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Medicare Meltdown
WSJ ^ | May 9, 2007 | THOMAS R. SAVING

Posted on 05/09/2007 5:01:08 AM PDT by Brilliant

What's going to happen when the money runs out for Medicare? A recently released report by the program's trustees found that within seven years Medicare taxes will fall short of Medicare expenses by more than 45%. What's more, Medicare and Social Security combined are on track to eat up the entire federal budget...

The projected cash flow deficits in these two programs are staggering. For Social Security, the trustees estimate the 75-year burden on general revenues at $6.7 trillion. For Medicare the comparable burden on general revenues is $24.2 trillion... Thus the total burden these programs will impose on federal finances over the next 75 years is $31.9 trillion...

Members of Congress will not have to wait long to experience the practical effects of all of this. Until a few years ago, Social Security and Medicare were taking in more than they spent... Thus they provided revenue for other federal programs. That situation is now reversed, and last year the combined deficits in the two programs claimed 5.3% of federal income tax revenues. In 15 years these two programs will require more than a fourth of income tax revenues...

Could we force the elderly to pay for future deficits with higher Medicare premiums? Monthly premiums in constant dollars would more than quadruple by 2020, and be almost 30 times their current level by 2080...

Using taxation to fund the projected Medicare shortfalls is equally unpalatable. We would need a 10% increase in all nonpayroll taxes by 2020 and a 50% increase by 2080...

So what else can be done? ...On the demand side, someone must choose between health care and other uses of money... On the supply side, the way health care is produced must fundamentally be changed, replacing cost-increasing innovations with cost-reducing ones...

(Excerpt) Read more at online.wsj.com ...


TOPICS: Business/Economy; Government
KEYWORDS: medicare; socialsecurity
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To: kabar
What do you do to about hospitial and medical equipment costs? Perscription drug costs? Nurses? Lab technicians? Hospital administrators?

Those things are for the most part already subject to free market forces. You can do a little bit to improve in those areas, like abolish the remaining vestiges of certificate of need legislation, etc. But for the most part, you're not going to be able to achieve a better allocation of resources by focusing on that.

The bottleneck is in the area of physician services and other healthcare technicians. When you've got a bottleneck like that, it forces a complete distortion of the allocation of all other resources. That's largely why you see what appears to be uneconomic use of resources in those other areas. You've got vast quantities of surplus equipment, for example, because a highly paid physician cannot simply stand around while an orderly runs down the hall to get the needed equipment from another wing of the hospital.

Also, I think you need to realize that you can't just look at the charges that the hospital puts on the bill to determine how much it costs to use a particular piece of equipment. The hospital charges $10 for a cotton ball. But that is just their way of allocating the cost of the operation on the bill. It doesn't mean they actually paid $10 for that cotton ball. If the insurance company told them that they could not charge $10 for a cotton ball, then they would rewrite the bill, and the $10 would be allocated to something else.

41 posted on 05/09/2007 6:16:55 AM PDT by Brilliant
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To: kabar

spoken like a true idiot


42 posted on 05/09/2007 6:18:23 AM PDT by stopem (God Bless the U.S.A the Troops who protect her, and their Commander In Chief !)
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To: Brilliant
“It costs them a fortune to produce those doctors. That is one reason that they must ration health care.” I’m sorry, that just makes no sense.

I trained in England for six months in 1989. It is a completely different system. Students take an aptitude test and apply for medical school. The government decides how many doctors need to be trained. From the time a student enters the system, at 18, he becomes a government employee for life, first as a student, then as a doctor. They finance this system through high taxes and they manage costs by rationing. It is pure socialism. At that time, I said "American's would never tolerate this kind of health care." Eighteen years later, I see that Americans are, in fact, tolerating many of the things that the British patients were going through back then. We actually have the worst of both systems. I am a capitalist. However, my view from the inside is that our system is broken beyond repair. It was killed by Medicare and trial lawyers.

It is bitterly hard for me to make this prediction, but here it is: One way or another, we will have socialized medicine, in the European model, within fifteen years.

43 posted on 05/09/2007 6:18:41 AM PDT by outofstyle
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To: listenhillary

If we did try to fix the medical system disaster by removing government from the equation, the politicians proposing the change would be skinned alive.

