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fixing Medicare with metacare

April 17th, 2011 by dk

Some will call this proposal barbaric and I won’t disagree with them.

Medicare funding won’t get fixed until we all agree to do some 7th grade arithmetic. The demographic bulge of baby boomers are beginning to retire. Americans now retire earlier, live longer, and need more medi(cal)care. Meanwhile, medical innovation (and costs related thereto) is accelerating exponentially. Add these together and you have more people needing more care that costs more money for a longer time. And because family sizes have shrunk, it’s all supported by fewer workers. Not a recipe for sustainability.

So here’s a proposal, but please think of it as a thought experiment and nothing more. Seniors, at their worst self-entitled moments, will insist that they paid into the system and so they have pre-paid for their medical care. Fair enough. But that does not consider how medical care is “new and improved” every year. Many seniors will insist they have no use for progress when the topic is the Internet, but insist on the newest titanium knee replacement so they can continue skiing into their 70s.

What if the minimal Medicare coverage included only the medical procedures, drugs, and devices that were available they year when the patient retired? If they want anything fangled newly since they left the workforce, they would have to pay for it out-of-pocket — unless they paid for “Metacare,” which would always be optional. Metacare would cover the added costs of improvements that arrived after the patient stopped working.

This is not a new concept. Your property insurance premiums are lower if you insure the couch you have, which takes into account the age of the couch when you file your claim. For a slightly larger premium, you’re covered for the “replacement cost” of the couch, as if it’s always new.

I understand (for the third time) that a titanium knee is not comparable to a couch, and I wouldn’t be suggesting this, except that so many anti-tax advocates insist this is exactly what they want.

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