Medicare, Medicaid, and Prescription Drug Benefits
York's swelling Medicaid rolls are helping bankrupt Brooklyn's biggest hospital. Life, death, newborns
entering the world, a CEO raking in millions, politicians calling for an investigation: all part of the drama swirling
around Maimonides Medical Center, which lost a staggering $145 million last year. It's Brooklyn's largest
hospital, and newly released financials show it barely has the cash to make it through another year. The
Maimonides calamity could be seen as a soap opera, if so many patients weren't affected. Worse, the same basic
story is being repeated at hospitals everywhere that treat the poor. Safety-net hospitals are bleeding red ink
because Medicaid, the government health-insurance program, shortchanges hospitals, paying them only 67 cents for every
dollar of care. Most hospitals shift the 33% in unmet costs to the privately insured patient down the hall.
But at safety-net hospitals like Maimonides, fewer than one in five patients has commercial insurance. These
hospitals have nowhere to shift their unmet costs. They lose money year after year. It's also happening at
Atlanta Medical Center, closing in November.
panel exploring loosening tele-health rules for Medicare recipients. Two years after the outbreak of COVID-19,
healthcare continues to re-imagine new methods to deliver service to patients. Legislators across the nation are
beginning to take notice by actively working to pass legislation to provide more care at a lower cost for various
patients. On May 26, the Senate Finance Committee introduced a discussion draft addressing new mental healthcare
initiative policies. Notably, a new feature includes a "Bill of Rights" that focuses on mental health service
delivery. In addition, the draft's Bill of Rights seeks to address the requirement of an in-person visit before
tele-health services may begin for Medicare patients. However, the law has been temporarily halted due to COVID-19.
Payments In New York Medicaid Program Just Shy Of $1 Billion. An audit released Tuesday [4/19/2022] by New York
State Comptroller Thomas DiNapoli found that the state's Medicaid program paid $965.1 million in claims over a five-year span
to medical professionals not enrolled in the health insurance program. The audit claimed that most of those errors took
place during the first three years of the review. The errors were tied to eMedNY, the claims processing system utilized
by the state Department of Health to handle Medicaid payments to providers. The system continued to pay claims to
providers not certified to care for Medicaid enrollees. Auditors found nearly $6 million in claims processed for
providers that had been debarred from New York's Medicaid program.
is about to rob Medicare to 'save' the Postal Service. In the business world, low-performance departments are
often audited, reformed, and — if they continue to under-perform — eliminated. It's one of the
many ways companies stay competitive — by eliminating dead weight to stay profitable and keep customers happy with
high-quality service and competitive prices. This week, the House is set to do the exact opposite. In typical
"kick the can down the road" action by our elected officials, a bipartisan group of politicians are shifting billions of
dollars in retirement costs from the U.S. Postal Service to Medicare. Supporters celebrate that USPS will remove
unaffordable retirement costs from its balance sheet, thus keeping itself solvent. What they've tried to hide is
Congress's sleight of hand, which will accelerate Medicare's projected 2026 bankruptcy.
Medicare 'free' at-home COVID virus test boondoggle. Medicare recipients at first were left out of the "free"
Covid tests that private insurers were required to provide. Well, now us old folks are included among those able to
grab 8 free tests per month. [...] With 8 tests per month x 12 months x 60 million people on Medicare, that's
up to 6 billion tests per year. At, say, $5 wholesale per test, that could be a cool $30 billion in annual
revenue for the companies making them. [...] Medicare will need to pay a higher amount per test based on whatever markup it
negotiates with the retail pharmacies. How much earlier will the program go broke?
the Feds Handcuff States to Medicaid. During the pandemic, the number of Americans enrolled in Medicaid
skyrocketed from 75 million to 90 million. The issue? Not everyone currently enrolled in Medicaid is
eligible. And the federal government is trying to prevent states from removing ineligible Americans from their
rolls. This costs the taxpayer serious money, explains Hayden DuBlois, deputy research director at the Foundation for
Government Accountability. "The reality is very, very disastrous for state and federal taxpayers alike, for the truly
needy who are kept waiting, for other budget priorities, which are now getting more and more crowded out by Medicaid as it's
just consuming so much of state budgets," DuBlois says. "So it's really snowballed into this crisis that is quickly
falling out of control."
