Tag Archive: Medicaid


ObamaScare’s House of Horrors


Just when you thought it was safe, after having been lulled to sleep, the nightmares are about to begin.

Universal's House of Horrors

Something wicked this way comes hiding deep inside the belly of the beast we know as ObamaScare. Whether or not the website problems get fixed there is no escape from this horror show coming to your house.  This nightmare will have you missing sleep for many days to come.

By now almost everyone has heard the horror stories since the roll-out of ObamaScares sign-up began. Well fasten your seat-belts because the horror show has just started and there are many more scarey stories to come. If you have not been sufficiently scared off by the initial phase of the ObamaScare road show, brace yourself for even greater horrors to come.

First up huge deductibles:
When consumers finally do get onto the Healthcare.gov website, they are in for a new kind of sticker shock. Avik Roy of the Manhattan Institute has exposed the high cost of Obamacare premiums — the next price shock will be the whopping cost of the deductibles.A Chicago Tribune analysis showed that 21 of the 22 lowest-priced plans offered for Cook County residents on the Illinois exchange have annual deductibles of more than $4,000 for an individual and $8,000 for family coverage.(Deductibles are the money consumers must spend on health care before most insurance benefits kick in.)

The huge deductibles along with the hefty premiums turns what once was a health insurance plan into a self-insurance plan. When you add up the premiums you must pay, and then add in the huge deductible, plus the additional out-of-pocket expense to pay the co-pay in any given year it maybe cheaper to simply pay for your health expenses as they occur and put the premiums you would have paid into a HSA (health savings account) for future expenses. But since Obamascare is now a MANDATE and you MUST buy a policy you are being forced to part with your money to essentially get absolutely nothing in return.Why are these premiums so high, this policy design is a direct result of the law’s instructions about the percentage of average health costs that insurance must cover (60 percent for Bronze, up to 90 percent for Platinum plans).

ObamaScare #2 Will people pay?

The Congressional Budget Office expects 7 million people to enroll in health insurance through the exchanges by 2014, and it needs about 2.7 million of them to be “young healthies” who will enroll, and pay premiums that are higher than their age or health status would warrant because of the law’s regulations. Enough Americans may enroll, but will they keep up with their premiums month after month?

The first month of the new health law’s rollout reveals an unexpected pattern in several states: a crush of people applying for an expansion of Medicaid and a trickle of sign-ups for private insurance.

This early imbalance — in some places, nine out of 10 enrollees are in Medicaid — has taken some experts by surprise. I guess they really where not experts after-all if they could not have foreseen that the FREE MEDICAID plans would see an influx of sign-ups while the EXPENSIVE private-care plans would not. I personally believe that this was the plan all along, to make it as easy for people to sign-up for the FREE PLAN and as difficult and unaffordable as possible for everyone else because the end game is to get everyone under a Federally run and administered health-care plan.

Low enrollment in private insurance, meanwhile, could increase premiums as it would likely indicate that only sick people, who really need coverage, were signing up. And the experts could not foresee this? Really those of us who are not experts knew this was going to happen.

ObamaScare #3 Attracting the sickest:

Sicker Americans, with high health costs, are the ones most determined to get through the Healthcare.gov website to enroll. If they dominate enrollment, premiums will have to rise in 2015, discouraging even more young healthies from applying in the future. The industry calls this a “death spiral.”

Again couldn’t the experts predict this? I believe they did know all this and it did not matter because once again this whole nightmare is not about providing the best possibly program for the most American citizens, the current private-sector programs would not have been tampered with, what it is about is gaining control of an individuals health-care.

 http://www.nationalreview.com/article/361946/top-ten-obamacare-disasters-come-grace-marie-turner

Need proof?
Thousands get health insurance cancellation notices

Oct. 18, 2013 at 2:55 PM ET Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, …
Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. The new policies supposedly will offer consumers better coverage, in some cases, for comparable cost — especially after the inclusion of federal subsidies for those who qualify.  Now that is a big caveat, if you do not qualify for a federal  subsidy (read taxpayer support) then your premiums will most likely be much higher.

So now you are not only paying for your own plan, plus those who are already on Medicaid, now you are going to be asked to help pay for your neighbors plans as well. Face it folks we are being seen as a REVENUE source and not as individual human beings with lives. We are being subjected to this tyranny.The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care, whether you need them or not.  That’s right guys your policies will now have to cover your maternity care. What you say you do not need maternity care? Too bad you will have to buy it anyway.

In addition less expensive alternative plans are being outlawed.