We are in the same position that Russia was in trying to shift from socialism to a private economy. It is horribly painful to learn to walk again after 40 years of inactivity. If given a choice, 90% would probably not be willing to sacrifice anything.

Pretty depressing.


44 posted on 05/09/2007 6:20:37 AM PDT by listenhillary (Democrats are sacrificing civilization for political power)
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To: Brilliant

Chickens are coming home to roost. Who would have thought a pyramid scheme would finally crumble.


45 posted on 05/09/2007 6:22:25 AM PDT by unixfox (The 13th Amendment Abolished Slavery, The 16th Amendment Reinstated It !)
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To: Extremely Extreme Extremist
... - if low-income people can afford take-out meals, cable television, beer and cigarettes, then they can afford to buy their own healthcare policy.

I was behind someone at the checkout counter at the supermarket yesterday. She had 3 separate transactions of 15 items each of baby food and diapers. She was paying for each with a state issued welfare check. It took the clerk 20 minutes to ring everything up. All that time, the mother was chatting away on her cell phone. She can afford a cell phone, but can't afford to feed her kid !!!

46 posted on 05/09/2007 6:23:36 AM PDT by TheCipher
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To: Brilliant
The only reason that our health care system is broken is due to the very simple fact that the tainted finger of government touched it. Nothing more...all market forces were removed...period.
47 posted on 05/09/2007 6:23:54 AM PDT by DH (The government writes no bill that does not line the pockets of special interests.)
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To: THEUPMAN
I know this sounds really harsh ... but .... it’s not my responsibility to provide for anyone but myself.

Along these lines, do not expect those like myself who are approaching retirement to roll over and play dead and not fight for some return on the money we poured into the system. In the case of my wife and myself, it is approaching a quarter of a million dollars over our working careers.

48 posted on 05/09/2007 6:25:21 AM PDT by abb (The Dinosaur Media: A One-Way Medium in a Two-Way World)
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To: DH

#44


49 posted on 05/09/2007 6:26:26 AM PDT by listenhillary (Democrats are sacrificing civilization for political power)
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To: Brilliant
The bottleneck is in the area of physician services and other healthcare technicians. When you've got a bottleneck like that, it forces a complete distortion of the allocation of all other resources. That's largely why you see what appears to be uneconomic use of resources in those other areas. You've got vast quantities of surplus equipment, for example, because a highly paid physician cannot simply stand around while an orderly runs down the hall to get the needed equipment from another wing of the hospital.

We already supplement our medical school graduates of around 17,000 a year with foreign trained doctors. Most of our major big city hospitals couldn't operate without them. We are also bringing in foreign trained nurses under J-1 visas. The problem isn't an overall shortage of doctors, but how they are distributed geographically and in what specialties.

The foreign born account for 25.2 percent of all physicians; 17 percent of nursing, psychiatric and home health aides; 15.8 percent of clinical laboratory technicians; 14.8 percent of pharmacists; and 11.5 percent of registered nurses.

Also, I think you need to realize that you can't just look at the charges that the hospital puts on the bill to determine how much it costs to use a particular piece of equipment. The hospital charges $10 for a cotton ball. But that is just their way of allocating the cost of the operation on the bill. It doesn't mean they actually paid $10 for that cotton ball. If the insurance company told them that they could not charge $10 for a cotton ball, then they would rewrite the bill, and the $10 would be allocated to something else.

You make my point. Hospital costs are a major portion of health care costs. More doctors are not going to reduce those costs, which are also inflated due to the requirment to treat the uninsured regardless of their ability to pay. Those costs are passed on to the consumers who can pay.

50 posted on 05/09/2007 6:28:39 AM PDT by kabar
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To: Biblebelter

No need to worry about Medicare for illegals. Medicare is only for those who have actually worked and contributed to the system. No the illegals get Medicaid—totally FREE healthcare.

People who work get to pay copays and only get about 70% covered.


51 posted on 05/09/2007 6:30:15 AM PDT by lone star annie
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To: Brilliant
What's going to happen when the money runs out for Medicare?

Euthanasia.