Part B premiums for 2022 jump by 14.5% from this year, far above the estimated rise in cost. The standard
premium for Medicare's outpatient care coverage will jump by 14.5% for 2022, far outpacing an earlier estimate of 6.7%,
according to the government. The standard premium for Part B, which covers outpatient care and durable equipment, will
be $170.10 next year, up $21.60 from $148.50 this year, said a senior official for the Centers for Medicare & Medicaid
Services on Friday. The program's trustees had estimated this summer that the premium would rise to $158.50. The
deductible for Part B will be $233, up $30 (14.8%) from this year.
plan to bankrupt Medicare in a year. Democrats now plan to ruin Medicare to get us all on Medicaid as part of
their $3.5 trillion 'human infrastructure' bill. The plan is for Medicare to completely cover dental, vision, hearing
services, and more. They plan to give Medicare to younger people of age 60. Illegal aliens will receive it.
Democrats want to give it to people with lower incomes. Medicare is a program for the elderly and disabled.
Democrats will turn it into full-on welfare. It's part of their plan to make more people dependent on the central
government. "Democrats are ramming through a reckless new expansion of Medicare — just as it's a few years
from bankruptcy," said Rep. Kevin Brady, R-Texas, in prepared remarks at a House Ways and Means Committee session on
Thursday as debate began on portions of Democrats' massive legislative package. Economic illiterate Bernie Sanders has
come up with the plan. The plan to cover the cost is to tax the rich, who already pay most of the taxes. Everything
will be at the expense of the rich and there just aren't enough of them. The middle class will pay for it.
Do Doctors Go Along with COVID Panic Porn and CDC Prescriptions? [Scroll down] My group cared for
patients of all descriptions, with roughly half of them on Medicare and another batch on Medicaid. Both programs are
ultimately managed by the feds, one of the most humorless groups on the planet. They write a whole bunch of rules on
how you have to document everything you do. If you didn't document it correctly, it didn't happen, and you won't get
paid. But that's not the half of it. Suppose you have one of those patients brought in by the ambulance from
under the bridge. His only clothes are the ones he's wearing, and he doesn't have two nickels to rub together.
It's more than obvious that this surgery for bowel obstruction will be a charity case. Before Medicare, you'd simply
write it off as your good neighbor duty. Now you don't get a choice. CMMS (the actual administrative agency)
requires you to send a bill. Twice. Or maybe three times. Whatever it takes to turn the bill into bad
debt. Then you have to send it to a collection agency. Your only alternative is for your group to bring it up in
its Board meeting and declare it a write-off that gets noted in the minutes.
firm that donated big to Biden, Dems pays $90 million for allegedly bilking Medicare. A California health care
firm whose executives and employees donated big to Joe Biden and other Democrats has agreed to pay a $90 million civil
penalty to settle allegations it bilked Medicare by filing paperwork to make patients look sicker than they were. The
penalty was one of the largest ever reached in a case involving Medicare Part C fraud, government officials said.
Sutter Health, headquartered in Sacramento, Calif., agreed to pay the fine and enter into a corporate integrity monitoring
agreement with the government for five years to resolve allegations it violated the False Claims Act by knowingly submitting
inaccurate diagnosis codes for Medicare Advantage patients, the Justice Department announced Tuesday.
GOP demands answers over $87B in improper spending on entitlements. House Oversight and Reform Committee
Republicans sounded the alarm Tuesday about hundreds of billions of taxpayer dollars that have been improperly spent on one
of the government's largest and fastest-growing entitlement programs. Rep. James Comer, the top Republican on the
committee, sent a letter to the Centers for Medicare and Medicaid Services, which oversees Medicare and Medicaid, demanding
answers about "rampant [and] improper" Medicaid payments. Mr. Comer and the committee's other Republicans are
concerned that CMS' own data shows that more than $57 billion was spent on improper Medicaid payments in fiscal 2019 and
nearly $87 billion in fiscal 2020, accounting for one of every five Medicaid payments.
group sues government over information on $143 billion in improper Medicaid payments. The libertarian
organization Americans for Prosperity Foundation is suing the Centers for Medicare and Medicaid Services to find out what it
is doing about $143 billion in improper payments made by Medicaid. The complaint asks for records on CMS's efforts to
recover improper Medicaid payments and for data showing improper payment rates by states. According to CMS, improper
Medicaid payments totaled $143 billion in 2019 and 2020, rising from 14.9% of all payments in 2019 to 21.4% in 2020.
