So we don’t want to ration by dictating to somebody, okay, you know what, we don’t think that this senior should get a hip replacement. What we do want to be able to do is to provide information to that senior and to her doctor about this is the thing that is going to be most helpful to you in dealing with your condition.
So let’s say that person is diabetic. It turns out that if hospitals and doctors are providing reimbursements for a nurse practitioner or a social worker to work with that diabetic to control their diets and their medications, then they may avoid having to get a foot amputation. That’s a good outcome. And by the way, that will save money. That saves Medicare money. And if we save money on Medicare, that means that it’s going to be more stable and more solvent over the long term.
So the thing that I’m — if I were — look, I think I’m scheduled to get my AARP card in a couple years, is that right? (Laughter.)
MR. CUTHBERT: Anytime you want one. (Laughter.)
THE PRESIDENT: I know I’m automatically getting — associate member, right? Okay. (Laughter.)
So if I was thinking about Medicare and making sure that I was secure, the thing that I would be most worried about right now is health care inflation keeps on going up and the trust fund in 10 years is suddenly in the red. And now Congress has to make some decisions: Are they going to put more money into Medicare, especially given the deficits and the debt that we already have? Or are they, at that point, going to start making decisions about cutting benefits, but not based on any science or what’s making people healthier — they’re just going to start making it based on politics?
And what we’re saying is we can avoid that scenario by starting to make some good decisions now about how do we improve care, make the system more rational, make it work better. That will actually stabilize and save Medicare over the long term.
One last point, because I think Caroline also raised the issue of we’re taking some money out of Medicare. The only things that we’re talking about have nothing to do with benefits. It has to do with things like subsidizing insurance companies or, for example, right now we reimburse hospitals for the amount of time that you’re there without checking to see if they’re doing a good job in the first place. So they have no penalty. If you go into the hospital, they’re supposed to fix you; suddenly you have to go back three weeks later. That hospital gets paid all over again, even though they didn’t get it right the first time.