Tag: Medicare

Categories
Accountability government transparency too much government

The Liability Behind the Curtain

Do not look at the liability behind that curtain! Or: Do not mention that we don’t know what the liabilities are.

Some things are too painful to report.

Apparently.

The folks who audit the Social Security Administration are late on a set of reports. The reports in question account for the financial and actuarial (un)soundness of Social Security, specifically on the (un)funded liabilities of the pension system and Medicare.

Unlike corporations, which are required to report to the IRS on March 15 each year, and individuals, who must report on April 15, there’s no set date for the trustees of our federal government’s biggest program to make its report. But in recent years the reports have been published early enough to allow summary by May. The last report summary we have is for 2009.

Why so late?

Could it be that things have gotten so bad that it’s difficult to figure out — and embarrassing to sign one’s name to — the actual financial situation? After all, this year Social Security ran out of money to write checks for its promised (and quite immediate) pay-outs.

Sheila Weinberg, CEO of the Institute for Truth in Accounting, writes that she heard the reports were late because “trustees wanted to include the effect the health care bill had on these liabilities.” Ms. Weinberg not unreasonably challenges this rationale. Wouldn’t Social Security’s liabilities have been worth knowing before Congress committed to more entitlement spending?

This is Common Sense. I’m Paul Jacob.

Categories
national politics & policies too much government

Sometimes a Great Prediction

Five years ago, I compared Social Security to the Titanic. Insolvency played the part of fatal iceberg. On Monday I noted that the first stage of insolvency —  projected back then to take place in 2017 — has been refigured to arrive early. This year.

So much for our leaders’ plan of “not putting off till tomorrow what can be put off a decade.” Decades sure aren’t what they used to be.

Neither are the budget numbers politicians throw around. Take the Democrats’ just-​passed medical reform package. Do you really believe it will save us money?

Who’s right depends on the reliability of the reform package’s cost projections. And, from what I can tell, those projections are filled with trickery. 

A typical sleight of hand is to project ten years in advance, and extoll how that decade’s first years don’t add much burden to the taxpayer. But that’s only because chunks of the programs stagger into effect over the first half of the decade.

But before you go poring over the bill’s two thousand and more pages, checking the  numbers, ask yourself: When have government economists correctly predicted costs of a major new entitlement? 

Never.

Take Medicare. Initial projections for catastrophic coverage were half of the real amount; Medicare as a whole grew nine times over its promised size; and the costs of Medicare’s Disproportionate Share Hospital Adjustment program proved 17 times higher than originally predicted.

Congress is in the business of making bad law, not good prophecy.

This is Common Sense. I’m Paul Jacob.

Categories
free trade & free markets too much government

A Doc Drops Out

Doctor Alan Dappen wasn’t going to take it any more. So he got out.

Eight years ago, he decided that his office would no longer accept Medicare payments. Why? As he tells his patients, “We can’t afford to.” Medicare won’t pay for consultations by phone or email, won’t cover the full cost of a house call, and “barely pays for an office visit.”

Then there’s the regulatory burden. Dappen can’t understand a lot of the regulations. Further, as far as he can tell the folks enforcing them don’t understand many of them either. Yet the bureaucrats can audit a doctor’s paperwork and impose huge fines based on these unclear regs.

Medicare-​mired physicians would be more effective if only they didn’t have to worry about complying with arbitrary regulatory dictates all the time. These rules make it harder for doctors to do their jobs. So Dr. Dappen took the risky but more satisfying path of operating in an unhampered market. And, of course, he invited his patients to join him.

Today, in the name of mandatory universal health coverage, the Obama administration wants even more restrictions on medical freedom. Shouldn’t we consider the consequences on the decision-​making ability of doctors and patients of current coercive micromanagement when assessing the viability of yet newer coercive schemes?

Dr. Dappen figures he is better off with freedom. You and I are too.

This is Common Sense. I’m Paul Jacob.

Categories
responsibility tax policy too much government

March to Bankruptcy

I have warned, before, about the upcoming double-​barrel crisis aimed at the U.S. financial system: The insolvency of the U.S. government itself, as entitlement debt can no longer be kept afloat by FICA withholding, and as Treasury debt can no longer be maintained on a monthly basis simply because it has grown too big.

Last week our entitlement system’s trustees said that the current recession is so undermining Medicare Part A that payments for elderly care will fail in eight years, with Social Security itself imploding in less than 28.

That is, if the economy doesn’t get worse.

Medicare Part B, covering doctors’ visits and outpatient care, and Part D, covering prescriptions, are right now insolvent, sucking money from general revenues.

This crisis rushes closer, even as our president insists on reforming health care in ways that will almost certainly add new entitlements — which will also have to be paid for. 

President Obama says that more government will do the opposite of what it’s done in the past. Until now, government involvement in medicine has increased costs and prices. Now he says what he’ll do will make for more “efficiency.”

Why do politicians believe in the magic of their new programs rather than the history of their old ones?

Why is it that, in politics, irresponsibility rises to the top? 

However you answer that, the march to bankruptcy is picking up pace.

This is Common Sense. I’m Paul Jacob.

Categories
free trade & free markets general freedom national politics & policies

The Freedom to Opt Out

A new administration is poised to take over, with medical care a high priority. There’s been lots of talk, lots of trust put on big government. Unfortunately, the doctors, hospitals, insurers and others that opposed HillaryCare, way back when, now jockey to get whatever benefits they can out of whatever new system that develops … which, jumping the gun, they consider a “done deal.”

And yet the simplest, most sensible bit of legislation about health care garners almost no attention.

Introduced by Representative Sam Johnson several months ago, the Medicare Beneficiary Freedom to Choose Act would allow seniors who go on Social Security to opt out of Medicare.

At present, when you retire with Social Security benefits, you are required — forced — to accept Medicare part A benefits. Doctors whom you hire for cash can be penalized.

Quite a system.

You might think anyone who’s for freedom of choice would support the bill.

You might think it uncontroversial, since it simply allows people who have saved money for their own medical care to continue to use that money.

It doesn’t affect anybody negatively. It doesn’t reduce Medicare taxes that anyone is forced to pay. It simply lets people who want to opt out of a bureaucratic system do just that.

And it would save the government money.

Oh, maybe now I get it. The name of the game is money, spending, and … regulation of our lives.

“Congress knows best.”

That is the very antithesis of Common Sense. I’m Paul Jacob.