Medicaid is a joint federal-state healthcare program for the poor. "Failing to recover $143 billion in improper Medicaid
payments is an affront to hardworking American taxpayers and a threat to Medicaid's long-term fiscal stability," said Dean Clancy,
a senior health fellow at Americans for Prosperity Foundation. "More transparency and accountability is needed to ensure that
CMS manages Medicaid responsibly."
taxpayers to pay $1.3 billion to enroll more illegal immigrants in Medicaid. California taxpayers will soon pay
more in taxes to enroll more illegal immigrants in Medicaid, a plan that was part of a recently approved state budget.
Younger illegal immigrants are already enrolled in Medicaid, SNAP and other federally funded programs. The plan
proposed by California Democrats guarantees that low-income illegal immigrants older than age 50 will receive health
insurance. Coverage would take effect in 2022 and cost taxpayers $1.3 billion per year. It follows a
$213 billion taxpayer-funded plan proposed in 2019 to allow low-income illegal immigrants between the ages of 19 and 25 to
enroll in Medicaid. Democrats then estimated that adding 90,000 people to Medicaid would cost taxpayers $98 million
enrollment swells during the pandemic, reaching a new high. The number of Americans relying on Medicaid swelled
to an apparent all-time high during the coronavirus pandemic with nearly 74 million Americans covered through the safety-net
health insurance, new federal figures show. From February 2020 through January, Medicaid enrollment climbed nationwide
by 9.7 million, according to a report, based on the most recent available data, released Monday by the Centers for Medicare
and Medicaid Services. Some people signed up last year as the pandemic's economic fallout took away their jobs, income
and health benefits. But according to federal health officials and other Medicaid experts, much of the increase is
because of a rule change that was part of the first coronavirus relief law adopted by Congress last year.
Plan To Raid Medicare Shows His Callous Disregard For Math And Voters. [Scroll down] We've seen this
gimmick before. Obamacare raided Medicare, to the tune of $716 billion over a decade, to pay for that law's new
entitlements. Kathleen Sebelius, then the Secretary of Health and Human Services, infamously testified before Congress
that this $716 billion could "both" save Medicare while funding Obamacare. Only Washington politicians could claim with
a straight face to spend the same money twice. President Biden, who has spent the last half-century in Washington,
wants to do just that. His budget takes a page out of the Obama playbook, raising Medicare taxes while raiding those
additional funds from Medicare to pay for his Obamacare expansion.
accused making $800k-plus from health care fraud. The federal government is suing a local doctor to recover
more than $800,000 it says he was paid after fraudulently billing Medicare and Medicaid. In a civil complaint filed in
U.S. District Court in Greenbelt, the Department of Health and Human Services says it wants to recover $814,315 that
Dr. Abdul Fadul allegedly collected from the two programs through fraud. The complaint, which also names one of
his clinics, the Cardio Vascular Center in La Plata, as a defendant, says Fadul billed Medicare and Medicaid for procedures
that weren't performed thousands of times between 2004 and 2005. Fadul ran the scheme, the complaint says, by setting up
billing systems at the center that automatically rendered bills for more tests than a physician performed.
3 Ignores What Mature Adults Want from Their Healthcare System. Congress is once again tossing around a piece
of legislation that will do more for big government than for Americans. While intended to lower out-of-pocket costs for
prescription drugs and treatments, H.R. 3 could take away mature adults' ability to make their own healthcare decisions and
put it in the hands of the federal government. Government interference not only imposes on the patient-provider
relationship, but it also puts mature adults' health at risk by restricting what treatments should be at their finger
tips. Millions of retirees rely on the Medicare program because it provides access to various treatments for chronic
conditions, such as cancer, Rheumatoid Arthritis, and other serious illnesses, and the flexibility to personalize these
treatments based off their individual needs. However, by referencing foreign countries' prices and healthcare systems,
policymakers could import the same access issues patients abroad face, leaving Americans with fewer treatments to choose from.
Sues To Block 'Biden's Power Grab' To Strip State Of Medicaid Waiver. The Biden administration was slapped with
a lawsuit on Friday after Texas Attorney General Ken Paxton launched a suit countering changes to the state's federally
funded portion of Medicaid last month. In April, the administration rescinded a Trump-era eight-year extension to
provide billions of dollars in federal funds annually for Texas' uninsured residents, which was set to expire next
year. While the move does not revoke healthcare funding through 2022, Paxton called it an "unlawful abuse of power
aimed at sovereign states." "The Biden Administration cannot simply breach a contract and topple Texas's Medicaid
system without warning," he said in a Friday statement.
