Archives for July 2019

Medicare for All Will Cripple Doctors and Hospitals
By Sally C. Pipes

Americans have health on their minds. Nearly four in 10 voters think health care is the most important policy issue our country faces.

Some lawmakers — including several Democratic presidential candidates — think a government takeover of the nation’s health insurance system is the answer.

But Medicare for All isn’t what voters are looking for. It would drive doctors from the profession and cripple hospitals. Fewer of America’s brightest students will pursue medicine. Ultimately, Medicare for All would make it harder for patients to gain access to care.

Already, the United States is facing shortages in the supply of care. Our nation will be short more than 120,000 doctors by 2032. Rural and underserved communities will be hit hardest.

In many ways, this is a stress-driven shortage. More than four in 10 physicians report being burnt out. Around half plan to change career paths. A similar proportion wouldn’t recommend that their children go into medicine.

A survey of physicians found that “bureaucratic tasks” were the most common contributor to burnout. More than one-third cited long hours as a stressor; a similar share pointed to insufficient pay. Two of every 10 doctors said government regulations contribute to burnout.

Medicare for All would make these problems worse. A government takeover of healthcare would smother doctors in new bureaucratic tasks. Meanwhile, patients would consume even more care, now that it’s free. Doctors would have to work longer hours to meet that demand.

And they’d do so for less pay. Medicare for All envisions paying doctors at Medicare’s rates, which are significantly lower than those for private insurance. Physicians would receive about 30 percent less for procedures including hernia repairs or gallbladder removals, compared to current private rates. Reimbursement rates for emergency visits and chest x-rays would be 60 percent lower.

Asking doctors to treat more patients for less money is no way to address the looming physician shortage. Practicing doctors will leave the profession, and budding doctors will consider other lines of work.

Hospitals would also see revenues decline under Medicare for All. Currently, hospitals receive just 87 cents for every dollar they spend on Medicare patients. Over two-thirds of hospitals lose money on Medicare inpatient services.

Hospitals depend on private insurers to stay in the black. By eliminating private insurance, Medicare for All will deprive hospitals of the revenue they need to balance their books. One study estimates hospitals will lose $151 billion in annual revenue under Medicare for All.

Hospitals would likely have to cut staff or eliminate services. Some might close entirely. Already, one-fifth of rural hospitals are in such poor condition that they are at risk of closing.

These dire scenarios are not hypothetical. They’re the reality in single-payer systems in other countries.

In the United Kingdom’s National Health Service, a majority of general practitioners said in 2017 they felt pressure due to long working hours, increasing workloads, and burdensome paperwork. Two in five planned to leave direct patient care by 2022. That’s twice as many as were planning to quit in 2005.

Many British hospitals lack the funds to replace outdated and low-quality equipment.

Voters are right to focus on health care. But if Democrats interpret that level of interest as an opportunity to sell Medicare for All, they’ll be sorely disappointed.

Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The False Promise of Single-Payer Health Care (Encounter). Follow her on Twitter @sallypipes. This piece originally ran in the Oklahoman.

Those early days of retirement can be exciting as you are finally rewarded with a little rest and relaxation after all those years of toil.

But it can be a bit unsettling as well when the regular paychecks you counted on stop appearing in your bank account.

That’s why anyone who’s still a few years away from retirement should ask themselves: Am I ready for that moment both financially and emotionally?

The answer could come down to whether you have a solid retirement plan – or a plan at all.

“Regardless of how much you accumulate for your retirement, poor planning or lack of planning can put you at risk of exhausting your resources,” says Tad Hill, a retirement planner and author of Retire with Freedom: The Five Steps to Getting a Good Night’s Sleep After the Paychecks Stop (www.askfreedomfinancial.com).

Hill says people nearing the end of their working years should follow this five-step process for a more secure retirement:

• Create your ideal picture of retirement. What is it you want out of retirement? Do you want to travel? Volunteer with a charity? Spend time with the grandkids? The first step isn’t about your financial portfolio, Hill says, it’s about forming a clear image of the big “why” of your ideal retirement. “Otherwise, even though your money may last the rest of your lives,” Hill says, “you may never achieve your dreams because you’re unclear on your dreams.”
• Put your situation to the “stress test.” With the help of a financial professional, give your retirement plan a “stress test.” That can include reviewing how to best maximize your Social Security benefits and examining how your portfolio might perform under a variety of market scenarios. “Analyze all the factors that could affect your retirement plan over the next few decades and create a strategy for dealing with those risk factors with as much certainty as possible,” Hill says.
• Design your plan. Designing a retirement plan, Hill says, is much like creating the blueprint for a house. “These blueprints identify the strategies available to help minimize risk, increase certainty, avoid excess taxes and ensure an adequate retirement income,” he says. Some of the concerns that need to be addressed include income planning, investment planning, health care planning, tax planning and legacy planning.
• Build the plan. Once the design is agreed upon, it’s time to implement it. “That can mean making changes to your current structure, adding some things and getting rid of others,” Hill says. “Maybe risk-prone aspects of your current approach that we need to eliminate were discovered in the design step. We also often identify new strategies that you aren’t using that can really make a difference.”
• Seek continued guidance. Even a great retirement plan may need tweaks and adjustments over the years. “Times change, people change and situations change,” Hill says. With his clients, he holds a regular yearly consultation to help ensure they are on the right pathway to retirement success at all times. “You need to look at whether there are things that have changed in your life that need attention,” he says. “Are there decisions you need to make about a pension or Social Security? Is your spending tracking at the amount you thought it would?”

“There are no guarantees of anything in life, including how your retirement will work out,” Hill says. “But taking action to create a solid and well-thought-out plan for this important part of your life is a critical first step.”

About Tad Hill

Tad Hill, author of Retire with Freedom: The Five Steps to Getting a Good Night’s Sleep After the Paychecks Stop (www.askfreedomfinancial.com), is the founder and president of Freedom Financial Group. He is registered as an Independent Advisor Representative and is a radio and TV host, industry trainer and speaker who helps retirees work toward their financial and retirement goals. Hill has passed the Series 65 securities exam and holds licenses in life and health insurance in Alabama, Florida and Texas. He has earned his Registered Financial Consultant (RFC®) and Chartered Retirement Planning CounselorSM (CRPC®) designations.