Posted on 04/14/2015 7:06:20 PM PDT by Star Traveler
WASHINGTON — The Senate on Tuesday approved sweeping changes in the way Medicare pays doctors, clearing the bill for President Obama and resolving an issue that has bedeviled Congress and the Medicare program for more than a decade.
The 92-to-8 vote in the Senate, following passage in the House last month by an overwhelming vote of 392 to 37, was a major success for Republicans, who devised a solution to a complex policy problem that had frustrated lawmakers of both parties. Mr. Obama has endorsed the bill, saying it “could help slow health care cost growth.”
The bill, drafted in the House in negotiations between Speaker John A. Boehner and Representative Nancy Pelosi, the Democratic leader, also extends the Children’s Health Insurance Program for two years, through 2017.
Without action by Congress, doctors would have faced a 21 percent cut in Medicare fees on Wednesday or Thursday. Senate leaders cleared the way for final passage by allowing votes on several amendments sought by liberal Democrats and conservative Republicans.
(Excerpt) Read more at nytimes.com ...
>>Sure, someone will eventually have to pay but please let it be my neighbor or my children and grandchildren. After all why should I be responsible for my own healthcare bills? That someone else’s responsibility! sarc
Agree. If the government would stop stealing from us at every opportunity, we would be able to pay for our own healthcare and insurance. But the government bureaucracy, the civil servants who are employed by it, and the big businesses who profit from it do not want to loosen their grip on our money.
It would come down to making changes to it, what they would consider improvements. The only problem with that is that those should have been dealt with prior to the final day when 21% cuts to doctors were to go into effect (that being today). I’ve see what the doctors normally bill all their patients (Medicare or not) and Medicare tells the doctors that they will only approve about 1/2 of the billing. I’m amazed that doctors even take Medicare with that, as it is, and then they were talking about cutting off another 21% from that today!
BUT in terms of what one would call a “bipartisan vote” ... that was definitely something you NEVER see (with the numbers voting for it in the House and Senate) except with one other subject - ISRAEL!
You can’t get much more support for a bill than the numbers shown here. Even Obama would have been overridden on a veto, if he had attempted it. And, keep in mind that this is what the GOP has been trying to get through for a long time, but we’re blocked by the Democrats in the past.
I read the whole article and have no idea what this change really means. If Obama likes it then it can't be good. All of Congress supported it because it avoided big cuts to doctors who would dump medicare patients. Beyond that who knows what is in this bill.
First of all, Medicare is not an investment plan. It was never portrayed that way at inception or thereafter. The fact that people get three times more (in inflation adjusted dollars) then they put into the system means that Medicare is unsustainable. It will bankrupt the country if not reformed since 40% of all Medicare payments come from the General Fund and 75% of Medicare Part B and D payments come from the General Fund. Only 25% of the costs are paid by the premiums charged to retirees.
Unlike SS, there is no cap on the income levels for the HI portion of the payroll tax. In 1966 the HI rate was .350 each for employer and employee; today it is 1.450. 80% of Americans pay more in payroll taxes than they do in income tax.
If I am correct, those people who complain that the average senior is taking out more than he put in are mistaken. It is not only the next generation, but the seniors themselves who are being ripped off by the government. (What a surprise. /s)
Pure sophistry. Today's seniors and I am one, are getting far more out of Medicare than they put in and those costs will go up as the costs of new medical technology increases and people live longer. The problem is the unsustainability of the system. Today's seniors are enjoying benefits that there children and grandchildren won't. If Medicare is to be solvent, benefits must be cut or taxes increased or some combination thereof.
From the SS&Medicare 2014 Trustees Repport
"The Trustees project that the Medicare Hospital Insurance (HI) Trust Fund will be the next to face depletion after the DI Trust Fund. The projected date of HI Trust Fund depletion is 2030, four years later than projected in last year’s report. At that time dedicated revenues will be sufficient to pay 85 percent of HI costs. The Trustees project that the share of HI cost that can be financed with HI dedicated revenues will decline slowly to 75 percent in 2047, and will then stay about flat. HI non-interest income less HI expenditures is projected to be negative this year (as it has been in every year since 2008), and then turn positive for six years (2015-2020) before turning negative again in 2021.
Medicare is not an investment program. The government is not getting compound interest on your contributions, which do not belong to you. Medicare is a pay as you go system with today's workers paying for today's retirees. It has been running in the red since 2008 with more money being paid out than received in taxes.
Getting more than three times what you paid into the system in inflation adjusted dollars is a good deal. That will not be the case for our children and grandchildren. By 2030 Medicare will only be able to pay 85% of the costs having depleted its supply of non-market US T-bills aka IOUs. Benefits will, by law, have to be cut. SS is in a similar situation.
How many people would be investing the money if there was no Medicare? In 1966 the contribution for an individual for HI was .350. For those at the lower end of the economic ladder, they are getting far more than three times their contributions.
