I Am Against Government Healthcare

ObamaCare's Nasty Surprise for Seniors

JOHN C. GOODMAN8/24/2016

Is there any other way to save Medicare without hurting quality of care for seniors or breaking the bank? (Ingram Publishing/Newscom)

Here are three things everyone who is on Medicare or who hopes to live long enough to qualify for Medicare should know.

First, Medicare is no longer a financial nightmare in the federal government's future. For the last half century health care costs per capita have been growing at twice the rate of income, both here and abroad. This has policymakers everywhere wondering how we are going to pay the medical bills for future retirees. But no longer is that going to be a problem in the United States. At least not as long as we have ObamaCare.

Unless some future Congress and some future president change the law, Medicare's growth going forward will stay in line with the growth of our economy – insuring that the program will remain affordable, indefinitely into the future.

How did that happen? On March 23, 2010, when President Obama signed the Affordable Care Act he signed into law a bill that wiped out more than $50 trillion in Medicare's unfunded liability. That's not a misprint. That's trillion with a "t". The savings are almost three times the size of our entire economy.

But ObamaCare is supposed to be about insuring the uninsured. It's about health insurance exchanges and the expansion of Medicaid. What has that got to so with the elderly and the disabled? A lot, it turns out. One of the most important sources of funds that are being used to pay for ObamaCare comes from cuts in future Medicare spending.

All this comes at a price, however. And this is the second fact you need to know.

A letter issued by the Medicare Office of the Actuaries at the time ObamaCare became law warned that Medicare fees paid to doctors and hospitals will fall increasingly behind what other payers will be paying in future years – threatening access to care. That warning was repeated in the latest Medicare Trustees report, which warns that by 2040 half of all hospitals, 70% of all skilled nursing homes and 90% of home health care services will not be able to survive under Medicare's increasingly skimpy fees.

These comments by the actuaries, however, have been ignored by just about everyone. In the latest Trustees' report they appear at the very end – on page 260. If you are a senior, you have to be really, really interested in numbers, tables and actuarial arcana before you'll ever get to the page where you learn that you may not be able to see a doctor when you need one.

Here is a third thing you need to know. Although Republicans have criticized the "Obama cuts in Medicare spending" as threatening access to care for the elderly, the GOP alternative essentially does exactly the same thing. The Paul Ryan budget – which was approved by almost all of the Republican members of the House –envisions a path for Medicare spending that is virtually identical to the Obama administration budget.

Essentially, the Republicans are planning to do what the Democrats plan to do: squeeze the providers. Only the methods differ. Democrats plan to reduce provider payments through a political mechanism. Republicans would do it through an economic mechanism -- by reducing premium support, thereby forcing health plans to reduce their costs by reducing what they pay doctors and hospitals.

Here is the bottom line: By 2075 the expected reduction in Medicare spending for the average senior under both Democratic and Republican budgets will equal about half of their Social Security income. Put differently, were the elderly required to make up for the cuts in Medicare spending, with increased out-of-pocket costs, that would be the equivalent of a 50% tax on their retirement income.

So as not to leave the reader totally depressed, let me add that there is yet a third way. The Democratic and Republican approaches to Medicare reform are what I call "eat your spinach" reforms. Somebody is always losing. Democrats try to hide the costs and often pretend that there are no victims. Republicans, on the other hand, seem to wear the infliction of pain as a badge of honor. If someone is not suffering, it can't be real reform.

What I propose, by contrast, is win-win reform. This is reform where everybody gains – the young, the old, the taxpayers and the current beneficiaries. It involves three fundamental changes to Medicare: special Health Savings Accounts that would let retirees manage at least one-fifth of their own health care dollars; letting physicians benefit from innovations that lower cost and raise quality; and investing payroll taxes in private accounts so future retirees can pay the bulk of their own health care costs.

The specifics are in A Framework for Medicare Reform, which I designed with the help of former Medicare Trustee Thomas Saving and our colleague Andrew Rettenmaier.

Goodman is president and CEO of The Goodman Institute for Public Policy Research

This page is a permanent link to the reply below and its nested replies. See all post replies »

lov2smile · 36-40, F

Northwest,

First of all, you still haven't named a government agency run efficiently.
Secondly, you are naive to believe the government is not running the healthcare industry and providing insurance through bureaucratic red tape and overburden government regulations and bureaurocacy once obamacare is fully implemented.

However, you seem to be having trouble reading my post so I guess it would be too much to ask you to read the affordable healthcare act online

Instead of splitting hairs of what I have researched and typed....READ it and LEARN.

BTW your cute little story about sex in high school doesn't cut it.
Pregnancy among school age teenagers is at the highest level in history.

