Archive for May, 2011
Despite President Obama’s assurances that his massive overhaul of the health care system would control health care costs and allow Americans to keep their current coverage, the outlook indicates otherwise. PricewaterhouseCoopers (PWC) recently released its annual report on medical cost trends for 2012, and it is revealing.
The report shows health care costs and premiums continuing to rise—and uncertainty increasing for employers who offer insurance to their workers. Health care spending increased by 7.5 percent in 2010 and will grow by 8 percent this year. In 2012, it will rise again by 8.5 percent. This is exactly the opposite of the President’s promise that his health care plan would reduce premiums by $2,500 per person.
Even steeper rises in the cost of private insurance are possible, due to Obamacare’s reductions in Medicare payment rates and its expansion of the Medicaid program. PWC writes, “Hospitals and health plan executives agree that when Medicare and Medicaid pay less than costs, private payers must make up the difference.” The new law will cut provider payment rates across the board, which Medicare’s Chief Actuary warns could cause 15 percent of hospitals, skilled nursing facilities, and home health agencies to become unprofitable by 2019. As more Americans enroll in Medicaid in place of other forms of coverage, providers will face lower reimbursement for a greater number of patients. According to the report, the impact of these changes will likely mean greater cost-shifting to privately insured patients—indirectly increasing premiums. (Read the rest on The Foundry…)
Solving our nation’s fiscal crisis is not up for debate, and politicians should be past the point of using it as fodder for political gain. But you wouldn’t know it by looking at the latest from liberals in Congress who are digging in their heels and refusing to recognize the reality of America’s budgetary mess.
Yesterday, the Senate at long last voted on House Budget Committee Chairman Paul Ryan’s (R-WI) FY 2012 “Path to Prosperity” budget, which had previously passed the House. It was defeated 57-40, with no Democrats voting for it. Senators Rand Paul (R-KY) and Pat Toomey (R-PA) also had their budget alternatives defeated, with Toomey’s bill receiving 42 votes. Senate Democrats have yet to even offer an alternative, and, notably, President Barack Obama’s budget failed yesterday by 97-0, a unanimous rebuke of the President’s proposal. Ryan reflected on where Congress now stands:
[Republicans are] the ones who actually put the specifics on the table—$6.2 trillion in savings over the next ten years. We put a budget up — we passed a budget, brought it to the table. Where are we now? It’s been 754 days since the Senate Democrats proposed, let alone, passed a budget. They’re not offering any solutions, putting nothing on the table. (Read the rest on The Foundry…)
When it comes to the budget, there’s fact and fiction, distortions and reality. And today, the left has been lobbing lies about Chairman Paul Ryan’s (R-WI) House-passed Fiscal Year 2012 Budget – The Path to Prosperity – alleging that it puts Medicare at risk.
In a new video, Chairman Ryan lays out the truth behind his budget plan. And in a statement today, Ryan noted:
This video lays out the clear choice our nation faces on Medicare: Will Medicare become a program in which a board of bureaucrats manages its bankruptcy by denying care to seniors? Or will leaders work together to save and strengthen Medicare by empowering seniors to choose health care plans that work best for them, with less support for the wealthy and more help for the poor and the sick? (Read the rest on The Foundry…)
Successful health care reform requires bold changes, not more of the status quo. Nowhere is this truer than in the case of Medicaid, the federal-state partnership to provide health care to the poor and disabled. Unfortunately for taxpayers and program beneficiaries, this was neglected by Obamacare. The new law leaves failing policies in place while expanding the program to cover more than 20 million new individuals. This will only exacerbate existing problems.
Despite the bad policies that are now law under Obamacare, some in Washington continue to recognize that Medicaid is in crisis mode, pushing for reform to reduce the program’s burden on taxpayers while improving its quality. Last week, Senators Tom Coburn, M.D. (R–OK), Richard Burr (R–NC), and Saxby Chambliss (R–GA) introduced legislation to give states flexibility to fix Medicaid.
Medicaid is on an unsustainable path and promises to consume a growing portion of state budgets and increase deficit spending. In response, state legislators have begun to aggressively seek ways to reduce the program’s cost while also improving it. But due to federal mandates and bureaucratic barriers to change, this is easier said than done. Both the stimulus and Obamacare enacted maintenance-of-effort (MOE) requirements that restrict states from altering Medicaid eligibility. Moreover, states must apply for waivers from the Department of Health and Human Services (HHS) to make significant changes to the programs—a lengthy and often unsuccessful endeavor. (Read the rest on The Foundry…)
As the debate heats up over how best to control runaway Medicare spending, one provision of Obamacare has received growing attention. The new law creates accountable care organizations (ACOs) primarily to address fragmentation and rising costs in the health care system, but supporters tout ACOs as a key solution to Medicare’s looming insolvency. As more details come to light, however, government establishment of ACOs appears to be more difficult than purported.
