Another False Dilemma and Medicare

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A more complicated scenario that is still a False Dichotomy is that if we privatize elderly care in the US, then the elderly will not be able to afford it, and so they will prematurely die. If we simply keep Medicare, then they will get the care they need near the end of their lives.

This sentiment shows a much higher level of thought than the simple, “If government does not provide health care, then they will not have it” false dichotomy. However, it boils down to the same problems.

I’ll list the factors that will go into determining whether the elderly can afford health care if we get rid of Medicare. Here are the most obvious ones:

  1. Medicare pays the bills, and since it has deep pockets, the cost of elder care skyrockets.
  2. Medicare regulates the industry, preventing doctors from choosing the best course of action and forcing them to prescribe unnecessary medicines and treatments.
  3. The elderly may receive care from charitable organizations, in addition to their children and grandchildren.
  4. Those who are planning for their retirement will have to plan for the true cost of their medical care, rather than relying on government subsidies.

Now, let me iterate a few things that, in addition to the above, are critical.

First, the elderly receive treatment that is far and away better than the treatment available even last year. Why? Because there is a tremendous profit motive to invent and provide these things. These treatments otherwise would not exist. When you consider the moral dilemma, “Shall we provide this person a life-saving treatment?” the morality of the issue changes depending on whether the treatment is available. It is the profit motive that creates the treatments in the first place, and allows us to even consider the question. Without the profit motive, there is no moral question at all.

Second, while today we provide treatment for the elderly, no such treatment will be available in a few years. This is the hard, cold facts. there is no tax high enough, there is no source of wealth large enough, there is no class of doctors that we can enslave and force to provide health care to the elderly. We cannot print the money, for if we do we will not afford any more health care than we otherwise could. We cannot borrow the money, because that amount of wealth simply does not exist. In this matter, no scenario wherein the elderly of the future receives medical care provided by the Federal Government exists. Let me reiterate: There is no way the elderly of the future can receive medical care courtesy of the Federal Government. At some point, the entire scheme will collapse, and we will no longer have any means to provide medical care because there is no means whereby the Federal Government can persuade people to provide it.

We are already seeing the effects today. So-called “death panels” already exist, determining which elderly get which treatment. Doctors are refusing to work for Medicare, because Medicare does not provide enough payment to compensate them. And Medicare cannot afford any more care, nor can they raise taxes because there is not enough wealth in the United States to provide even a hope of balancing the Medicare fiscal problems.

At best, we can hope for a “soft landing”, a phasing out of Medicare over the next few years, and probably limited coverage for a small minority of the elderly. Maybe some smart accountants can juggle the budget around and provide more or less soft landing, but ultimately, Medicare cannot exist.

Those who do not accept this fact are delusional, or they know something I do not. When you have a liability worth hundreds of trillions, you are talking about money that can simply never be created, not for thousands of years.

Paul Ryan’s budget is addressing this fact. His budget is the first of many that will gradually phase out Medicare, or replace it with something at least marginally sustainable. But even Paul Ryan’s budget is a promise that cannot be kept. Eventually, costs will rise, revenues will fall, and we will be back to where we are today.

The best solution is the hardest solution, the solution the people will most likely never tolerate. That is the constitutional solution, which is that Medicare is eliminated immediately. If we took such a drastic step, not only would the economy improve, but for reasons I listed above, the cost of treating the elderly will fall dramatically. The money saved by regular, working people can be used to charitably donate to people’s grandparents, churches and communities to support the elderly in the later years. If such money cannot be raised, then the economic means to provide treatment to the elderly does not exist, and so we no longer have a moral issue of “Shall we provide this treatment to this person?” Instead, we only have the choice of not providing it because the means to provide it do not exist.

Yes, that means that people will die, but those are people that would die anyway under the same circumstances because the means to treat them do not exist, even if the knowledge does.

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