Monday, November 29, 2010

Medicare Already Limiting Seniors' Access to Care, As Will Obamacare

The Washington Post reports on physicians' reducing the number of appointments they'll give to seniors enrolled in the traditional Medicare monopoly.

What is needed is rigorous measurement of this phenomenon – like the Canadian Fraser Institute’s measurement of waiting times for specialist and hospital care under the government monopoly up there. Obviously, the U.S. government would never fund such research.

It is becoming increasingly clear to laymen that Medicare beneficiaries do not have the same access to care as the privately insured (or those in Medicare Advantage plans). The political challenge is obvious: It’s not possible that America’s seniors will tolerate politicians who allow this to happen.

So, the political class has two choices. First, it could voucherize Medicare and allow seniors to choose any health plan they prefer. Second, it could equalize the environment by imposing more restrictions on both the demand and supply sides of private care. For example, it could force health insurers to match the Medicare payment schedule. (Unless Obamacare is repealed, health insurers might actually lobby for this, because it will facilitate the collusion and cartelization necessary for them to survive under Obamacare.) And/or, it could make Medicare participation necessary as a condition of licensure. (Given the volume of health dollars flowing through the federal government, I have little doubt that states could be induced to legislate this.) Physicians would have to report how many Medicare beneficiaries they had seen, as a proportion of total patients.

Given the ambitions of the political class, I would not bet on its increasing choice, rather than imposing more restrictions.

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