ACOs are merely the latest in a long history of health policy ‘silver bullets.’ Since the 1970s, Congress and successive Administrations have promoted a number of mechanisms to control rising health care costs, including the introduction of Medicare hospital payment formulas based on fixed payments for hospital services (payments for diagnostic related groups of services, or DRGs), as well as health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Costs have continued to rise despite these efforts. At the same time, concerns about fragmentation of care and diminished quality have increased significantly.” (Read the rest at The Foundry…)
A week ago, the Medicare Trustees issued their annual report, which showed that the program is on the fact track to insolvency. The 2011 analysis projected that the Hospital Insurance Trust Fund (which funds Medicare Part A) will be insolvent in 2024, and the program’s long-term unfunded obligations—promised benefits that are not paid for—amount to $24.6 trillion. Heritage noted the highlights. Page 266 of the official report included a note from Richard Foster, the Medicare Actuary, who said the Trustees’ financial projections “do not represent a reasonable expectation for actual program operations.”
Late Friday afternoon, the Office of the Actuary (OACT) released a separate analysis detailing why the Trustees’ report is unrealistic. While the timing was curious, the reasoning is straightforward. Because the Trustees use assumptions based on current law, OACT warned, “the projections…should not be interpreted as our best expectation of actual Medicare financial operations in the future but rather as illustrations of the very favorable impact of permanently slower growth in health care costs, if such slower growth can be achieved.” (Read the rest on The Foundry…)
If you knew a dangerous virus was about to hit America and that you could beg the government for a vaccine, you’d probably do it, wouldn’t you? That’s just what states and businesses alike are doing right now in preparation for Obamacare. But rather than seeking a vaccine, they’re asking for waivers from the law’s onerous requirements.
To date, the Department of Health and Human Services (HHS) has approved 1,372 Obamacare waivers, covering 3.1 million Americans. Yesterday, The Daily Caller reported that among HHS’s most recent round of 204 Obamacare waivers, “38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district.” That’s right: Nearly 20 percent of exemptions from Pelosi’s crowning health care achievement were doled out in her backyard.
If that’s not enough irony for you, try this waiver on for size: On Monday, the Las Vegas Sun reported that Nevada—Senate Majority Leader Harry Reid’s home state—received a partial statewide Obamacare waiver, too. If you’re keeping score, Reid was Pelosi’s counterpart in the Senate fighting to get Obamacare passed into law. Now his state will be one of three to get a waiver from the law’s requirements, while the rest of America suffers. (Read the rest on The Foundry…)
When Rep. Nancy Pelosi (D-CA) said of Obamacare, “[W]e have to pass the bill so that you can find out what is in it,” apparently she meant that it would include pain and suffering for America’s businesses, except for those fortunate enough to get waivers, including a few high-class restaurants, night clubs and hotels that reside in her congressional district. Matthew Boyle at The Daily Caller reports:
Of the 204 new Obamacare waivers President Barack Obama’s administration approved in April, 38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district.
Pelosi’s district secured almost 20 percent of the latest issuance of waivers nationwide, and the companies that won them didn’t have much in common with companies throughout the rest of the country that have received Obamacare waivers. (Read the rest on The Foundry…)
On Tuesday, May 10, 2011, the U.S. Department of Health and Human Services released a report on the uninsured population and their ability to pay their hospital bills. One of the more interesting takeaways from the report is that if you add up all the savings of the uninsured with incomes over 400 percent of the federal poverty level (or about $88,000 for a family of four), it will cover about 37 percent of their total hospital bills.
How do the uninsured get away with not having the assets to pay their bills? Well, the average uninsured person only pays for about a quarter of their total health care costs. Taxpayers end up covering about 75 percent of the unpaid tab through direct payment and extra disproportionate share hospital (DSH) payments made by Medicaid and Medicare, while those with private insurance, hospitals, and charities pick up the rest. (Read the rest on The Foundry…)
The just released 2011 Medicare trustees report does not contain any big surprises. Much of what the trustees say in this report they have said before: Medicare poses enormous challenges for patients and taxpayers alike, and its financial condition continues a downward slide. Some key findings:
- Medicare’s unfunded obligations increased by $2 trillion. A key indicator of the true cost of the program is the cost of the promised benefits that are not financed by dedicated revenues. Using their standard 75-year projection (2011–2085), the trustees estimate this year that Medicare benefits promised that are not paid for amount to $24.6 trillion, compared to their projection of $22.5 trillion last year. These and other projections in the report are based on current law, including the official assumption that the estimated $575 billion in savings from Medicare provider cuts under Obamacare will be sustained, as well as the 29 percent reduction in Medicare physician payments in 2012. The Medicare trustees concede the point: “Although the long-term viability of some of these provisions is debatable, the annual report to Congress on the financial status of Medicare must be based on current law” (emphasis added). Different assessment and different accounting techniques, of course, can yield different estimates of these long-term costs. Based on an alternative scenario of projected costs and spending that many analysts considered more realistic, the Medicare actuary in 2010 estimated the long-term Medicare debt at $34.8 trillion. The Medicare actuary has yet to offer his alternative assessment for 2011. (Read the rest on The Foundry…)
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