Medicare enrollees could get insulin for $35 a month. Many Medicare recipients could pay less for insulin next
year under a deal President Donald Trump announced Tuesday [5/26/2020] in a pivot to pocketbook issues important in
November's election. "I hope the seniors are going to remember it," Trump said at a Rose Garden ceremony, joined by
executives from insurance and drug companies, along with seniors and advocates for people with diabetes.
Department sues Anthem for alleged diagnosis fraud scheme totaling millions of dollars. The Justice Department
sued Anthem, one of the nation's largest health insurance providers, over an alleged fraudulent scheme to inflate diagnosis
numbers to scam Medicare out of millions of dollars a year. It is among the largest Medicare fraud lawsuits yet.
Investigators said that they filed this civil lawsuit because Anthem "falsely certified the accuracy of the diagnosis data it
submitted to the Centers for Medicare and Medicaid Services for risk-adjustment purposes under Medicare Part C and
knowingly failed to delete inaccurate diagnosis codes" between 2014 and 2018.
federal government issued $175 billion in 'improper payments' in 2019. Roughly $121 billion (69 percent) of the
waste was concentrated in just three programs: Medicaid ($57.4 billion), Medicare ($46.2 billion), and Earned Income
Tax Credit (EITC) ($17.4 billion). In other words, Medicaid accounted for more waste than all of the other government
programs (aside from Medicare and EITC) combined. This is another reason why it would be better to convert Medicaid into a
direct subsidy to those in need, much like food stamps, rather than funneling it through corrupt managed care. The rate of
improper payments for Medicaid accounts for a whopping 13.5 percent of the entire cost of the program, as compared to a
6 percent improper payment rate for the food stamp program. The same principle applies to the Children's Health
Insurance Program (CHIP), which is also funneled through the managed care cartel and racked up improper payments ($2.7 billion)
composing 15 percent of the program's budget.
Canadian-Style Health Care Would Not Cut Costs in America. One common claim by supporters of single-payer
health care is that it would ultimately save money while providing universal health coverage for all. Having one
centralized bureaucracy, they say, would eliminate complicated administrative inefficiencies that waste enormous sums of
money each year. As reported by Time, researchers behind a new study believe that by adopting Canada's single-payer
health care system, the United States would be able to save enough money to more than pay for universal coverage. This
is a bold claim, considering that the United States wastes so much money on health care administration despite, or perhaps
because of, Medicare being the largest single payer of national health expenditures.
Medicaid payments top $75B: More than entire food stamp program. $75 billion. That is not the cost of
Medicaid. That is merely the cost of improper payments from the Medicaid program, accounting for roughly 20 percent of
the total program tab, according Brian Blaze and Aaron Yelowitz writing in the Wall Street Journal. Prior to the Obamacare
expansion of Medicaid incentivizing states to flood their rolls with Medicaid recipients, the improper payments accounted for
roughly six percent. Now, just the official fraud and waste of Medicaid amount to more than the entire cost of the food
stamp program! In many ways, the entire Medicaid program is one big fraud perpetrated on the American taxpayer, designed
to serve as a cash cow for the insurance cartel and major hospital and health care administrator networks.
Elizabeth Warren Really Thought about Her Tax Plan? I have a friend with a chronic back problem that needed an
operation. She got a run-around from her Medicare program for years and finally paid $13,000 to have the operation done
privately. My parents were briefly resident in a Medicare nursing home. It was terrible, with demented people
wandering around screaming, etc. When they moved to a non-Medicare nursing home, the difference was between a zoo and a
4-star hotel. The cost was only marginally higher. However, doctors declined to visit the patients in the nursing
home because the reimbursement was extremely low under Medicare. If you go to a medical facility that mostly deals with
seniors, such as an eye clinic, you will find assembly-line medicine: long waits and brief visits to the doctor.
If you have a problem with a private insurance company, it is feasible to sue it, and the company fears that. If you
have a problem with Medicare, forget about it.
Biden: Warren's A Liar.
Democratic presidential candidate Joe Biden on Friday [11/1/2019] accused Sen. Elizabeth Warren (D., Mass.) of making up the numbers
for her recent Medicare for All cost estimate. Biden went on the attack after PBS host Judy Woodruff repeated the Warren campaign's
estimate that government run health care would only cost about $20 trillion. "She's making it up," Biden said. "She's
making it up. Look, nobody thinks it's $20 trillion. It's between $30 and 40 trillion dollars. Every
major independent study that's gone out there — that's taken a look at this, there's no way — even Bernie, who
talks about the need to raise middle class taxes — he can't even meet the cost of it."
people charged with defrauding Minnesota Medicaid program. Minnesota's attorney general's office says it has
charged 11 people with defrauding the state's Medicaid program of more than $800,000. Attorney General Keith Ellison
said in a statement Friday that the charges involve nine different cases. The announcement comes on the heels of an
investigation into a northern Minnesota care center that bilked Medicaid out of nearly $2.2 million. Among those
charged Friday were 33-year-old Kaldeq Yusuf, of Hopkins, and 39-year-old Abdifatah Ali, of Eagan, who owned and managed
Diversity Home Health Care, Inc.
