The next big health story

What’s going to be the big health story of 2012 – health care reform? The impact of state and federal health spending cuts?

Nope. The next attention-grabbing story could well be about the future of Medicare, the federal program that covers millions of older Americans. This is the assessment of Trudy Lieberman, a contributing editor at the Columbia Journalism Review, who recently blogged about Medicare’s ascendancy as an issue of critical importance.

I’m inclined to agree.

Medicare is headed for a crossroads. Given the size of the federal budget deficit, cuts to the Medicare program are almost inevitable and will likely hit both providers and enrollees – the former in the form of less pay for caring for these patients and the latter in more out-of-pocket costs. The millions of baby boomers poised to become eligible for Medicare over the next couple of decades will only add to the pressure.

Lieberman writes that the outcome of the policy debate about Medicare “will determine whether nearly 50 million older and disabled people will be able to afford health care at all and what kind it will be.”

Most people’s eyes tend to glaze over when the conversation turns to Medicare. It’s not an exciting topic. I’d argue we should make a better effort to pay attention, however, because as with any policy discussion of this magnitude, decisions ultimately will trickle down to the local level.

Imagine, for instance, the hard decisions some doctors might have to make between turning away Medicare patients vs. losing money by continuing to see them.

To be clear, there’s no evidence this will become a widespread trend. But physicians are talking about it and some of them have already taken the step – for instance, a family practice clinic in Raleigh, N.C., that stopped seeing new Medicare patients three years ago. One of the partners told WRAL TV, “Our job is to take care of patients, which is what we love, but if we can’t run our business, we can’t take care of any patients.”

A potentially even larger issue is what might happen if seniors have to start paying more out of pocket for their care.

Lieberman points out, “When you consider that the median income for older women receiving Social Security is only about $15,000 a year and for men about $26,000, you can see why they get upset when there’s talk of cutting benefits or ending the program. Without it, they would get no health care.”

I’d hate to think of this happening to my parents or, for that matter, to any of us as we get older. While it’s true that health decisions made in our younger years can help make or break our health in later years, there’s no escaping the fact that age is an overall risk factor for health issues, period. The social cost of creating an entire future generation of aging adults unable to afford health care hardly even bears thinking about.

What’s the solution for Medicare? I wish I knew. In the meantime, I plan to stay tuned to the debate.

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