Tag: "Medicare"

Budget Gimmicks and the “Doc Fix”

This is Michael Cannon, writing at the Cato@Liberty blog:

Back in 1997, Congress enacted automatic reductions in the price controls that Medicare uses to pay for physician services. Congress has delayed those cuts year after year… If the accumulated cuts were to take effect in 2012, as provided by current law, Medicare payments to physicians would fall by some 25 percent, and lots of seniors would find their doctor no longer accepts their Medicare coverage…

Enter President Obama’s FY2012 budget submission… The administration proposes to delay these cuts until 2014 at a cost of $54 billion. The administration proposes to pay for this additional spending by reducing the rate of spending growth in other areas of Medicare by $62 billion over the next 10 years.

Note that only 6 percent of these Medicare “cuts” will occur in 2012 and 2013. The other 94 percent of the “cuts”…would take effect after Barack Obama is no longer president.

Mar 01, 2011 | 5 comments | by

It’s Good to Be a Teacher in Wisconsin, and Other Links

The average Milwaukee public-school teacher salary is $56,500. But with benefits, the total package is $100,005.

The rates of back surgery among Medicare beneficiaries range from 1.7 surgeries per 1,000 in the Honolulu area to 10 per 1,000 in Casper, Wyoming. Also, lots of regional variation in elective surgery rates for early-stage breast cancer, knee and hip arthritis, gallstones and other conditions.

Proposal:  the healthiest and youngest 20 percent of renal failure patients should be given the best kidneys. The remaining 80 percent of patients would wait longer, and the age difference between kidney donors and recipients would be no more than 15 years. (The New York Times endorses the idea this morning.)

Feb 28, 2011 | 4 comments | by

We-Have-To-Pass-It-To-Find-Out-What’s-In-It Fact of the Day

The White House has apparently decided that it won’t enforce the unpopular parts of its health-care plan until after the 2012 election. The latest evidence is its decision not to slash Medicare Advantage …. Last Friday, Health and Human Services released its annual “call letter,” which introduces the formula that will set Medicare rates for 2012. Out of nowhere, per capita Medicare Advantage payments will increase by 1.6% on average. The update was 0% for 2011, and most Wall Street analysts were forecasting a negative update for the coming year, given that ObamaCare cuts $136 billion over a decade and indirectly steals another $70 billion through such payment adjustments.

Feb 28, 2011 | 5 comments | by

Does AARP Rule America?

This is Robert Samuelson, writing in The Washington Post:

Power is the ability to get what you want. It suggests that you control events. By these standards, AARP runs government budgetary policy, not presidents or congressional leaders. Obama says we must “win the future,” but his budget (and, so far, the Republicans’, too) would win the past and lose the future…

President Obama’s proposed 2012 budget … reflects a long-standing bipartisan consensus not to threaten seniors. Programs for the elderly, mainly Social Security and Medicare, are left untouched. With an aging population, putting so much spending off-limits inevitably means raising taxes, shrinking defense and squeezing other domestic spending – everything from the FBI to college aid.

Feb 25, 2011 | 6 comments | by

Will ACOs Mark the End of Innovation in Medicine?

This is Scott Gottlieb, writing in an American Enterprise Institute report:

The Obama Administration is pinning its hopes for controlling Medicare costs on accountable care organizations (ACOs)—a system in which groups of doctors are given responsibility for a large population of patients, with a share of the doctors’ reimbursement dependent on their ability to reduce spending and improve clinical outcomes.

The Obama team relies heavily on hospitals to develop these new organizations. Yet historically, most of the significant innovation in health care delivery has developed in for-profit companies, often started by entrepreneurs, and has aimed to move patient care away from costly hospital settings and into less expensive outpatient settings.

The Medicare program and the Obama health plan are targeting many of these private businesses with new costs and regulations, so private investors are exiting the health services sector. The number of capital investments in health care services ventures in 2010 was fewer than half the median number of annual deals since 2000.

Feb 23, 2011 | 7 comments | by

FDA Okays Wider Use of Gastric Banding, and Other News

37 million potential surgeries. The FDA has sanctioned use of gastric banding for weight-loss surgery in a wider range of patients.