All I know about that is that the GOP has been trying to get that one for a while ... so now they’ve got it. However, I don’t know if it’s any good.
I understand that Medicare is not an investment program, but it is money that is taken from you that you “could” have invested had the government not taken it.
The fact that most people wouldn’t have the self control to actually invest the money if they were allowed to keep it shouldn’t be the deciding factor. By that reasoning, the government should just take all our money, since most people cant be trusted to spend it all correctly.
The point I was trying to make was to “pretend” that the funds we give to the government for Medicare are actually set aside in a long term CD that pays 5% interest by the government on our behalf, and that when needed we can draw funds from that account to pay for a certain amount of our medical bills.
*** I know that is not at all what the program actually is***
But, the point I was trying to make was that when you look at it that way the amount that we get back is more comparable to what we put in.
It was never portrayed that way by anyone. It is medical insurance.
But, the point I was trying to make was that when you look at it that way the amount that we get back is more comparable to what we put in.
No, it is not comparable. Today's seniors get back far more than they paid into the system. It is the reason why the system is bankrupting the country. I know many Freepers like to use this argument to rationalize that they actually have paid for or deserve these benefits. The truth is that our children and grandchildren are footing the bill. We are borrowing the money to pay the benefits for today's seniors--including me.
The changes in this new Medicare doc fix will add to the deficit and raise taxes on "wealthy" Americans. Medicare Part B is already means tested with five tiers of premiums based on income. This new bill increases the premiums on the wealthy. I see Medicare and SS heading towards means tested systems as a way to keep them solvent and to increase taxes on the so-called rich who will continue to see the definition of rich being changed. Eventually the welfare state is going to run out of other people's money.
That makes me think a little about my disagreement with a certain radio economic advisor who thinks it is wrong to get all your parents’ assets safe before Medicare can take them away.
On the surface, that seems to undercut my general assent to the “getting back what they paid in” argument you raise.
But it is not getting what I paid in, it is getting a return on my investment.
But then I have to wonder, how much would these hypothetical recipients have if they had invested that 55k steadily over their working lives?
Now, my figuring may have some issues, which I would like to have pointed out to me by anyone who can think this through more knowledgeably, but here is what I am thinking:
This is 55,000 put in total over the person’s working life, adjusted for inflation, etc, in 2010 dollars (note no wage gap assumed for male versus female!:)?
If I divide that 55k by 30 years then I have put in an average of 1833 per year, or 152.78 per month.
Going to moneychimp’s compound annual growth rate calculator yields a CAGR of 7.69 for the S&P 500 for the years 1980-2010, and an “average” return of 9.16.
Dave Ramsey’s Investment Calculator says that 152 a month for 30 years at 7% would yield over 184,000 - at 9% it would be 271K.
Now, if the individual worked for 40 years before retiring in 2010, the CAGR and “average” returns are lower (5.39 and 7.03 respectively), but the additional ten years of investment yield over 173K for the low figure, and 292K for the higher “average.”
In any of these scenarios, the taxpayer would have come out about the same at worst, and way ahead at best, to have invested that 55K in the market, with a lot more choice for how his health care was run.
Of course, my understanding of the figures may be completely off base, but given that the projected expenditures for men and women over the course of their remaining (future) lives is based on completely unknowable factors, it is probably at least as meaningful of an interpretation of what’s going on.
I also admit that hindsight calculations are irrelevant to making a past decision (forced) to invest in a government backed and guaranteed (maybe) insurance plan. On a certain level, the guarantee would be worth the lost possible income (if it were run by competent people), as no one wants to have uncertainty about their healthcare in their latter years. But we still have that uncertainty with Medicare and the ACA.
Further, if it is viewed as insurance, not an investment, no one pays a monthly premium their insurance company hoping “they will get back what they paid in,” they pay it knowing (hoping) that they will get back *more* than they paid in if there is a catastrophic occurrence in their lives. Otherwise they would simply save the money themselves, or not bother.
It is up to the actuaries at the insurance companies to determine the risk and likelihood of their product being needed. If they fail to make accurate predictions, they go under or get bailed out. If they are government, they print more money, or change the rules, or steal from the public at large or doctors in specific.
But any thoughtful person should have realized from the inception that Medicare was neither an investment nor an insurance program, but a forced Ponzi scheme with kickbacks and votes on the line for the enforcers.
We need to find a way to scrap it while honoring previously made payments, not kick the can further down the road.
Let me add another dimension to this.... If you are a doctor who knows you will have a non compliant patient who is a smoker, diabetic, alcoholic etc and you know that you only get paid if they follow the advice you give them that they have decided not to take for the last 40 years...why would you agree to take them on as a patient?
Sure thing Mr. Hyperbole! Your "cred" for establishing a military heroes firing squad is as applicable.
Glad you worship at the alter of your "benefits."
Well ... don’t think I’m about to crawl into a hole and die, just because of you ... LOL ...
