Flush with Cash by Pat Conrad MD


Medicare is an economic failure, a massive voter by-off, and now so deeply embedded in our psyche that elderly yet able-bodied relatives of mine have said – quite sincerely – that they would “die” without it. In 1991 Harris Wofford became the spark that lit the ClintonCare smolder, that threw an ember into RomneyCare, and then lit the bonfire known as ObamaCare. The whole progression has been based on the unshakable belief in the government’s ability to do good. If not enough good is accomplished at first…add more government.

Last year we talked about this report on fraudulent or erroneous Medicare payments: $60 billion, or about 10% of the 2014 Medicare budget went to doctors who were at dubious practice locations (“a vacant lot”), had committed crimes, or had just died. No doubt there was some error in compiling that error rate, but 60 B ain’t just accounting slippage. As both a theory and in practice, Medicare is a failure.

It doesn’t matter. Bernie Sanders wants to give everyone “free” healthcare and has no idea how to pay for it, which lives up to an august legacy. LBJ wanted to give the elderly free care, and never cared about how to pay for it. Bush ’43 offered the shuffleboard demographic free drugs in exchange for votes, and only added to the debt. As bad as that budget-buster was, it nearly is an accounting error next to the Affordable Care Act.

Now President Clinton’s Wife wants yet another level of Medicare. She said, ” I’m also in favor of what’s called the public option, so that people can buy into Medicare at a certain age.” The certain age she is targeting is the 50-54 crowd, about 38 million already covered under some sort of employer plan, and another 7 million that is uninsured. The article explains that Medicare might actually be a more expensive (than ObamaCare plans) option for some, but a tradeoff might be broader networks and lower deductibles. But how exactly will we pay for this new group on top of the government patients we already can’t afford?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Flush with Cash by Pat Conrad MD

  1. Stan Siefer
    May 25, 2016 at 3:26 pm

    Comments like “Medicare is a failure”. Leave me cold. Fix the problems that exist with any system. Improve what needs improving. Don’t just trash it. The problem, it seems to me, is a broken legislative system that cannot work constructively.

    • Pat
      May 25, 2016 at 5:30 pm

      Stan, I agree with your analysis. Medicare is a program that does not, cannot self-fund; it is an obvious conflict of interest, whereby its beneficiaries wield extremely powerful political clout for their own gain, at the expense of others. That is why I use the term “failure.” The fix is to phase it out ~ Pat

  2. Pat
    May 21, 2016 at 9:10 pm

    Author’s note: apologies for the typo, but the “certain age” is 50-64.

  3. Thomas Guastavino
    May 21, 2016 at 6:53 am

    Agree with everything said here, except the Medicare buy-in. Buy-in means that, assuming it is done right of course, it should not cost anything additional. These patients would be paying their own premiums. Plus, if you make the payments tax deductible (as ay other private buy) and add other options such as cross state line competition, Medicare buy-in would be just another option to choose from.
    And, of course, we need tort reform.

    • Steve O'
      May 21, 2016 at 11:21 am

      The problem with excellent ideas, Tom, is that they are always implemented according to strict, unchanging laws of doing business in America. No matter what is wanted, the same product is rolled out. The Medicare buy-in is not a bad idea; neither, frankly, is Obamacare. The problem is what rolls off the assembly line, what does it do, what are its parameters.
      The rules of American healthcare is that each change will decrease the amount of money paid through certain sources, will please certain constituencies and resonate well among the voters. It will have scrupulous “quality oversight” and aggressive punishment of the “violators.” Given these rules, there’s no way to run anything decent off the assembly line, even if sunshine and rosebuds go into the ideas that fuel the machine.
      “Buy-in means that, assuming it is done right of course, it should not cost anything additional.” Of course, but there will me an insistence that it will produce 5%-10% improvement in cost by enacting quality and efficiency standards. Who is against efficiency, and quality?
      Sanders is the closest candidate to a “change-the-paradigm” approach, but his followers are naive in the hopeless intellectual way – that those who benefit from unfair actions and principles will recant what they do, once it is pointed out to them. It’s the same idea behind penitentiaries and reformatories that teach criminals not to be bad people. The occasional criminal, in fact, does the the light and go straight. But none of the masters of American Healthcare are quite so interested in doing the right thing at the right time for the people. They are interested in how to hijack EVERYTHING to benefit their own ways.
      Medicare buy-in is no worse than Obamacare, or of many other excellent ideas in theory. But once trust is rallied, the powerful swoop in. That is the law.

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