The Nuerosurgeon's Health Care Plan

All the Republican candidates for President are for reducing Medicare and Medicaid. Dr. Ben Carson, a retired neurosurgeon, is currently leading in the polls. He has a plan to replace Medicare and Medicaid with a plan that covers all Americans, young and old. Every person would receive $2000 a year from the government to pay for health care, with $700 to go towards health insurance and $1300 available to pay routine medical expenses. If you don't use the $1300, it accumulates in your health savings account.

It's a great plan for everyone who is not currently on Medicare or Medicaid. Quite simply, they get $2000 from the government that they are not currently receiving. For a family of four, that's $8000 a year. Very nice. Working people would still be able to get health insurance through their employer, so for them, this is just free money. If I were 18, I'd vote for that.

What about people on Medicaid? Some would be better off but some would not be better off. Those with low medical bills would get free money from the government. For those with high medical bills, the $2000 a year would fall far short.

But for people like myself, retired and on Medicare, it's a complete disaster. First of all, there is currently no private health insurance in the United States for persons 65 and older, and even if there were, it's unlikely that I would be able to get it for the $60 a month that Carson's plan provides. For someone born when the plan is in effect, they might be able to save enough from the $1300 a year that they have plenty in their health savings account by the time the get older, but that doesn't work if you're already retired when the plan goes into effect. I've had no medical expenses this year, but last year was an ordeal involving three surgeries and the medical bills were almost $150,000.

Total yearly medical expenditures in the U.S. are about $3 trillion, of which about one-third is Medicare and Medicaid. There are 320 million Americans and that times $2,000 is $640 billion a year. So the Carson plan pays less than one-fifth of total medical expenditures. Those on Medicare and Medicaid, whose expenses are now pretty much fully funded, get hit with an 80% reduction in the amount that the government pays for their care. 

There is a sense in which the Carson plan is more fair, of course. It treats everyone equally, rich or poor, young or old, healthy or sick. That's great for the rich, the young, and the healthy, but it leaves the poor, the old and the sick in a hopeless position. In particular, it pulls the rug out from under retired people who have paid for Medicare all their lives through payroll taxes and were counting on it in their old age.