ObamaScare #4 Less Expensive Plans Vanish

As previously stated since these “catastrophic” health plans do not contain the “required” basic coverages they are not permitted to be sold. And despite Obama’s continued claims that if you like your policy you can keep your policy, you can not.

ObamaScare #5 Families lose out:

Obamacare’s subsidies will mean that the federal tax code’s existing marriage penalty will get much bigger for certain Americans, especially older, middle-income couples. Families will have to reckon with the fact that remaining married could cost them $10,000 a year or more because single people with lower incomes qualify for bigger subsidies.

Massive Marriage Penalties in Obamacare Health Insurance Exchanges

On the Obamacare health insurance exchanges, being married can cost you a lot. Get divorced (or avoid getting married, if you live togeth…

Hans Bader

ObamaScare #6 More Jobs to be lost:

The Obama administration delayed for a year reporting requirements for the mandate that companies provide health insurance for their employees. But with those provisions coming into effect in 2015, employers will continue to restructure their businesses to stay under 50 employees and push workers under 30 hours a week to avoid the hefty fines that will be used to enforce this regulation.

Andrew Puzder, chief executive of CKE Restaurants, wrote in The Wall Street Journal that “the evidence that Obamacare is having a negative impact on hiring is unequivocal, abundant and consistent with common sense.” Job creation will continue to suffer.

ObamaScare #7 Identity Theft and Fraud will explode

Tens of thousands of “navigators,” “assisters,” and other agents are being hired, generally by nonprofit organizations, to help people apply. They will be gathering personal information, such as one’s Social Security number, address, income, employer’s name and address, children’s names and birthdates, and health habits, to find out if you qualify for Obamacare subsidies. Others are going door-to-door to get people enrolled, and there is no easy way of determining if the person at your door is legitimate. While these aides do receive some training, they’re not professionally licensed and don’t go through the background checks required of insurance agents and brokers. Even temporary census workers had to meet tougher standards.

The Obama Administration itself is warning that con artists will take advantage of confusion over the law to steal people’s identities.Beyond the potential for one-on-one fraud, security may be inadequate in the giant government “data hub.” This warehouse of detailed personal information of everyone in the exchanges will be available to people in many different government agencies. The security of that database still has not been independently tested and verified.The risks of potential identity theft are very real, and 13 attorneys general have expressed deep concerns about the security of the exchanges’ information. When this starts happening, it will generate a new wave of negative coverage of the law.

Lawmakers seek answers on Obamacare Data Hub security

Ask HHS for information on access controls, monitoring tools, and the measures used to protect against cyberattacks Computerworld – Two R…

ObamaScare #8 Repaying Federal Subsidies

It’s going to be very important to accurately indicate annual income on one’s insurance application. Those who understate income, either because their situation changes or they reported inaccurate information, and therefore get a larger subsidy than they are entitled to will be required to repay the excess, possibly amounting to thousands of dollars. And since the IRS is in charge of enforcing compliance you can see how this is going to end badly for the individual

ObamaScare #9 Losing your Doctor

To keep rates from going even higher, insurance companies have limited the doctors and hospitals patients can visit.

Many insurers have opted to limit their selection of doctors in some exchange plans to keep premiums and other costs down. And they are also excluding large academic medical centers, which are often pricier because they tackle sicker patients and more complex cases.

“The sticker price will be lower if the number of options are lower,” said Joe Mondy, a spokesman with Cigna (CI, Fortune 500), which is participating in five state exchanges. “The issue is how many options can you do without?”

For example, WellPoint (WLP, Fortune 500), a Blue Cross Blue Shield insurer that offers policies in 14 states, is narrowing its networks in many markets after research showed consumers care more about the price than the provider.

In areas with a heavy concentration of doctors, WellPoint might offer Obamacare plans with only half the number of doctors available in its off-exchange plans, said Colin Drozdowski, vice president of provider engagement and contracting. But where there’s less choice, the network might be only 10% to 20% smaller.

Insurers are also restricting participants access to doctors through HMO plans that don’t offer out-of-network benefits. So patients have to stick to a certain set of physicians and hospitals or foot the full bill themselves.

ObamaScare #9 Doctor choice in Obamacare? Not so much

Many insurers have opted to limit their selection of doctors in some exchange plans to keep premiums and other costs down. And they are a…

And ObamaScare #10 Customer Service Nightmares

If they  could not get the website to work can you imagine the nightmare awaiting you if you actually have a health related problem and need to contact someone ASAP?

