There is much in the news these days about Medicaid and its expansion (or non-expansion) across the nation as a result of the passage of the Affordable Care Act. Texas is still trying to work something out with the federal government about Medicaid expansion from what I read.  But, let’s not forget Medicare — the federal health insurance program for 50 million elderly and disabled Americans.  It is critical to the success of Texas Tech Physicians.  Just how critical?  Last year we collected $12,243,768 from the Medicare program. Of course, the Medicare program is huge for our entire nation. For example, in 2012, spending on Medicare accounted for 15 percent of the federal budget.

I cannot help but be a bit amused when people say something like, “I don’t want the federal government involved in health care.” Well, it is about 48 years too late to express that thought. Regardless of what one thinks about the pros and cons of the federal government being involved in health care, an honest observer must admit, Medicare plays a major role in the health care system. In fact, it accounts for 21 percent of total national health care spending, 28 percent of spending on hospital care, and 24 percent of spending on physician services.

As I am reading the news this morning and typing this article at home on my laptop, one of the ideas floating around Washington is that instead of traditional Medicare, Americans turning 65 in the next decade and beyond would get vouchers that would give them the option to purchase private insurance. Expect much argument — proponents say this is the only way to insure a viable the health system for seniors, while opponents counter with the argument that vouchers would not come close to covering the cost of coverage. Personally, I think changing the Medicare program to one largely based on private insurers would simply shift a substantial amount of spending onto Medicare beneficiaries. It would not attack the root problem of why medicine is so expensive.  In sum, it would basically be moving from a defined benefit to a defined contribution.