No ... you will get rid of that patient. AND ... that means I am going to be quite the desired patient ... being a non-drinker, non-smoker (and not ever one), and not over-weight! I’ll have doctors fighting to get me ... :-) ...
The problem with that reasoning is that you put in $152.78 a month from the very beginning of joining the system. The contribution rates have changed over time. In 1966 the rate was .350 of income. In 1973 it was 1 percent. In 1981 it was 1.3% and from 1986 onwards it has been 1.450.
In any of these scenarios, the taxpayer would have come out about the same at worst, and way ahead at best, to have invested that 55K in the market, with a lot more choice for how his health care was run.
The reality is that the vast majority of the public does not have the fiscal discipline or the resources to put that sum of money aside for future healthcare costs. Also, under Mecicare, the spouse is eligible even if he/she never made any contributions.
Further, if it is viewed as insurance, not an investment, no one pays a monthly premium their insurance company hoping “they will get back what they paid in,” they pay it knowing (hoping) that they will get back *more* than they paid in if there is a catastrophic occurrence in their lives. Otherwise they would simply save the money themselves, or not bother.
In most cases. people buy insurance (auto, flood, wind, hail, etc.) hoping they never have to use it. Healthcare is different. They know they will use it. And 9 out of 10 Medicare recipients carry Medigap insurance to cover the costs Medicare doesn't.
Unfortunately. people have come to expect that their insurance should cover all costs. Government involvement has fueled that expectation. Healthcare insurance would be much cheaper if we had higher deductibles. Obamacare has raised deductibles, but it has also expanded covered services and taxpayer subsidies. And it has expanded the Medicaid rolls where all expenses are covered.
But any thoughtful person should have realized from the inception that Medicare was neither an investment nor an insurance program, but a forced Ponzi scheme with kickbacks and votes on the line for the enforcers. Medicare and SS are Ponzi schemes. You are making my point. Today's seniors are at the top of the pyramid. We get much more out than we contributed. Our children and grandchildren will not be as lucky. They will see reduced benefits and higher taxes.
We need to find a way to scrap it while honoring previously made payments, not kick the can further down the road.
Never happen. Medicare has become so embedded that there is no political will to change it. The politicians will have to come up with a solution that saves the system. There are some ways of doing it, but they are all painful to various constituencies. But something must be done or Medicare and SS will bankrupt the country consuming the entire federal budget. Right now, Medicare and SS consume 41% of the federal budget and it is growing as 10,000 baby boomers retire every day for the next 20 years,
Wow. Can you exaggerate much more? How about you suggest I wanted to torture puppies instead? I thought we were talking about entitlements and Congressional spending bills? Too bad your own self interest clouds your perspective this much, but that is really your problem.
That’s no exaggeration when you get to my age and there is any restriction on health care. That’s why Sarah Palin was talking about “DEATH PANELS” ... which caused other “naysayers” to laugh at her, too!
“Medicare along with Obamacare should be cut by 100% and the money should be returned directly to the taxpayers. So much money would be returned that the taxpayers could afford health care and have a huge pile of money left over.”
There’s only one way you would have a “huge pile” of money left over. If Mom, Dad, Granny or Auntie are still alive and old they will be unable to support themselves, house themselves, pay for their medicine and food along with the doctor’s care and hospital care they will undoubtedly need at their advanced age. That leaves you to take up where all those government programs left off. They’re your family.
The only way you could avoid that expense is to keep the money for yourself and withhold care so they would die. This generation seems to have no problem whatsoever with that solution.
However, when reality finally set in, they would all be screaming for the the government to do something, anything to absolve them of their guilt at watching Granny expire under their care and watching that “huge pile” of money they had saved by scratching Medicare and Social Security dwindle to nothing.
Or, maybe not. Maybe that wouldn’t happen until they became old, sick and dependent themselves. Better think about all the ways Medicare and Social Security benefit you in roundabout ways before you advocate their abolishment. Social Security and Medicare were meant to be “pay it forward” programs and they would have worked if greedy politicians hadn’t stolen the money in the very beginning. After that it was a huge “Check and Go” scheme.
Who takes care of your Granny, Mom and Dad? I hope they’re all rich.
This is why Senator Cruz opposed it: “While I appreciate the work done by my colleagues in the House, I cannot support the Boehner-Pelosi bill, which institutionalizes and expands Obamacare policies that harm patients and their doctors while adding roughly half a trillion dollars to our long-term debt within two decades,” Cruz said in a statement to National Journal.
http://www.nationaljournal.com/2016-elections/ted-cruz-will-oppose-house-s-medicare-reform-bill-20150414
“Maybe they should gut the law saying Medicare is not allowed to shop for drug prices, that would save some big $$$.”
But that would be really tough on Congress and lobbyists like Billy Tauzin because then they wouldn’t get their fat campaign payoffs from big pharma. The system is rigged against efficient operation that would save money and serve Americans. Too much corruption, cronyism and favoritism masquerading as a political ideology.
When did this happen???????
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