I think we need to separate the operation of the Medicare insurance system from the way Congress has chosen to fund it over many years. It would be like having a terrific private insurance policy from a company that for whatever reason chose not to raise the premiums to reflect the true cost. In the case of Medicare, Congresses for many years have taken the easier political path of reducing payments to Medicare providers and then simply "making up the difference" with yearly special appropriations to keep Medicare afloat. Yes, the actions...or I should say inactions...of Congress have weakened Medicare, but that's not to say that as an insurance operation it is mismanaged and doesn't work. The part that is mismanaged is the role of Congress in funding it properly. Yes, that's definitely a part of the Medicare equation, and probably always will be. But as an insurance provider for healthcare costs, most users think it works pretty well.

I've said this before here in this forum, but what it boils down to is that Medicare premiums or other qualifications must increase in order to correct this "defect". In particular, before all is said and done I think "means testing" will become a part of the Medicare formula. It makes little sense to me that taxpayers should be saddled with the costs of providing free healthcare insurance to those who can't afford it, while at the same time providing deeply discounted healthcare insurance to the many who are perfectly capable of paying much higher premiums. I'll be surprised if that's not the direction we're headed.

But of course I'm speaking as a former businessman, not a member of Congress who will be seeking re-election to one of those sweet jobs in the next few years. Left to them, they still may take a less logical, politically-motivated path to creating legislation, which may not fix Medicare funding as it should.