the Screws on Medicare
turn of the screw makes
a bad situation worse, especially in order to force someone to do something.
25, 2013 - The following paragraph in President
Obama’s inaugural speech is being interpreted by critics as Obama saying he will not allow Medicare, Medicaid,
or Social Security cuts. In the case of
Medicare, this may not be possible because Medicare is the main economic engine
driving the national debt towards possible national bankruptcy.
Obama’s position is ironic because Obamacare
already cuts Medicare by unprecedented, unreognized, and unacknowledged amounts.
Paragraph from Obama's Inaugural Address
“We, the people, still believe that every
citizen deserves a basic measure of security and dignity. We must make the hard
choices to reduce the cost of health care and the size of our deficit. But we
reject the belief that America must choose between caring for the generation
that built this country and investing in the generation that will build its
future. For we remember the lessons of our past, when twilight years were spent
in poverty, and parents of a child with a disability had nowhere to turn. We do
not believe that in this country, freedom is reserved for the lucky, or
happiness for the few. We recognize that no matter how responsibly we live our
lives, any one of us, at any time, may face a job loss, or a sudden illness, or
a home swept away in a terrible storm. 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.”
of Medicare Cuts
The critics may be right. Medicare cuts must be made
at some point or the program will go belly-up.
President should acknowledge this inevitability, and he should admit
that Medicare cuts on a massive scale are already underway under Obamacare.
Look at it
this way. The government spent $528
billion on Medicare in 2010. This will
rise to over $1 trillion in 2020. The
new health law cuts over $913 billion (During the campaign, the GOP claimed the
true amount was a modest $716 billion) from existing Medicare programs, at the
rate of over $ 90 billion a year over the next ten years as follows:
Medicare spending cuts, $458 billion
Medicare payment rate cuts, $196 billion
Medicare Advantage plan cuts, $136
Other Medicare/Medicaid cuts, $123 billion
Total Medicare Cuts =$913 billion
the Cuts Will Come From
These cuts come out of the hide of hospitals,
skilled nursing facilities, home health agencies, physicians, and other health
professionals serving Medicare patients.
These Medicare providers have several options – raises prices, cut
services, or refuse to accept Medicare patients. To makes these cuts stick and to regulate
prices charged, Congress has created the Independent Payment Advisory Board
(IPAB). The IPAB will consist of 15
unelected experts nominated by the President.
To overturn IPAB decisions, Congress must vote to do so by a
three-fifths majority, an unlikely outcome.
Republicans would like to end IPAB.
So would the pharmaceutical industry,
hospitals, and doctors.
Cuts Not Popular
To bring about new Medicare cuts will not be
easy. A recent poll indicates Americans
want to trim the federal deficit, but not anything related to Health care by
Health Insurance subsidies, 40%
Those polled were against raising the eligibility
age of Medicare from 65 to 67 (51%) and requiring all seniors to pay higher
Medicare premiums (95%). Instead they preferred to get a “better deal” from the
pharmaceutical industry for lower income seniors (85%) and asking high income
seniors to pay more (59%).
Americans like Medicare as it is, even at the risk
of future bankruptcy or having future generations pay more. Most Americans seem unaware that massive
Medicare cuts are already underway under Obamacare. President Obama’s position that no more
entitlement cuts should occur will be politically popular, but economically
60% of Americans do not favor Medicare cuts,
this salient fact, polls indicate no ifs, ands, or buts,
do people know, Medicare cuts are already in motion.
cuts are the main engine of the ACA’s locomotion.
Medicare cuts turn the Medicare screw by cutting its fiscal guts.
title of this post, “Turning the Screws on Medicare, “ is borrowed from the title
of Chapter 10, ObamaCare Survival Guide,
Humanix Books, 2013.
Agnes Carey, “Americans Want Deficit Addressed without Medicare Cuts,” Capsules KHM Blog, January 24, 2013.
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