Should the dead pay back their medicare bills?

[woolfe9999]

Here is an idea for Medicare reform which ought to be controversial:

http://motherjones.com/kevin-drum/2011/05/why-not-let-dead-pay-medicare

In a nutshell, the idea is as follows:

During the time you use Medicare, you receive bills for all services paid for. You do not have to pay them. When you die, Medicare gets reimbursed out of your estate. However, Medicare can only collect up to 100% of your estate, so people who leave nothing behind would not be paying Medicare back.

The author leaves on the table the idea that all Medicare taxes paid during your lifetime would be deducted from the final bill, so you aren't paying into a system then giving back all the benefits you got at the end.

Some problems I can see with this are that people may try to evade it through making inter vivos gifts to their heirs, or in some cases they may just decide to spend their money during their lifetime rather than leave it to the government. There may be some ways to craft the legislation to close some of these options but probably not all of them. Another problem is, suppose the decedent's assets are all tied up in a business, the business might have to be liquidated rather than passed in full to the deceden'ts heirs, thus putting people out of work. This problem could probably be worked around in the legislation.

Thoughts?

- wolf

 

[ShawnD1]

That certainly is an interesting idea, but I don't think it will fly when you suggest a 100% estate tax.

It probably wouldn't make much difference anyway. When someone like Paris Hilton dies, people care where their trillion dollars goes. When some guy with $20 to his name dies, nobody cares who gets his money. Does the government get his $20 or does his son get that $20? Who cares. His medical bill was probably 100000x that. Drop in the bucket won't fix anything.

 

[Jaepheth]

What happens if I give most/all of what I own to relatives as Birthday and Christmas presents right before I die?

 

[piasabird]

What about lawyer fees, administration fees, etc.

Also dont your relatives have a right to your real estate before the government?

Suppose you are a gradparent and some of your relatives have nowhere to stay, dont you think they deserve to inherit your property?

I would also think they have a right to the SS money you were forced to donate to the government.

 

[ShawnD1]

Also dont your relatives have a right to your real estate before the government?

Debtors get first dibs.

 

[woolfe9999]

That certainly is an interesting idea, but I don't think it will fly when you suggest a 100% estate tax.

It probably wouldn't make much difference anyway. When someone like Paris Hilton dies, people care where their trillion dollars goes. When some guy with $20 to his name dies, nobody cares who gets his money. Does the government get his $20 or does his son get that $20? Who cares. His medical bill was probably 100000x that. Drop in the bucket won't fix anything.

It won't fix the entire Medicare shortfall, sure, but by what logic would this not substantially improve Medicare's fiscal outlook? The average person gets $450,000 in Medicare benefits during his or her life. If you deduct taxes and co-pays from the final bill, I'm guessing the shortfall is in the area of $150,000. Many people's estates have that much or more in them. And even partial reimbursement is still $$$.

 

[Zebo]

I don't like it. So you die leave family farm to your heirs and they have to shut it down/sell it to the bank because they now have a $400,000 bill? Sounds like just a way of nixing inheritance exemption.

Will they charge interest? then it would be outrageous easily eclipsing 1 million dollars.

Obviously more fucking the middle class who leave a paltry house and a dog to their heirs; get nothing while we refuse to do something about costs.

 

[JSt0rm]

What happens if I give most/all of what I own to relatives as Birthday and Christmas presents right before I die?

Then liberal death squads are sent to their homes to gun them down and take the money.

 

[woolfe9999]

What happens if I give most/all of what I own to relatives as Birthday and Christmas presents right before I die?

You'll notice I raised that issue in my OP. It's a valid point. I should mention, however, that under the current system there is a tax for gifts over and above a certain value (with an annual cap.)

 

[woolfe9999]

I don't like it. So you die leave family farm to your heirs and they have to shut it down/sell it to the bank because they now have a $400,000 bill? Sounds like just a way of nixing inheritance 1.6M exemption.

Another point I raised in the OP and also a valid concern. I assume exceptions can be crafted into the legislation, like allowing the reimbursement to be made in installments over time when the assets are tied up in a business, or even forgiving some or all of it under those circumstances.

 

[ShawnD1]

Whoa I just realized you said Medicare and not Medicaid. Big difference. Yeah this would fuck over the lower and middle classes big time.

 

[woolfe9999]

Whoa I just realized you said Medicare and not Medicaid. Big difference. Yeah this would fuck over the lower and middle classes big time.

How so? If anything, this is a form of means testing that would affect the wealthy the most. The lower classes tend to have no estate on death, so it wouldn't affect them.

 

[manimal]

terrible idea... at least its a new idea..but ya terrible...


How about we means test as a start.

 

[ShawnD1]

How so? If anything, this is a form of means testing that would affect the wealthy the most. The lower classes tend to have no estate on death, so it wouldn't affect them.