[4:09:56 pm]: Thanks for contacting Health Insurance Marketplace Live Chat. Please wait while we connect you to someone who can help.[4:09:59 pm]: Please be patient while we’re helping other people.
…..
[4:29:20 pm]: Please be patient while we’re helping other people.
[4:29:50 pm]: Please be patient while we’re helping other people.
[4:30:27 pm]: Welcome! You’re now connected to Health Insurance Marketplace Live Chat.Thanks for contacting us. My name is PGSTX0534. To protect your privacy, please don’t provide any personal information, like Social Security Number, or any other sensitive medical or personal information. (after you spent hours inputting all that information into the exchange website)

[4:30:51 pm]: PGSTX0534
Hello, how may I help you today?

[4:31:12 pm]: Alice

My information is not recording correctly in the summary of my application[4:32:21 pm]: PGSTX0534

Thanks for your interest in the Health Insurance Marketplace. We have a lot of visitors trying to use our website right now. That is causing some glitches for some people trying to create accounts or log in. Keep trying, and thanks for your patience. We’ll continue working to improve the site so you can get covered

[4:32:40 pm]: Alice what does that mean?

[4:32:52 pm]: Alice
It says my application is “in Progress”

[4:33:12 pm]: Alice
Does that mean it is not completed and I can continue to try to edit it?

[4:34:14 pm]: PGSTX0534
Thank you. One moment please while I look that up.

[4:36:19 pm]: PGSTX0534
The only way we can see your application is you will have to call The Health Insurance Marketplace Call Center at 1-800-318-2596. We are open 24 hours a day, 7 days a week to assist you.

[4:36:47 pm]: Alice
What does the Chat Service do then?

Alice it does nothing it only makes you feel better  that you actually talked to someone. They are not concerned about you and your well being.

President Obama said that buying insurance through the exchanges would be like shopping at Amazon.com. We all know how “truthful” Obama is by now right? Instead of simply clicking a few buttons online, many people will spend hours following up with phone calls, emails, and faxes. As recently as two weeks ago, government software couldn’t reliably tell people the correct price for their insurance or their subsidies. Again all of this is by design, because the end result is the government wants as many people enrolled in a Federal Insurance plan like Medicaid so as to make it almost impossible for any future congress to end the program. This nightmare is going to have more sequels  then Freddy Kruger.

Here’s How Well Obamacare’s Customer-Service Live Chat Works

The site failed to record her information correctly and she could not alter the incorrect information it’d recorded, so “Alice” went …

Thanks for visiting the ObamaScare House of Horrors. Our aim is to SCARE you to death so that we do not have to pay for your medical care. Thanks for your contribution to our campaign.

And this has been a “View From the Nest”.

But those who are waiting for the Lord will have new strength; they will get wings like eagles: running, they will not be tired, and walking, they will have no weariness. Isaiah 40:31 (BBE)


Along for the journey

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The statements, comments, or opinions expressed are solely that of the author and do not represent the views or opinions of the host of this site or any affiliates thereof. Any questions or comments should be directed to myself and not to the host or hosts of this site.

 

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Why I Can Not Vote Democrat


 

 

There are lists circulating the Internet listing the 12 or more reasons why people vote republican or democrat and I was going to make a list why I vote republican but that list would be very short since the only reason I vote republican is because I can not vote democrat. Now I would prefer to vote Constitutional Conservative but since there is no Constitutional Conservative party candidate on the ballot I am left with only a couple of options. Not vote at all, vote for a third-party candidate which is most likely not going to win, or vote for one of the other two candidates and since this article is about why I can not vote democrat that leaves me with only one option the Republicans get my vote by default. Now if the democrats ever change their policies to include my positions then I could just as likely vote democrat, but since I have been of voting age the democrat party has continued to exclude more and more of my positions leaving me with absolutely nothing in common with the current democrat party. So let’s see why it is exactly that I can not vote democrat.

