When I'm Sixty-Four
“I read the news today, oh boy"
The outlook for Medicare has improved substantially, or at least so say the Trustees of the Social Security and Medicare trust funds in their recently released report. According to this latest report, Medicare will now be solvent until at least 2029. The good news is, this is 12 years longer than previous estimates. The bad news is, I will only be 64 – 2 years short of eligibility for my full Medicare benefit. Paul McCartney's words – “Will you still need me, will you still feed me?" – suddenly have taken on a very personal meaning.
According to the report, this windfall for Medicare is entirely due to “...program changes made in the Patient Protection and Affordable Care Act.” It goes on to say that “If health care efficiency cannot be substantially improved through productivity gains or other measures, then over time the statutory Medicare payment rates would become inadequate.”
This new math is quite telling. With all the new programs and new ideas, why does health care reform only buy us 12 more years in an admittedly optimistic, best case scenario? For all of the talk about continuity and coordination, this plan is largely focused on gaining efficiencies in our current system. New models of payment do not necessarily equal new models of care. There are certainly opportunities to lower our costs, and improve our delivery, but there is a limit to the efficiency you can gain in any system. There is only so much juice in the proverbial orange.
We are currently living in a system of uncoordinated sick care with the goal being to move to a system of coordinated health care. Although the new law moves us in that direction, it really only gets part of the way – to a coordinated sick care system. Unless we can continue to move toward a model of truly coordinated health care, we are simply delaying the inevitable. We may have a good start, but we still need a better plan.
Title: When I'm Sixty-Four, John Lennon & Paul McCartney
Opening Quote: A Day In the Life Lyrics, Paul McCartney
