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May 27, 2011

Memo to MBM: Maybe You Should Report, One of These Days, That Obama Has Cut Medicare More Savagely Than Paul Ryan Would Even Consider

Seniors are very misinformed. Intentionally, of course. AARP (a partner of the DNC) and the MBM (a junior partner of the DNC) are telling them that Paul Ryan's plan is a threat, and represents cuts in service.

What they are vigorously suppressing with all their might is that Barack Obama already cut trillions from Medicare and, through the Medicare rationing board, has proposed cutting trillions more, in a move he calls "reform" but everyone else knows as simple rationing.

And they're suppressing the fact that the current "plan" for Medicare is for it to go bankrupt in 8 years or so, with seniors facing automatic across-the-board reductions in what Medicare pays their hospitals and doctors. And there is no law that says a doctor or hospital has to accept very-below-market rates of compensation.

They can turn away your business, and dump you off to the sort of doctor who is willing to take small money as payment. They're already doing that now, and they're going to be doing even more of that in the next few years.

The worst seniors-benefits cutter is ObamaCare, which slashed trillions to make room for new Medicaid enrollees. And then on top of that Obama proposed further trillions in cuts as his big idea for balancing the budget. Well, not balancing it, but lying about doing so.

This article is a must-read, and has clarifying graphs attached. I hope if I strongly urge readers to read it the WSJ will excuse a longer-than-usual excerpt:

The Obama administration has repeatedly claimed that the health-reform bill it passed last year improved Medicare's finances. Although you'd never know it from the current state of the Medicare debate—with the Republicans being portrayed as the Medicare Grinches—the claim is true only because ObamaCare explicitly commits to cutting health-care spending for the elderly and the disabled in future years.

Yet almost no one familiar with the numbers thinks that the planned brute-force cuts in Medicare spending are politically feasible. Last August, the Office of the Medicare Actuary predicted that Medicare will be paying doctors less than what Medicaid pays by the end of this decade and, by then, one in seven hospitals will have to leave the Medicare system.

Medicaid is health insurance for poor people, and we pay about that rate for it.

The plan is to make Medicare into health insurance for poor people.

If you like your doctor, you can keep your doctor.... as long as you pay him yourself out of your own pocket, because Medicare's going to be paying for "Doctor" Nick Riviera, and I say "Doctor" Nick Riviera because he graduated not from a school of medicine school but instead "graduated" from a "school" of "medicine."

But suppose the law is implemented just as it's written. In that case, according to the Medicare Trustees, Medicare's long-term unfunded liability fell by $53 trillion on the day ObamaCare was signed.

But at what cost to the elderly? Consider people reaching the age of 65 this year. Under the new law, the average amount spent on these enrollees over the remainder of their lives will fall by about $36,000 at today's prices. That sum of money is equivalent to about three years of benefits. For 55-year-olds, the spending decrease is about $62,000—or the equivalent of six years of benefits. For 45-year-olds, the loss is more than $105,000, or nine years of benefits.

In terms of the sheer dollars involved, the law's reduction in future Medicare payments is the equivalent of raising the eligibility age for Medicare to age 68 for today's 65-year-olds, to age 71 for 55-year-olds and to age 74 for 45-year-olds. But rather than keep the system as is and raise the age of eligibility, the reform law instead tries to achieve equivalent savings by paying less to the providers of care.

What does this mean in terms of access to health care? No one knows for sure, but it almost certainly means that seniors will have difficulty finding doctors who will see them and hospitals who will admit them.

And bear in mind, hospitals are supposed to treat everyone, but in fact they do hurry indigent patients out the door. Often just with painkillers and other palliatives. They have to; this is life.

Medicare patients will not be indigents, but they also will be a financial loss to each doctor and hospital treating them. Not a 100% loss, as with an indigent, but a 20-30% or even 40% loss.

Expect 20-30%-40% more "take some codeine and God speed you on your way."


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posted by Ace at 02:02 PM

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