  1. RIGHT TO LIFE: I am a strong supporter of the Declaration of Independence right to LIFE provision. And that to me means all life should be considered SACRED and should be protected. ALL have the RIGHT TO LIFE and that right should be protected at all costs. Since the democrat party protects at all cost the killing of innocent children and are not the party of “Right to life” I can not vote democrat.
  2. DEFENSE OF TRADITIONAL MARRIAGE: Since I believe solid families make for a solid community I support the defense of marriage act. Since the democrats have come out so strongly for non-traditional marriage and redefining the terms of marriage they again leave no door open for those of us who happen to believe in the traditional marriage make-up. Therefore I can not vote democrat
  3. FATHER KNOWS BEST: Yes I know this is old-fashioned but marginalizing the role of fathers in our society has led to many ills. Many souls who are imprisoned will lament the absence of a solid father figure. Studies show households with both fathers and mothers outperform homes of single parents in many key factors. According to childwelfare.gov Fathers are important in the healthy development of children. The democrat “war on poverty” policies have had a devastating effect on many urban families. And as such I can not vote for more of the same so I can not vote democrat.
  4. TAXES: The progressive income tax has cost many American jobs. We now have the highest corporate tax rate of any developed nation and as a result many companies are taking jobs and investments off shore. As a result our job market is being adversely affected. Democrats seem to like HIGH TAXES and have yet to propose any solution to this high corporate taxation. Therefore again I can not vote for a failed policy and  thusly I can not vote democrat.
  5. OBAMACARE: This really does not need much of an explanation. I do not believe the federal government should be involved in health care at all. Medicare and Medicaid are failing and since the government is in charge of these programs I am convinced that another program like it will fail just as miserably. Besides forcing an individual to buy anything is unconstitutional even if the supreme court says that it is.
  6. THE RIGHT TO BEAR ARMS: The second amendment has been a thorn in the Democrat side for years in fact I recall then candidate Obama saying that we like to cling to our guns and our religion. With that attitude toward gun owners I find it impossible to pull the lever for a Democrat so as a believer in the second amendment I can not vote democrat.
  7. THE FREEDOM OF SPEECH: Corporations are indeed a group of people. Brick and mortar do not create jobs nor pay taxes nor hire employees and since the democrats have a real problem with corporations contributing to candidates other than democrats I can not vote democrat. Usually the democrats love the Supreme court but in the “Citizen’s United” case they are singing another tune. Recently Obama and the democrat party has gone on a rampage against business and free enterprise and as a result I can not vote democrat.
  8. FREEDOM OF RELIGION: Forcing religious organizations to violate their conscience is unconscionable. The constant railing against religion disenfranchises those of us who take our religion seriously. Again this comes down to a right protected by the Constitution and yet another reason I can not vote democrat.
  9. THE RULE OF LAW: Ours is a nation governed by the rule of law not the rule of men. However since taking office Obama has ignored Constitutionally passed legislation and has ignored Supreme court orders. His is a lawless administration but no one from the democrat party seems to have a problem with Obama’s selective refusal to obey or enforce the law. And since I believe very strongly in the ‘rule of law’ I can not vote democrat.
  10. THE CONSTITUTION: This founding document is the ruling law of this nation and its enumerated powers clause was meant to be a hindrance to run-away government. Our founders knew the dangers of too much government and tried to safe guard future generations by limiting the powers of the central government. Democrats have a history of finding clever ways to get around the Constitution of the United States even so much as calling it “living and breathing”, meaning that it has no regulatory meaning at all if it can be changed at the whim of any lawmaker or special court ruling. I can not support interpreters of the Constitution, what I can support are defenders of the ORIGINAL INTENT of the Constitution. Therefore I can not vote democrat.
  11. STATES RIGHTS: Once again we are faced with a Constitutional dilemma. Powers not specifically granted to the federal government remains with the states or the individual. Since taking office and appointing Eric Holder as US Attorney General there have been many lawsuits brought against the STATES regarding Voter ID Laws, Defense of Marriage amendments to state constitutions, illegal immigration enforcement, and even attempts to tell companies which states they can work in. All this is beyond the powers enumerated in the Constitution of the United States. States are free to operate independently of federal intervention. Where the federal government fails to fulfill its duties to the citizens the citizens have a right to expect their States to work in their best interests.   Since I believe in the sovereignty of states and enumerated powers granted to the federal government by the states I can not vote democrat.
  12. A STRONG NATIONAL DEFENSE: This issue comes up each time the democrats gain control of both houses of congress and the white house. Defense spending is the only area they ever find waste and cost cuts. No other department is ever considered for any cuts or reductions it is always the military. The current administration is unilaterally disarming our military while the rest of the world is arming themselves. This I feel is a very dangerous policy and as a result I can not vote democrat.
  13. SCHOOL CHOICE: I believe parents should be given options when it comes to educating their own children. Since democrats are beholden to the teachers unions they are against school choice and any voucher program and education reform in general. One of the current administrations first act as an elected leader was to end the DC VOUCHER program. For this reason and because I believe in school choice I can not vote democrat.
  14. ENTITLEMENT REFORM: The democrat’s experiment with the “great society programs” have all proven to be failures. Yet there is not one democrat willing to discuss the failures and offer solutions or fixes. Whenever a proposal is made by the opposing party to discuss the failures of these programs it is demagogued to death and the sponsors of the bill are demonized. For this reason I can not vote democrat.
  15. FISCAL RESPONSIBILITY: No budget since 2007. The primary responsibility for congress is to present a budget every year. The democrat controlled Senate has not produced a budget in over 3 years. As a result we are accumulating $1 trillion plus debt every year. This is irresponsible and reprehensible. And another reason I can not vote democrat.
  16. NATIONAL SECURITY: Border control is important. Our country is being infiltrated by trespassers and the current administration wants to grant these lawbreakers amnesty, and bestow upon them rights retained for true American citizens. There are many who wish to come to this country legally and I am all for LEGAL ORDERLY immigration policy, but this, crash our borders, squatters rights is not in the best interest of this country and as such I can not vote democrat since they promote this continued illegal activity.
  17. FOREIGN POLICY: Two words “Arab Spring”. A huge reason I can not vote democrat.
  18. TEA PARTY: Democrats do not want us therefore I can not vote democrat.