Judge: Medicaid Must Pay for "Sex Change". If you're on Medicaid, the program won't cover your root canal or a
nose job that could make you feel better about yourself. But if you want the body alteration known as "gender-reassignment
surgery" so you can feel better about yourself, taxpayers must now foot the bill — according to an Obama-appointed judge.
Federal Department [is] Now Spending $100 Billion Per Month. For the first time in our nation's history, there
is now a federal department spending an average of more than $100 billion per month. No, it is not the Department of
Defense, which is charged with the core federal responsibility of defending us from foreign enemies. It is the Department
of Health and Human Services, which, if Democratic Sen. Bernie Sanders of Vermont has his way, will run the "Medicare for
All" program. As it now stands, HHS runs Medicare for many and Medicaid for more.
Are Democrats So Incredibly Ignorant About 'Medicare for All'? Ask Democrats whether they support "Medicare for
All" and the vast majority will say yes. Ask them what's actually in it, and most don't have a clue. That, at
least, is what a new survey shows. The Kaiser Family Foundation asked multiple questions about Medicare for All, and
broke down the findings by partisan affiliation. You'd expect that Democrats, who have been calling for single-payer
for decades, and now have two bills in Congress that would achieve it, would be the most well-informed of anyone. It
turns out, they are the worst informed.
Health Care Will Increase Fraud, Corruption. It seems fitting that the Democratic National Committee chose
Miami to host the first debates of the 2020 presidential campaign. Given that many of the candidates appearing on stage
have endorsed a single-payer health care plan, the debates' location epitomizes how government-run care will lead to a
massive increase in fraud and corruption. In South Florida, defrauding government health care programs doesn't just
qualify as a cottage industry — it's big business. In 2009, "60 Minutes" noted that Medicare fraud "has
pushed aside cocaine as the major criminal enterprise." One former fraudster admitted that likely thousands of businesses
in the Miami area alone were defrauding Medicare.
People To Work To Get Medicaid Went Really Well In Arkansas Until A Judge Stopped It. Since 2000, the number of
able-bodied adults using Medicaid quadrupled nationwide. The program is one of the chief costs for state governments,
squeezing other priorities. When last summer Arkansas became the first state to require Medicaid recipients to work in
exchange for taxpayer-provided health care, welfare advocates would have had you believing the world was ending: health
coverage for the needy was being slashed, the reporting process was too complex, and those who lost coverage didn't even know
about the requirement. On and on the hysteria went. But those apoplectic claims were far from reality.
Arkansas' work requirement was a big step towards restoring the state Medicaid program to its objective. It was saving
taxpayers money, freeing up resources for the truly needy, and — notably — changing people's lives for
Stupid Party. [Scroll down] Take, for example, their support for Alexandria Ocasio-Cortez' Green New
Deal and its promise of Medicare For All. Yes, as I've written previously, it's true that Medicare's trust
fund for hospital care will run out of money in 2026. And yes, according to the Medicare 2018 Annual Report, the trust
fund is already in the red for $4.5 trillion of unfunded obligations. And yes, that means Medicare is effectively
bankrupt even under the current situation in which it only covers senior citizens. And yes, yes, that means it's beyond
stupid to promise Medicare For All without even talking about how to fix Medicare For Seniors.
Medicare and Social Security Circling the Drain. Seven years, at most, is all we have. Remember the last
time Republicans tried to address the looming entitlement crisis? Do you recall how the Democrats responded? Did
they propose common-sense reforms? Raising the eligibility ages of recipients? Something, anything to attack the
imminent crisis? Uhm, no. You got it. They aired nonstop commericals of Paul Ryan — then
a key Republican helping George W. Bush try to reform these programs — pushing Granny off a cliff. Here's
the bottom line. This crisis is entirely on the Democrats' hands.
for All is a rotten deal for most. President Barack Obama made a stunning policy shift Friday, endorsing
Medicare for All — a single-payer health system for the nation. Most Democrats contending for the 2020
presidential nomination and many Dems vying for congressional seats this fall are backing it, too. Beware:
They're pulling a bait-and-switch. The phrase Medicare for All sounds as American as apple pie. A new Reuters
poll shows 70 percent of Americans respond to it favorably. Yet the public isn't getting the truth about what it
means. The actual plan these Democrats are pushing doesn't look anything like Medicare. They're slapping the
Medicare label on what will be dangerously inadequate health care.