52 posted on 05/09/2007 6:32:17 AM PDT by Jim Noble (We don't need to know what Cho thought. We need to know what Librescu thought.)
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To: listenhillary
We are in the same position that Russia was in trying to shift from socialism to a private economy. It is horribly painful to learn to walk again after 40 years of inactivity. If given a choice, 90% would probably not be willing to sacrifice anything.

That is exactly correct. In fact, presently, American's experience many of the negative aspects of socialized health care, and many of them pay a premium for it.

53 posted on 05/09/2007 6:32:54 AM PDT by outofstyle
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To: outofstyle

I think you’re probably right about the system being socialized, but I don’t think it’s going to fix the problem.

In fact, I would say that a big reason why we have the problem is that there is a certain number of politicians who have deliberately sabotaged the existing system in order to force us to move toward a socialized system. You don’t “fix” something that works fine. So they broke it in order to give themselves an excuse for changing it.

You can be certain that once they reach their goal, the malpractice crisis will end. They will pass all kinds of laws restricting malpractice litigation, in order to make socialized medicine appear like a godsend. They won’t do it now, though, because it would divert them from their goal of socialized medicine, and instead demonstrate that we can have a viable healthcare system without socialism.

I don’t doubt that the bulk of what you say about the EU system is true. My point is just that if they’ve got to ration healthcare, then I don’t think that the government subsidies and government control have generated plenty of doctors. I would say it’s more accurate to say that despite the subsidies and government control, they still don’t have enough doctors.

That, however, is really not all that different from our situation.

The lefties continually blame capitalism and free markets for the mess in the healthcare sector. But the truth is that the healthcare sector is already the most heavily regulated sector. You can’t blame capitalism if you don’t have it. And we don’t really have it in that sector.


54 posted on 05/09/2007 6:33:09 AM PDT by Brilliant
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To: stopem
spoken like a true idiot

Your statemment that "SS and MCR should be offered to seniors only age 70+ that have a combined income under $45k is idiotic. It is just more wealth redistribution, which is part of the problem with the current system.

55 posted on 05/09/2007 6:33:10 AM PDT by kabar
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To: Jim Noble

Biodiesel


56 posted on 05/09/2007 6:33:10 AM PDT by listenhillary (Democrats are sacrificing civilization for political power)
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To: listenhillary

57 posted on 05/09/2007 6:36:55 AM PDT by abb (The Dinosaur Media: A One-Way Medium in a Two-Way World)
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To: Brilliant

How about a simple solution: end foreign aid first.


58 posted on 05/09/2007 6:38:17 AM PDT by Old_Mil (Duncan Hunter in 2008! A Veteran, A Patriot, A Reagan Republican... http://www.gohunter08.com/)
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To: abb
The solution may be as simple as returning the system to actuarial soundness. The problem is people are living too long compared to when it was begun. There is a retirement age that would restore the 16:1 ratio again. Whether that is politically possible, I cannot say.

I guess you could keep on raising the retirement age until no one could collect the benefits. SS is a Ponzi scheme. If we have 70 million people of retirement age by 2030, you would need 16 times that number of workers or 1.2 billion people in the US. The Census Bureau projects we will have 364 million by 2030 up from our current 301 million today. We have added 100 million since 1970, 53 million people since 1990, so we are well on our way to a billion early in next century, with most of the increase due to immigration, legal and illegal. It is a brave new world we are entering.

59 posted on 05/09/2007 6:39:41 AM PDT by kabar
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To: kabar

“The problem isn’t an overall shortage of doctors, but how they are distributed geographically and in what specialties.”

It may appear that is the problem. However, keep in mind that the geographical distribution is something that IS determined by the market still. If they are gravitating to certain markets, then it’s because the greater demand is there. To a lesser degree this is also true of the concentration in particular specialties, although, even in that area, there are regulatory restictions on who can practice in what area, so the market does not reign supreme.

My point is this: You can’t say that the market is misallocating resources geographically or by specialty. What’s happening is that there is an overall shortage, and physicians are crowding into the geographical and specialization segments that are the most rewarding, thus leaving the other segments of the market with an inadequate number of physicians. It again is the bottleneck problem. If there were more physicians, then there would be more physicians in all of the markets. When you have an overall shortage, certain segments of the market suffer more than others.


60 posted on 05/09/2007 6:40:55 AM PDT by Brilliant
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