The huge bureaucracy created in the late 1960’s which we now identify as Medicare has become an overpowering, under-performing, incompetent and non-responsive part of our daily lives. Its creation attempted to monitor, regulate and control a national health care program providing health coverage to our senior citizen population. Unfortunately its creation ignored a basic rule of physics which essentially tells us that the further away from something we are, the less we can accurately control it.
We have seen the big differences between the Medicare program and the State supported Medicaid programs (also financially supported by the US Treasury). Billing is more precise and efficient. Approvals, authorizations and licensing are done in less than half the time it takes the federal agency to perform these same tasks. Localized and in some cases customized programs are built to accommodate the needs of particular communities or neighborhoods. Medicaid reimbursements to providers are typically two weeks (or more) faster than payments received from the federal agency. For many businesses, this is not efficient enough, and they need to utilize factoring and other options to get up front money to maintain their business.
So what should be the simple answer? As was proposed by quite a few presidential candidates over the past few elections: Turn over the Medicare program to the states. Provide the same financial support to Medicare (as is required by law) and close the federally centralized program. This will save billions on administrative and infrastructure costs allowing those savings to go to the states to more efficiently administer this program. Moving healthcare administration to local control will save money with less waste, fraud and redundancy. Sometimes the simplest of solutions is the wisest.
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