Cut Medicare – expand Medicare ❓

The following is an interesting read. You should read the full story. And you should keep all this in mind if you favor Medicare for All because it must be the same or worse.

“Let’s all agree to stand up for seniors,” President Biden told Congress in his State of the Union address. “If anyone tries to cut Medicare, I will stop them.”

Yet, Congress has been constantly pruning Medicare for over four decades — most recently under Biden and the Democratic majority only a few months ago. While most politicians promise to oppose cuts to Medicare on the campaign trail, the bulk of legislators have voted repeatedly to do so, because the growth of expenditure committed to the program is so substantial that it must be drawn from to finance almost any alternative fiscal priority.


Managing health care costs will never end. You cannot have unlimited benefits. The less individuals pay, the greater the demand for services and the less concern for spending.

All efforts to control spending have consequences.


  1. Don’t forget who pays when Congress “prunes” Medicare reimbursements. You do if you are one who isn’t covered under Medicare, Medicaid, Veterans coverage. Yes, your provider increases the charges you pay (directely in terms of point-of-purchase cost sharing or balance billing, or indirectly through the cost of health coverage, or both).

    I believe this is an update from a prior post. Consider Medicare point of purchase cost sharing for the past four decades –

    Medicare Part A:
    Per Admit Deductible: 1983: $304; 2023: $1,484, Average increase/year 4.24%
    Days 61 – 90 Copay: 1983: $76; 2023: $400, Average increase/year 4.24%
    Days 90+ Reserve: 1983: $152; 2023: $800, Average increase/year: 4.24%
    Skilled Nursing Copay/Day: 1983: $38; 2023: $200, Average increase / year 4.24%

    Medicare Part B:
    Premium: 1983: $12.20 2023: $148.50 Average increase / year: 6.72%
    Deductible: 1983: $75 2023: $220 Average increase / year: 2.8%

    There was no Medicare Part D in 1983, Rx premiums and copayments/coinsurance are very modest, only a small fraction of the costs retirees once paid, and a much, much smaller percentage of the Rx costs others pay. Thank you George W. Bush – your vote buying got you elected and only added another $10+ Trillion in unfunded promises added to our national debt.

    So, a large part of the decline in poverty among seniors has been Congress’ decision to insulate them from medical expenses – by capping what the government will reimburse (RBRVS, DRG, balance billing, etc.), shifting the cost to you (either in terms of the prices you pay for medical services and Rx or your tax burden, or both).


  2. No surprise. DRG’s and RBRVS have been part of Medicare for decades. It is one reason why the copays and deductibles under Medicare have increased on 3% – 4% per year for the past 40 years – as the federal government shifts more and more of the cost, directly and indirectly, to taxpayers … through limiting physician and other provider charges – who then cost shift to those who are not protected by Medicare limits on covered charges and balance billing.


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