The federal government is set to cut Medicare spending on older Americans and also to extract more Medicare taxes from younger Americans who can’t get any benefit from the program.

“Medicare is totally flying under the radar,” Dr. Lee Vliet, a preventive medicine physician with practices in Arizona and Texas, tells Breitbart News.

“Medicare is a single payer system in that funding comes from the taxpayers, but it is like Obamacare in preserving a lucrative role for private cronies, who receive the government money and disburse it,” Vliet explains. “When Medicare was enacted there was immediate trouble with an explosion in costs, resulting in an almost immediate violation of the original legislative promise of no interference with physician decision-making, or with their compensation.”

Older Americans on Medicare have faced big out-of-pocket costs that are about to get even bigger. In a report on Obamacare’s sixth year, Heritage Foundation health policy expert Dr. Robert Moffit notes that President Barack Obama’s signature healthcare reform would cut $715 billion from Medicare over the next decade to help pay for Obamacare.

“It is logically impossible to cut payments for Medicare services without affecting seniors who depend on those services,” Moffit writes, observing that in their 2015 report, the Medicare Trustees confirmed the Center for Medicare and Medicaid Services (CMS) Chief Actuary’s concerns about the severe impact of Medicare healthcare provider payment reductions on older Americans’ access to healthcare.

The CMS Actuary projected that by 2040, most hospitals, skilled nursing facilities, and home health agencies will become unprofitable, leading to a significant reduction in access to healthcare for older Americans.

“Few seniors have complained about the lack of an alternative, or the fact that seniors must enroll in Medicare Part A if they want their Social Security benefits,” Vliet observes. “The question is: Will Medicare be able to continue to provide the care today’s seniors expect? The answer is an unequivocal NO.”

Medicare is a government-run ponzi scheme, enacted by President Lyndon Johnson in 1965, which shifts the cost of healthcare for current older Americans on to younger working Americans.

In addition to the problem of increasing restrictions on healthcare for Americans on Medicare, there is the other dilemma of forcing younger, working Americans to pay for current Medicare recipients’ health needs even though the Medicare program will unlikely be there for them when it is their turn to retire. The question remains whether younger Americans should be able to save for their own retirement healthcare rather than be forced to pay taxes into a declining Medicare system.

Americans must sign onto Medicare Part A – which covers hospitalization – when they turn 65, or else forfeit their Social Security benefits. Unelected bureaucrats created this rule in the 1990s during the Clinton administration, even though the actual Social Security or Medicare legislations say nothing about such a requirement. A lawsuit aimed at decoupling the two programs failed in 2012, leaving any remedy of the situation up to Congress.

Physician and Arizona state Sen. Dr. Kelli Ward (R) – who is running a primary challenge against incumbent U.S. Sen. John McCain, tells Breitbart News, “Unelected bureaucrats have no business forcing government-controlled healthcare on Americans who choose other options.”

“Holding hostage a major portion of a worker’s lifetime earnings is not only unethical – a fiduciary dollar is a fiduciary dollar – it is also in this case entirely unconstitutional,” Ward adds. “I enthusiastically agree with Senator Mike Lee that all regulatory burdens proposed by executive branch agencies must be approved by Congress as required by Article I of the Constitution: ‘All legislative powers herein granted shall be vested in a Congress’ actually means ALL ‘legislative powers.’”

“Why would the government want to force people to take this Medicare benefit?” Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons and a specialist in internal medicine, tells Breitbart News. “Soon after Medicare was passed, Johnson wanted to force people into Medicare Part A because he wanted his program to succeed and he expected it wouldn’t if people still had the option to purchase private insurance.”

She continues:

And so Johnson basically talked all the insurance companies into cancelling policies for everybody over the age of 65. People were thus forced into Medicare. The financing of Medicare from the beginning was designed to fail or to be a ponzi scheme. I don’t think they foresaw the dramatic change in the demographics that have occurred, but nevertheless, in the way it was structured, money was never set aside, it was never invested for the people who were putting their money into it. It was always set up to depend upon new taxpayers.

At the time Medicare was signed into law, the average life expectancy was approximately 69 years. Because of advances in medicine, many seniors in 2016 are living well into their 80s and beyond.

“Longevity has definitely improved and, in addition, the baby boomers didn’t have enough children,” Orient says. “Now we’re down to two or fewer working people supporting each and every retired person. This is a burden the younger generation cannot sustain.”

