“First, ObamaCare’s restraints amount to nothing more than ratcheting down the price controls that traditional Medicare uses to pay health care providers. Structuring Medicare subsidies in this way — setting the prices that Medicare pays specific providers — makes it very difficult to lower those prices, because the system itself creates huge incentives for providers to organize and lobby to undo those restraints. As I explain more fully in this op-ed from September 2010, Medicare vouchers would change that lobbying game by reducing the incentives for provider groups to expend resources in the pursuit of higher Medicare spending. That gives the Ryan-Rivlin restraints a much better shot at surviving.”
“The government’s chief actuary for Medicare spending on Wednesday said he had more confidence that Republican Paul Ryan’s plan to reform entitlements would drive down health-care costs than President Obama’s recently passed overhaul.”
“Two of the central promises of President Barack Obama’s health care overhaul law are unlikely to be fulfilled, Medicare’s independent economic expert told Congress on Wednesday.
The landmark legislation probably won’t hold costs down, and it won’t let everybody keep their current health insurance if they like it, Chief Actuary Richard Foster told the House Budget Committee.”
“Medicare Advantage (MA) plans are private insurance options available to Medicare beneficiaries. The Patient Protection and Affordable Care Act (PPACA) cuts deeply into the projected payments to MA plans. Millions of Medicare beneficiaries enrolled in MA plans, or who would have been enrolled if not for the cuts, will experience very substantial reductions in the value of health care services provided to them by the Medicare program.”
“The problem is that the board is prohibited by law from proposing real structural reforms. The only cuts it is allowed to make would be cutting providers’ reimbursements—including administrative costs and profit margins of Medicare Advantage plans, which are already slated for a payment freeze and future cuts under the new law.”
“Under the Patient Protection and Affordable Care Act (PPACA), Congress has enacted record-breaking Medicare payment reductions. Most of these are reductions in Medicare payment updates to non-physician providers. To a lesser degree, these reductions are attributable to certain health care delivery reforms. The Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS), the agency that administers the Medicare and Medicaid programs, estimates an initial 10-year savings from the total set of Medicare changes amounting to $575 billion.”
“If liberals and Democrats want to make the fight over Obamacare about taxes, spending, and the budget deficit, Republicans should allow them to do so. The public has already taken sides in this fight. Taxpaying Americans are never going to be convinced that the government has found a way to give away new benefits to millions of people, with no cost to them or anyone else.”
“In the congressional floor debate leading up to the repeal vote, Rep. Paul Ryan (R., Wis.) highlighted a point that has generally gone under the radar: The Congressional Budget Office (CBO) says that Obamacare would increase the national debt. The CBO writes that, by the end of 2019 alone, Obamacare ‘would amount to a net increase in federal deficits of $226 billion.’ Elsewhere, in a conclusion that only the truly credulous could accept, the CBO says that Obamacare would decrease deficits. But, as the CBO notes, that’s before ‘factoring in that the [Medicare Hospital Insurance] trust fund would hold more than $358 billion of additional government debt by the end of 2019 compared with its holdings under current law.'”
“The long-term care pharmacy lobby says a proposed regulation that aims to reduce waste would end up raising prices for the Medicare Part D prescription program and taxpayers with little benefit to show for it.”
“Regional variation in Medicare spending is not correlated with variation in non-Medicare spending, and variation in non-Medicare spending is associated with measures of disease burden and health status. The data indicate that something is deeply wrong not with the doctors or the patients but with Medicare’s payment system, service mix, and incentives.”