Study: Medicare’s (risk adjusted) premiums encourage health plans to attract the healthy and avoid the sick. Small changes could help.

New Hampshire Governor to hospitals: stop building.

The Internal Revenue Service says it will need 1,054 new auditors and staffers just to watch over the initial implementation of President Obama’s health care reforms. Total cost to taxpayers will be more than $359 million in fiscal 2012.

Feb 22, 2011 | 7 comments | by

Is Government-Funded Health Care Sustainable?

It will cost almost $1½ dollars to spend $1 on Medicare:

This paper uses a life cycle model of labor supply, saving, and longevity improvement to measure the balanced-budget impact of continued growth in the Medicare and Medicaid programs. The model predicts that top marginal tax rates could rise to 70 percent by 2060, depending on the progressivity of future tax changes. The deadweight loss of the tax system is greater when the financing is more progressive. If the share of taxes paid by high-income taxpayers remains the same, the efficiency cost of raising the revenue needed to finance the additional health spending is $1.48 per dollar of revenue collected, and GDP declines (relative to trend) by 11 percent. A proportional payroll tax has a lower efficiency cost (41 cents per dollar of revenue averaged over all tax hikes, a 5 percent drop in GDP) but more than doubles the share of the tax burden borne by lower income taxpayers. (Emphasis added)

From an NBER Working Paper by Katherine Baicker and Jonathan S. Skinner.

Feb 22, 2011 | 9 comments | by

Has the Fight Against ObamaCare Morphed into a Fight Against Government-Run Health Care?”

While reading Paul Krugman’s allegation that the Republican plan is to “Eat the Future,” I was tempted to agree with some of the substance of what he wrote.  Namely, that public-opinion polls reveal an extremely poorly informed public with no coherent vision of what parts of Big Government have to shrink or disappear.

But what else is new? This is well understood: The average citizen is rationally ignorant about government action over which he has zero real influence.  So, he mistakenly believes that the U.S. can balance the budget by cutting foreign aid, which goes to tin-pot dictators, even though it is a trivial part of spending.  However, when it comes to the real cost drivers of the federal budget, especially Social Security or Medicare – politician beware!

The politician who challenges the entitlement state will have a short career.  As William Voegli of the Claremont Institute recently reminded us, conservatism has “clear, categorical arguments against permitting American government to take up any task it did not perform during Jefferson’s presidency.”  However, “In 1936 and 1964, the Republicans’ presidential candidates, after repeatedly expressing their commitment to these principles, won 36.5% and 38.5% of the popular vote, respectively” [“Neoconservatism and the New Frontier,” Claremont Review of Books, Vol. X, No. 4 (Fall 2010) p. 20, gated].

Read More » »

Feb 17, 2011 | 8 comments | by

The Opposite of Portable Insurance

The Affordable Care Act (ACA) creates two new subsidies in an attempt to insure 32 million people: expanded Medicaid eligibility and subsidized insurance sold in a health insurance exchange. Yet there’s a fire wall between the two. If you are eligible for Medicaid, you can’t be in the exchange and vice versa. A new study in Health Affairs suggests than an administrative nightmare is just around the corner:

The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level will experience a shift in eligibility from Medicaid to an insurance exchange, or the reverse; within a year, 50 percent, or 28 million, will.

Feb 16, 2011 | 6 comments | by

Bachmann = Right, Washington Post = Wrong

Michele Bachmann: “According to the National Center for Policy Analysis, in 2009, they said that college-aged students today…in your peak earning years, you will be looking at paying 37 percent of everything you make to the government just to satisfy Social Security and Medicare. 37 percent. That’s more than a third of your income just to pay for that.”

Washington Post: “Using NCPA’s math, we calculate the ‘payroll tax burden’ would be 29 percent, not 37 percent — a 22 percent improvement because of the health-care law.”

This would be true if the health reform law was really going to hold down Medicare spending, but no one — not the Congressional Budget Office nor the Medicare Chief Actuary — thinks that’s going to happen. There is no cost control in the bill other than pushing down fees for doctors. In 2050, when Medicare fees are 50% of private fees, the payroll tax will be lower, but retirees will have extreme difficulty getting health care.

Let us know what you think in the comments.

Feb 11, 2011 | 12 comments | by
« Previous Page — Next Page »