The idea of opting out of Medicare, however, often raises objections from both those who believe they are entitled to the government-run health care program because they paid taxes into it while they were working, and those who would simply prefer to have the government “take care” of healthcare for them.

Orient says older Americans who believe they are “entitled” to Medicare because they paid into the system aren’t understanding how the ponzi scheme works. In addition, with Medicare about to be even further restricted, current recipients will be in for a rude awakening as soon as next year when the program will feel even more like a burden to be endured.

“People are in denial, particularly about the fiscal realities of Medicare,” she continues. “Bernie Sanders may say that he wants to put everybody in Medicare, and his program has been estimated to cost from anywhere between $2 trillion to $14 trillion. Where is that money going to come from? The fact is it doesn’t exist! It’s hard to believe anyone would have confidence in such a plan.”

Vliet agrees that some are not understanding the realities about Medicare.

“Some people are looking at Medicare as it has been, not as it will be under the new rules, which don’t even really kick in until 2017,” she explains. “When people see that Medicare will be broke and thus will be restricting many more procedures that they may need, as well as hospital readmissions, etc. – and it will get worse when Obamacare’s Independent Payment Advisory Board gets here in 2017 – they will want some other options.”

Dr. Kristin Held, a Texas-based ophthalmologist, tells Breitbart News that another law passed by Congress last year will create higher costs for older Americans on Medicare Part B – which covers physicians’ services and out-patient and ambulatory surgery. Yet, the law hardly received any notice at all in the media.

“In the Medicare Access and CHIP Reauthorization Act (MACRA) that was passed last year, there is increased means-testing for Medicare Part B,” says Held.

She explains:

So, here you have people who paid into Medicare during their working years, and now, all of a sudden, in order to keep Part B they’re going to be paying $400 per month each for a Medicare plan that is also more restricted. A married couple already retired could be paying $800 per month for Medicare Part B. They will absolutely want to consider a private contract arrangement with their doctor.

Held, who has a blog about healthcare, herself opted out of Medicare as a physician last October, even though her ophthalmology practice sees many older Americans for treatments of cataracts and other eye diseases. She says she has seen patients who have what is referred to as “Medicare replacement plans.” In addition, her office tries to help patients understand what kind of coverage they have and help them file for reimbursement for themselves.

“That’s really more appropriate, because a patient’s agreement is with his or her insurance company,” she says. “My agreement is with my patient, not the insurance company. I tell my patients I am out-of-network and I work for you, but I will help you work with the insurance company you’re paying.”

“So, I might say to a patient, ‘You saw me today, and your copay would have been $65, but you have a follow-up visit at my office for $45. You saved $20 by not using your insurance.’”

Held warns people about to turn 65 that Medicare does not cover technology and innovation in ophthalmology. She explains how she works with patients who have Medicare:

If a cataract patient wants to have a special lens to correct astigmatism so she would not have to wear glasses after the surgery, Medicare will not pay for that lens. If she wants to have laser surgery, Medicare will not pay the additional cost for a laser, even though the outcomes are more predictable. So if a patient with Medicare comes to me to do the surgery, my fee includes the laser and the upgrade to the special lens. When I’ve compared my fee to that of my colleagues who accept Medicare, I am $1,000 less per eye than a colleague of mine five minutes away who is a Medicare participating provider. Patients who are smart and want that technology can come to me and file a Medicare opt-out form so they can private contract with me. They can use their Medicare Part B at the surgery center where I perform surgeries, pay me my direct fee, and save $1,000 per eye in this situation.

Held urges Americans who are on Medicare to explore options for private alternatives.

“People have to hunt around to find private health insurance plans that will take on older Americans who otherwise would be on Medicare Part B,” she says. “Health-sharing ministries were exempted from Obamacare and they often take on Medicare patients. There are other, more creative options out there, but people have to be willing to look for them if they really want to save money. Of course, we also have to be vigilant to ensure the government doesn’t shut this option down.”

Vliet, Orient, and Held agree that when more Americans opt out of Medicare, there will be more of a market for private insurance companies to contract with older Americans and for direct pay without the use of a third party payer system. If patients were able to purchase health insurance across state lines, competition among the insurance companies for that market would drive prices down as well.