Health Care Spending: A Trillion Here, A Trillion There
billion here, a billion there. Pretty
soon, you’re talking about real money.
McKinley Dirksen (1896-1969), attributed
23, 2012 - Another
name for this post might be ,”Everett Dirksen Updated.” Senator Dirksen was
telling us billions of dollars of
government spending was real money. He was reminding us money spent from
top-down Washington sooner
or later had to be extracted from taxpayers, now about $50,000 of future debt
for every man, woman, and child. The
only difference between then, when Dirksen made his statement, and now, and
2024, when the Congressional
Business Office tells us Obamacare will have cost us $2.6 trillion, is that billions
of dollars have become trillions. Future taxpayers
will have to pay back these trillions out of their incomes, which will be
in the thousands
said President Obama in his second inaugural address, the trillions are
“The commitments we make to each other - through
Medicare, and Medicaid, and Social Security - these things do not sap our
initiative; they strengthen us. They do not make us a nation of takers; they
free us to take the risks that make this country great.”
When one accounts for inflation, I suppose Obama may be right. Anyway, the trillions will not become due
until after he leaves office in 2016, so why should he worry.
But in present,
three recent Op-Eds cause me to wonder.
Christopher Conover, “ Nate Silver Gets It! Health Care Drives
Increase in Government Spending,” Forbes, January 17, “CBO Projects Spending on
Health Care will account for the entire increase in the size of Government.”
Greg Scandlen, “The HIT Scam,” in Our Money, Our Health, Our Choice,”
writes, “Last week
John Goodman posted a brief blurb about the latest problems with Health
Information Technology (HIT). The issue deserves a little more attention
because it is an abject lesson of how health policy always fails these days.The
articles from the New York Times and the RAND Corporation indicate that HIT has
not lived up to expectations. Actually, it is quite a bit worse than that. The
RAND piece is a sort of mea culpa for an earlier RAND "study"
that predicted $81 billion in annual savings if we adopted HIT (the version I
have said $77 billion, but what's $4 billion between friends?) This RAND piece
was the main rationale for spending over $20 billion (in two years) on HIT, but
rather than saving money, HIT seems to have cost more money because it made it
easier to bill for more services, according to the Times. It may also be
creating more errors and inefficiencies in medical practice."
But policy makers will not fret. These comments will not bother President
Obama or the Washington elite. They can always blame those greedy health plans
and greedy doctors. Besides, they will
never mention or allow any talk about Medicare or Medicaid “cuts” or modifications. For them, it’s profligate government spending – or bust!
Of the doctors, says Doctor
Gottlieb,” To try and get a handle on rising costs, the Obama Administration
will start to go after the healthcare providers. The President seemed to hint
about all this when he referenced the need to 'lower the cost' of healthcare in
his inaugural address. Simply cutting payment rates has consequences, or
course. It reduces reimbursement without regard to value or need. But
indiscriminate cuts to fixed rate schedules for everything from doctor visits
to hospital stays are Washington’s standard approach for sanding down Medicare
costs. The Affordable Care Act will institutionalize these same political
tactics across the rest of the healthcare market. This is the next iteration of
healthcare reform. Call it Obamacare 2.0. Doctors will become the next bogyman
in Washington. The target is already being fixed to their hide. As for the rest
of us, our health insurance will become increasingly illusory."
Tweet: Washington health care spending is out of control,
and talk of its main cause, Medicare and Medicaid entitlements, is verboten among the cognesenti.
Scott Gottlieb, MD. “Obamacare Sticker Shock Is
January 23, " A California
insurance broker, who sells health plans to individuals and small businesses,
told me that she’s prepping her clients for a sticker shock. Her local carriers
are hinting to her that premiums may triple this fall, when the plans unveil
how they’ll billet the full brunt of Obamacare’s new regulations and mandates. California
is hardly alone. Around the country, insurers are fixing to raise rates by
double digits. They’re privately briefing politicians in Washington
on what’s in store.
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