And the full Medicare Report
Bruce Webb h/t for the link Full Medicare Report (and here it is for your enjoyment).
Ken Houghton h/t who linked to a Reuters note:
The Medicare hospital trust fund is not projected to exhaust its funds until 2029, 12 years later than forecast last year, the trustees said…
Bruce – does this include something like $585B for “projected health care reform savings?”
Rusty,
I don’t know about the report here.
However, I checked wiki.
In 2005 a little more than 4% of GDP will be spent through Medicare and Medicaid.
http://en.wikipedia.org/wiki/File:U.S._healthcare_GDP.gif
If you go to the wiki article it shows that aging and related are not tremendous items driving up the outyear growth of US health spending as part of GDP.
So as the US goes from about 14% GDP to 16-18% GDP a very big part of the growth has nothing to do with demographics of aging.
Saving is needed and the medi’s are not the prime suspect.
I was surprised to observe that the empire security aparatus, wars of convenience and dominance in sand pits, against unindustrial foes are consuming about as much in percent of GDP as the two medi’s in 2005.
I have spent my morning on the Social Security Report. I know of no reason why the Medicare and Social Security Actuary wouldn’t have drawn upon CBO scoring so I expect so. I know there is an argument out there that these savings aren’t really savings because they are going to be spent covering the uninsured. Well frankly that is bullshit, it is like saying that massive cuts to Social Security wouldn’t really result in savings because that money was used to offset extending tax cuts or to build a couple of aircraft carriers. Medicare is for accounting purposes walled off from the General Fund, cuts to Medicare reduce the rate in which the Trust Fund is drawn down and so extend its lifetime. There is no double counting there.
Savings are needed, the question is how to get there.
I’m skeptical of obamacare reaching its goals.
I agree with you, if there are real Medicare savings yes they should be counted as Medicare savings, however else the money is used.
I’m very skeptical that obamacare will achieve the projected Medicare savings.
str,
There is no way Medicare savings will be even close to what is projected. If we could save that kind of money on Medicare we could have done that WITHOUT the rest of the bill. Its just hand-waving on teh part of the Obama admin. Build a bill that will make it come out the way you want (i.e the ‘right’ CBO score) and then don’t actually inact any of the cuts.
See Doctors re-imbursement cuts that get legislated away every year. Do you really beleive that they are going to cut cardiologist by 40% next year? Neither do I, but the CBO has to score it like its going to happen.
BTW, this kind of stuff is not just a D issue. Very bi-partisan problem…
Islam will change
Buff the people who have been gouging Medicare have very strong lobbies behind them, including a lot of firms and institutions that themselves are not gouging Medicare at all.
It is an article of faith, and for that matter reality, that Medicare is plagued by fraud and abuse. It is also plagued by a bunch of lying insurance companies that sold Medicare Advantage under the Right wing ideology that everything can be done more efficiently by the private sector. When that proved to be untrue the response of the then Republican controlled Congress was to make up the difference with a subsidy averaging 15%. Somewhat like half of the savings will be realized by forcing MA to operate on the same premium as regular Medicare. And that premium dollar amount is totally controlled by Medicare on the front end, it is not a matter of recovering it after the fact, the insurance companies never get their hands on the bucks to start with.
I think that much of that is because you are skeptical of Obama-anything.
I am also skeptical of the projected medicare savings being realized. But it is the first step in what appears to be the first serious effort to bend the spending curve.
Bruce:
You are correct that the Medicare Trust Fund is walled off for accounting purposes, but all the payroll tax dollars flow into the Treasury’s General Fund, like other taxes.
It is segregated only for accounting purposes.
The trust fund balance is merely the amount the fund can withdraw from the Treasury without an approproiation.
It does not represent future ability to pay benefits, because all those dollars were lent to the Treasury, spent on current expenses, thus keeping the deficit lower.
Don Levit
Bruce,
“It is an article of faith, and for that matter reality, that Medicare is plagued by fraud and abuse. “
If that is true we could have passed a bill to deal with that and not a monstrocity that we needed to pass to find out what’s in it. ObamaCare counts ona lot of savings when takling Fraud, Waste, and abuse. So has many reforms beform by prior administrations over a multitude of items. And those savings never really happen. I see nothing in the Obama administration that would give me any faith that they would disturb that track record.
Nor for that matter ny administration while I’ve been alive…
So yes I’m not even skeptical. ObamaCare will raise costs.
Islam will change
Skeptical of Anything Bush was acceptable though right?
Bruce,
And why shouldn’t we be?
Obama is just a typical Chicago Pol. And not a very smart one at that. Hopefully we will get a divided government after Nov. and bring us back towards the center.
Islam will change
Buff and Bruce–Staffing cuts in SSA and CMS have greatly reduced into the number of people working on quality assessment and fraud investigations. Medicare/caid is particularly vulnerable to durable medical equipment and padded billing fraud. There are thousands of providers of DME–practically impossible to audit and/or inspect properly. So, fraud has gone up.
True, CMS’s OIG routinely busts doctors and providers for fraudulently billing for treatments never given and equipment never provided. But, there’s no way they can keep up with the actual volume of illegal activity. Budget cuts and skimpy appropriations for the last 30 years are to blame for this situation. Too bad too, because literally billions could be saved with relatively small staff increases. Nancy Ortiz
Buff–He was smart enough to get elected, wasn’t he? And, somehow I think he’s quite a few IQ points up on Bush II. But, of course, smarts don’t cut it if your policies don’t produce jobs. Let me say that again. Jobs. Jobs. Jobs.
Still, he’s no worse than any president since Bush I. You’ve worked for these guys. You get to know them pretty well. So, this President is par for the course. Kinda between a meh and a bleh. Nancy Ortiz
Don the ability to draw on the Treasury without appropriation is a measure of Full Faith and Credit. The Chinese Central Bank needs on authorization to have it’s holdings honored at maturity. Neither does Social Security with the important exception that SS can redeem it’s bonds at par even before maturity.
Don you are confusing future productivity with Full Faith and Credit.
Notice the CAPS
Bruce:
I am not speaking of the ability to withdraw from the Treasury.
Even if the trust fund was totally depleted, I assume Congress would provide the necessary funnding.
The question is “What will the dollar be worth if peole lose their faith in their governmenmt’s ability to provide credit?”
You seem to think we are immune to that possibility.
How high would our debt need to be in relation to revenues for you to be concerned?
Don Levit
Don Levit
Don:
You worry the wrong issue and are more content to vex on cutting rather than increasing. If our Civilian Labor Force is meant to be at 2% less than what it was in 2001; then indeed, we do have a problem with decreased revenues from employment. In any case the gap has decreased for SS and also Medicare. Maybe the assumptions were not valid for the earlier projections.
Why concentrate on the race to the bottom when the answer is readily apparrent . . . put people back to work.
I am writing a piece on DME fraud, particularly organized crime and immigrant fraud, and how the whole mess was caused by Congress hating on doctors – will share it sometime.
I am sketching up a piece about complexity theory and why Obamacare as written is destined to fail.
What do the stim bill, Obamacare and FinReg have in common? Massive complexity that has destined stim to underperform and the other two to fail.
I don’t recall the other Presidents running on “Social Justice,” the mantra of the Democratic Socialist.
Obama is something new. He doesn’t even have half the relevant experience of any modern President….and it shows!
Yeh, Obama is something new but pritty good for us.
http://haheh.de