And the list goes on and on. Again I do want to emphasize that these are reasons why I can not vote democrat and not reasons to vote republican since many republicans fail to meet these same criteria, but since the democrats are opposed to every one of these points there is no room in the democrat party for someone who holds to these principles. The only conclusion I can come to is the democrat party does not wish to include people like me who believe like I do and since they are excluding me and my views I can not vote democrat.

Now that is the way I see it. What say you?
This has been A View from the Nest. The statements, comments, or opinions expressed are solely that of the author and do not represent the views or opinions of the host of this site or any affiliates thereof. Any questions or comments should be directed to myself and not to the host or hosts of this site.

 

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In a move that really comes as no surprise Indian Planned Parenthood halted services to Medicaid Patients after state funds where cut. Indiana’s Governor signed into law a bill which cut $3 million dollars from Planned Parenthood in an effort to limit tax payer money from funding abortions. Proving without any doubt that ABORTIONS are the main priorty of Planned Parenthood and not aiding the health needs of the poor.

If you had any doubt about Planned Parenthoods true motives doubt no more.

Amplify’d from www.onenewsnow.com

Planned Parenthood signIndiana Planned Parenthood, which lost $3 million in state funding, is halting services to Medicaid patients.

Planned Parenthood took that action pending a federal court decision. At issue is a newly signed law that halts state funds for any abortion-provider. Sue Swayze of Indiana Right to Life tells OneNewsNow Planned Parenthood made a poor choice.
 
“As our governor is fond of saying, they could have simply stopped providing abortions in order to comply with the new law,” the pro-lifer explains, “but instead [they] have chosen to stop serving women’s health patients and keep the abortion side of the house.” Swayze calls that “a telling statement of where their priorities lie.”
 
Susan Swayze (Indiana Family Inst.)Does that mean Medicaid patients will have to do without breast exams, pap tests, birth control, and other healthcare services Planned Parenthood provided?
 
“Absolutely not,” responds the activist. “In fact, Indiana has over 800-plus Medicaid providers throughout the state as well as upwards of 100 freestanding family planning clinics — Title X, and other kinds of family planning clinics. There are lots of other providers.”
 
Swayze also says one would hope Planned Parenthood would care enough about its clients to refer them to other facilities where they can get the medical assistance, rather than just dumping them. Meanwhile, the Obama administration is threatening to halt all Medicaid funding to Indiana.

Read more at www.onenewsnow.com

 


Indiana appears to be the next state to challenge federal law by passing a law of their own. Like Arizona on Immigration, Wisconsin on public sector unions, Florida on Obamacare, Indiana is taking on Taxpayer funded Abortions.

State officials in Indiana say they will defy the decision by the Obama administration asking it to not proceed with implementing a new pro-life state law that would revoke taxpayer funding for the Planned Parenthood abortion business.

Governor Mitch Daniels (a republican) signed the law , which would cut off anywhere from $2 million to $3 million the Planned Parenthood abortion business receives in federal funds via the Indiana government through Medicaid . Daniels said that “any organization affected by this provision can resume receiving taxpayer dollars immediately by ceasing or separating its operations that perform abortions.”

Like all other federal programs however, the feds like to have the last word. What they can not get passed through legislation they force upon the American people through the many agencies in the bloated federal government.

However, the Obama administration told the state it can’t implement the new law, with Centers for Medicare and Medicaid Services Administrator Donald Berwick denying a request to deny funds saying the federal Medicaid law stipulates that states can’t exclude providers based on the services they provide.

