If we want Medicare to work we are going to have to raise Medicare taxes and premiums.

[TreasonousBastard]

7. I'm not suggesting anything, except...

that we have to look at ways to reduce costs.

As far as "artificial means" goes, that sort of thing has to be further defined. I recently was asked about a feeding tube for my mother, who was refusing to eat. When I said to wait until it was absolutely necessary, they were relieved and admitted they hated the idea themselves, but had to ask. As you probably know, a large percentage of patients rip the tube out, meaning more surgery or other expense to deal with that. So far, they've found ways to get her to eat enough to keep going. She's paying almost $40,000 a year for this facility, including pharmacy charges, and at least once a year gets rushed to the hospital for a 30 grand day or two of ER and intensive care.

It's not the care that's the problem, it's the cost. The facility she's in is excellent, and the hospitals are first-rate. And, the truth is that 3-4 grand a month is toward the low end of what a decent NYC hotel would charge for the room and three meals a day delivered to the room.

But, she's not staying in a hotel for a couple hundred a day-- this is her home for the rest of her life,and it's a very expensive way to live. I'm not sure just where we can cut costs, but starting at the hospital may be the first place to look. Fee for service is outmoded and the Europeans are way ahead of us there. I'm not looking to single payer as a salvation because it will be politically impossible to impose and doesn't answer the fee for service questions.

Anyway, people closer to the nuts and bolts of providing care have to have even more imagination at coming up with savings before millions of us boomers are in nursing homes spending 50 grand or more a year to sit in our wheelchairs. And not Ryan's "plan" which would be more efficient than those death panels at eliminating patients as the problem.