicare,” Bob Dole later boasted, “Because we knew it wouldn’t work in 1965.” In 1964, George H.W. Bush was among the first to call it “socialized medicine.” And three years earlier, Ronald Reagan voiced his opposition:

    “One of these days, you and I, are going to spend our sunset years telling our children and our children’s children what it once was like in America, when men were free.”

    Fifty years later,the sky is still falling.

  4. Porter Lansing 2015-07-31 11:15

    Remember Alf Landon? PS … the Texas Tea Party’s revisionist attempt at changing the AP History curriculum across the USA has been rebuked and a new 2015 version is soon released. The 2014 revision which removed many so called “confrontations between citizens and government” from textbooks has caused a majority of the school board members in Colorado’s second largest school district to be up for recall in November. Think Vietnam protests and union uprisings. The resolution stated that AP history classes should promote “patriotism and … the benefits of the free-enterprise system” and should not “encourage or condone civil disorder.”

  5. MD 2015-07-31 12:32

    I wanted to include the dataset but I was on my way out the door when I wrote my previous post.
    This dataset provides information on Medicare reimbursement to Physicians and other health care suppliers such as ambulance services, some pharmacy services, outpatient services, etc. which are outside of a hospital diagnosis related group.
    It really shows the stark variations in reimbursement and payment, it is lacking in some respects, but it is the best we have. I find ambulatory surgical centers and ambulance services the best ways to compare prices.
    As a pertinent example:
    There are two ambulatory surgical centers listed as providing screening colonoscopies in Aberdeen – Sanford Clinic and Surgical Associates.
    For a low risk colon cancer screening, Sanford Clinic charges $1,587 of which Medicare states that they should only be charging $281. Their average final reimbursement is $276.
    On the contrary, Surgical Associates charges Medicare $452 for the same colonoscopy which Medicare allows a charge of $297 and reimburses $292.
    That is a bit upside down. (Bear in mind this is only the surgery center’s facility charge, the physician and anesthetist can also receive reimbursement).

    If we want to keep Medicare a fair, equitable, and sustainable, we need to take steps to bring reimbursement parity through something such as a public, negotiated reimbursement schedule for Medicare. The current system attempted that with relative value units, but as we can see, it still leaves a lot to be desired.

  6. leslie 2015-07-31 18:15

    MD, you and my new friend MD______, rapid city, could together do much to help efficiently instruct and lead democratic politics w/respect to medicaid expansion ect in SD, along w/ Rick Weiland and his MD brother.

  7. Deb Geelsdottir 2015-07-31 20:40

    Jenny might be able to help me with this, but I think MN has been working on creating a publicly accessible database showing comparable medical costs. In searching for links, I found this description of MN Health Scores:

    “MN HealthScores is brought to you by MN Community Measurement, an independent, non-profit community organization founded in 2004. Our goal is to accelerate the improvement of health by sharing information on health care quality, cost and patient experience with all Minnesotans. – See more at:

    I don’t know if this is the site I have in mind, but it is a good resource. MN medical hospitals, clinics and doctors have been the biggest impediment to creating a resource for consumers. They complain that there are too many variables, too many unknowns.

    This is a comparison that may seem like a reach, but I don’t think so. There is a book for auto repairs that lists the labor time that should be charged for every job. The repair shop will write an estimate based on that time and their hourly charge, plus parts. Health care needs to do the same.

  8. John 2015-07-31 21:25

    I note with glee the two most popular medical programs in the US are: 1) the VA, and 2) the military TriCare — both socialist to their core.

  9. larry kurtz 2015-08-01 20:06

    South Dakota: Land of Infinite Voidability.

  10. larry kurtz 2015-08-01 20:06

    Wake up or die, South Dakota Democrats.

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