See a pattern here? A state passes a law that the federal government does not like and the federal government steps in to threaten the state and force them to comply.

Planned Parenthood challenged the constitutionality of the law and filed a lawsuit in U.S. District Court in Indianapolis just hours after Daniels signed the legislation into law. It alleges the law would violate contracts already in place between it and the state and that it forces Planned Parenthood to choose between doing abortions and getting taxpayer funding.

On the heels of the federal government strong-arm tactics lawsuits are filed by the various special interest groups, all designed to force states to spend even more taxpayer money to fight off the federal government. The federal government has gotten way out of hand. They have usurped their limited constitutional powers and have set themselves up as supreme rulers.

“The Obama administration appears to be intent on trying to force Indiana to subsidize the business of abortion in direct contrast to the desires of the state legislature and the people of Indiana.  Indiana must refuse to be bullied by the federal government and must challenge this politically-charged determination with full vigor.  The state of Indiana has a right to determine how it will manage its Medicaid program and to select the providers it will partner with.  Planned Parenthood is not entitled to public funding,” he said.

The people voted in 2010 and sent a strong message to Washington that "we the people" are still in charge of America. They sent a loud message that they were not happy with the direction the Federal government was taking the country and they voted to replace state and local leadership hoping they will be more responsive to the ‘will of the people’. Arizona, Florida, Indiana, Wisconsin all seem to have gotten the message and are working hard to return the country back to the people. At each step of the journey the federal government is spending taxpayer money to fight against the tax payers.

There are more of us then there are of you so be warned, things are about to get very interesting for 2012.


 

Unofficial seal of the United States Congress

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Since the creation of Medicare in 1965, the program’s basic structure has caused spending to grow rapidly decade after decade. Even aside from the role of general inflation and demographic factors in rising health costs, there are at least four additional cost drivers built into Medicare’s current design.

 

  • First and foremost, Medicare allows enrollees and health care providers to spend other people’s money. That all but eliminates any incentive for either party to economize and invites waste, fraud, and abuse. Researchers at the Dartmouth Atlas Project and elsewhere estimate that about 30 percent of Medicare spending does nothing to make patients healthier or happier.18 That estimate does not include Medicare spending that provides some value, but whose benefits are smaller than the costs. This research suggests that Medicare wastes well over $100 billion per year. A study by health economists Amy Finkelstein and Robin McKnight found that “in its first 10 years, [Medicare] had no discernible impact on elderly mortality.”19 Crudely put, the $300 billion (in today’s dollars) that Medicare spent between 1966 and 1975 may not have saved a single life.20
  • Second, Medicare spending grows because the government keeps expanding the list of goods and services that Medicare subsidizes. Congress created the huge Part D prescription drug program in 2003, which has added hundreds of billions of dollars to the federal debt because legislators provided no funding source. Other expansions occur, without any congressional action or approval, when Medicare officials deem new procedures eligible for subsidies. In 2004, the Bush administration unilaterally announced that Medicare would begin subsidizing obesity treatments.
  • Third, Medicare overpays for many items because it often sets prices higher than a free market would. In the 1990s, for example, ambulatory surgical centers (ASCs) increased their productivity. A competitive market would have quickly translated those gains into lower prices for consumers. Yet Medicare took 16 years to lower the prices it paid ASCs. Those artificially high prices encouraged excessive use of ASC services with taxpayers footing the bill.21 Medicare sets prices too high in many other areas of medicine, including cardiovascular care.22
  • Fourth, Medicare’s fee-for-service structure—based on price and exchange controls—encourages providers to deliver too many services because that is what the structure rewards. That fact does not imply any greediness on the part of providers. Medicine entails considerable uncertainty, and Medicare encourages providers to respond to that uncertainty by delivering more services.

These factors help explain why actual Medicare spending usually surpasses projections. When Congress created Medicare in 1965, officials projected Part A would cost $9 billion by 1990; it ended up costing $67 billion. In 1967, official estimates projected the cost of the entire Medicare program would reach $12 billion in 1990; it cost $110 billion that year. When Congress created Medicare’s home-care subsidies in 1988, official estimates projected it would cost $4 billion in 1993, but it ended up costing $10 billion.23

So when the Congressional Budget Office projects that Medicare spending will grow at an annual rate of 7.0 percent during the next decade, it is important to take that projection with a grain of salt, given that Medicare grew at an average annual rate of 9.3 percent over the past decade.24

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