Northwest · M

@lov2smile:

Why would I need to name a government agency that's run efficiently? The topic of discussion is the ACA. You said that you had a problem with it, and I asked what your specific issues were. What you listed are either not related to ACA, or you incorrectly attribute them to the ACA.

Let's take, for instance, your claim about "death panels". This is NOT part of ACA. This was a slogan, launched by Sarah Palin, 8 years ago! It's still untrue today, as it was 8 years ago.

Even when I tried to be light hearted about it, you replied with something that you invented.

"Pregnancy among school age teenagers is at the highest level in our history"

Absolutely wrong. In fact, pregnancy rates were cut by 50% since 1990. Here's the link: http://bit.ly/2bKSmEs

You also keep saying that I am naive. Stay clear of personal attacks, because you have yet to provide a single piece of factual information.

This is not about splitting hairs, it's about you being 100% wrong, on every single thing you posted. You have demonstrated that you have no idea what ACA is, and you're just pulling things, from a Presidential campaign, 8 years ago. These are not facts.

As to government run agencies, I get tired of people, who have no clue, throwing it out there. Efficient? compared to what? There is no equivalency, period!

Let's take DSHS for instance. What private agency do you want to compare it to? Pick one, go ahead. When you get to a certain size, any organization, is going to have inefficiencies, and it's a full time job, for a lot of people, to continue looking for solutions. Enough with the slogans.

Northwest · M

Are you honestly trying to tell me, or anyone for that matter, that the ACA is not run by the government? Quite honestly, I'm trying to be kind by calling you naive.
Because if you are not naive, you are trying to deceive.

This is not even part of the discussion. You said that ObamaCare is bad, and I asked you to tell me, specifically, what's wrong with it.

It seems as if the only solid thing you can come up with, is that it's run by the government. As all the other arguments you brought up, are either propaganda, or outright falsehood.

I have a pretty good grasp of the law.[/qupte]

[quote]Having Health insurance is not the same as getting good health care. In fact, it doesn't matter how many Americans obtain insurance under the ACA. Most will have difficulty finding a physician. Specifically for the reasons stated above. The government will pay doctors and hospital less and less every year.

Having health insurance is not the same as getting good insurance. This has ALWAYS been the case. ACA has nothing to do with it. This was true during the Eisenhower, Kennedy, Johnson, Nixon, Ford, Carter, Reagan, Bush, Clinton, Bush and now Obama.

It is absolutely FALSE, that "most will have difficulty finidng a Physician". This is NOT a side effect of the Obama plan. It is the insurance plan, that the individual has, that determines the doctors who are part of the network, and the out of network policies.

Also, insurance providers pay doctors and hospitals, not the government. CMS is something different, but you're mixing these things up.

CMS is NOT an ACA side thing. It's been there, long before ACA.

Employers will drop millions from health care plans as Obamacare premiums spike

More falsehood, and failure to grasp the simpe concept, that the government is NOT providing health insurance. It is providing an Exchange. That's it. It also offers individual states the option to have their own exchanges.

Every single one of the insurance companies, that make up the Exchanges, is a PRIVATE company. The government DOES NOT run any of these companies.

It does not take two years of reading to grasp this concept. The only thing the law did, was force insurance companies, to accept all applicants, who can afford a particular plan.

The other thing ACA does, is provide a place, where low-income eligibility, can be determined faster.

Ah yes, the proverbial death panel. Silly me.

Definition of proverbial: commonly spoken of : widely known

and then, in another post, you say:

BTW Nice Try on trying to diminish my credibility by tying Sarah Palin's name to your post. Although the word "Death Panel" is not used, certain patients over 70 years old will not receive the same care that would be afforded before obamacare was put into effect.

So, then, you acknowledge, that the "death panel" thing, is not really commonly spoken of. Well, because it does not exist.

Who talked about it, and made it seem as if it was real? Sarah Palin. 8 Years ago. So, if you're not parroting Sarah Palin, then congratulations, you achieved her status, all on your own.

And you also continue to make the same false assertion: that 70 years old will not receive the same care that would be afforded before ACA.

So called death panels, or treatment guidelines, have been around ever since Insurance companies started to exist. Insurance companies get to decide what's an acceptable treatment. This has ALWAYS been the case.

The fact that you dispense these "truths" so easily, when they're falsehood, is alarming.

It's like your claim that "Pregnancy among school age teenagers is at the highest level in history."

Another falsehood. Teenage pregnancy peaked in 1990, and has since dropped 55%.

Any other falsehood you care to spread?

I have problems with ACA, and I can state them clearly, without inventing things.

ACA is an embarrassment. Outside of removing the pre-existing, and gender discrimination clauses, it kept the system AS IS. Not a single friggin change. A single payer system, similar to what they have in Canada, is what we should shoot for.