Simply put, every single middle class person would have 100% of their estate taken by the government. My parents house is worth maybe 1/3 of a million, but a couple month stay in a US hospital easily costs that much. People in first world countries tend to have long hospital stays near the end.

 

[Thump553]

If enacted that would effectively eliminate most middle class estates-everything would go to the government. And the elderly would end up paying twice for Medicare-once through a lifetime of payroll deductions and second through the seizure of their estate once they leave this mortal coil.

How about when husband dies leaving a widow. Is grandma going to have to sell the home to pay the claim due Medicare?

I could see an enormous growth in the business I basically consider a legal scam-living trusts-if such a crazy idea ever became law. Good full employment for estate lawyers, I guess.

 

[chucky2]

This sounds like a great idea for the resident socialists: Gov getting even more of what belongs to private citizens.

Peoples kids can be 'thankful' they get the lone leftover lamp to split amongst themselves, after the Gov took everything it never worked for. Terrible idea.

 

[OlafSicky]

I see no problem with it, if you don't want to pay you don't have to use medicare. It would certainly cut down on unnecessary medical treatments.

 

[ShawnD1]

This sounds like a great idea for the resident socialists: Gov getting even more of what belongs to private citizens.

Pretty much. That was the argument used for the death tax. The gov taxes inheritance of rich people because the kids didn't earn it? Well the gov didn't earn it either so wtf is this?

 

[Zebo]

What happens if I give most/all of what I own to relatives as Birthday and Christmas presents right before I die?

$13,000 a year max tho before being taxed as regular income.. Any reasonable estate would take forever to xfer,

There are some trusts formations though which would be used to escape this.

 

[BoberFett]

How about we actually learn to let people die with dignity in this country instead of keeping everyone alive hooked up to dozens of machines for a few extra weeks at a massive cost to society?

 

[ShawnD1]

I see no problem with it, if you don't want to pay you don't have to use medicare. It would certainly cut down on unnecessary medical treatments.

lol logic fail.

If I just spent a month in hospital to have my testicles removed + rehab, I already know my kids wont get any of my stuff. At that point, it doesnt matter how much I waste because my estate is already going to be 100% taxed.

 

[woolfe9999]

If enacted that would effectively eliminate most middle class estates-everything would go to the government. And the elderly would end up paying twice for Medicare-once through a lifetime of payroll deductions and second through the seizure of their estate once they leave this mortal coil.

How about when husband dies leaving a widow. Is grandma going to have to sell the home to pay the claim due Medicare?

I could see an enormous growth in the business I basically consider a legal scam-living trusts-if such a crazy idea ever became law. Good full employment for estate lawyers, I guess.

I agree with you on point number 1, regarding middle class estates, to some extent. However, with respect to paying twice, I will for the third time point out that this is addressed in my OP:

The author leaves on the table the idea that all Medicare taxes paid during your lifetime would be deducted from the final bill, so you aren't paying into a system then giving back all the benefits you got at the end.

So there is no paying twice.

Anyone else want to raise objections already addressed?

 

[Zebo]

If enacted that would effectively eliminate most middle class estates-everything would go to the government. And the elderly would end up paying twice for Medicare-once through a lifetime of payroll deductions and second through the seizure of their estate once they leave this mortal coil.

Well said. Makes me think how really poor the "ownership" society would get. It's already skewing towards 1% owning everything.

 

[woolfe9999]

Simply put, every single middle class person would have 100% of their estate taken by the government. My parents house is worth maybe 1/3 of a million, but a couple month stay in a US hospital easily costs that much. People in first world countries tend to have long hospital stays near the end.

Yes, the point is somewhat valid with respect to middle class estates, though you initially said middle and lower classes. I think, however, that you're overstating the case. As I said earlier, the average Medicare recipient gets $450,000 in paid benefits. After deducting from that all Medicare taxes paid, and all co-pays made to Medicare, you're probably looking at an average lien in the $100-200K range. I'm pretty sure many middle class people leave behind estates larger than that these days. However, your point does have some merit.

- wolf

 

[ShawnD1]

How about we actually learn to let people die with dignity in this country instead of keeping everyone alive hooked up to dozens of machines for a few extra weeks at a massive cost to society?

This is one of the most ironic things. Liberals are the ones who support right to die, but liberals are the ones who want the government to keep people alive as long as possible. Conservatives are often against right to die for religious reasons, but conservatives are also against keeping people alive when they can't afford it.

wtf?
New idea: free healthcare like Canada has and have suicide booths on every block. My uncle's hospital stay was free when he was dying from cancer, but I'm pretty sure he didn't want to be there. He looked terrible and was sick all the time. Helping him die would have been a lot more humane, and it would even cost less. Everybody wins.