Meddling in Kentucky Medicaid Causes Benefit Cuts. Before federal Judge James Boasberg vacated Kentucky HEALTH,
a Medicaid demonstration project approved by HHS in January and due to be launched on July 1, he should have taken the time
to learn about its benefits. State officials tried to tell him that non-medical vision and dental coverage were available
only through that project, and that these benefits would have to be cut if he struck it down. But the Obama-appointed
judicial hack was so intent on killing its "community engagement" provision that nearly half a million Kentucky residents
became collateral damage in the Democratic war against work.
The bad news on
entitlements piles up. The trustees for the Social Security and Medicare trust funds released their annual
reports last week. And the takeaway? Despite a strong economy, both programs have large and growing financial
deficits. Unfortunately, the gap between spending and revenue for these programs is likely even larger than the
official projections show because of assumed but unrealistic cuts in medical care payment rates and the persistently low
birth rates of recent years.
Broke But the Dems Want to Expand It. On Tuesday [6/5/2018] the Democrats received an unpleasant reality
check. The California primaries, which they believed would provide the impetus for a nationwide "blue wave" destined to
drown the GOP's congressional majorities, left them pathetically grateful not to be locked out of key races in November.
One of the rocks upon which their electoral fantasies foundered was their irresponsible support of Medicare-for-All, a
single-payer health care plan that would dramatically expand a government program that is already on the verge of
bankruptcy. The just-released Medicare Trustees report indicates that the traditional program for the elderly
will go broke in less than ten years.
Will Harm the Poor. Like all Democratic programs, it's about power and money. Obamacare incentivizes
expansion states to shift Medicaid's focus to able-bodied adults by paying over 90 percent of their coverage costs, while the
federal share of costs for traditional Medicaid patients remains below 60 percent. This does not mean, however, that
doctors and hospitals will receive more money. Providers will continue to be paid less by Medicaid than the cost of
treatment whether the patients are expansion or traditional enrollees. The extra money will go to political slush funds
and insurance companies.
Hampshire Becomes Fourth State to Require Work for Medicaid. New Hampshire became the fourth state to implement
work requirements — behind Arkansas, Indiana, and Kentucky. Under New Hampshire's waiver, able-bodied adults
without dependents aged 19 to 64 will have to complete 100 hours a month of employment, education, job skill training, or
community service to obtain Medicaid.
Trump Action Will Reduce
Immigrant Medicaid Enrollment. Many Americans are angry about the large percentage of their tax dollars being doled out
to immigrants in the form of public assistance, particularly at a time when federal budget deficits are skyrocketing. [...] Medicaid, for
example, costs the taxpayers $565 billion annually and, according to a widely cited 2017 report by the National Academies of Sciences,
Engineering and Medicine, 46 percent of immigrant households receive Medicaid benefits. The Trump administration is therefore
taking action to reduce the number of non-citizens who enroll in Medicaid.
Massive Medicaid Fraud. California is indeed the Golden State where Medicaid is concerned. The HHS Office
of Inspector General (OIG) has found that, by exploiting Obamacare's expansion of the program, California has enrolled
hundreds of thousands of ineligible adults in Medicaid. Consequently, the state has bilked the federal government out
of more than $1 billion in funding to which the state was not entitled. Indeed, these figures probably understate
the amount of money that California officials have fraudulently extracted from the taxpayers.
Extra' Delivers Socialized Medicine In Slow Motion. The Center for American Progress, one of the nation's most
influential left-wing think tanks, just released a plan to repeal Obamacare. Unfortunately, the proposal would replace
the law with something even worse — single-payer health care.
recipients find $1 premiums too confusing to pay. Imagine if you were poor and you got Medicaid, heavily
subsidized by the taxpayer, but you had to pay between $1 and $15 a month in premiums. Wouldn't that be confusing?
For many people, it is so confusing that they don't understand how to pay and end up being kicked off Medicaid.
York to guarantee Medicaid for 'Dreamers' no matter what happens in D.C.. New York will continue to provide
some illegal immigrant "Dreamers" with access to government-run Medicaid insurance no matter what happens in Washington,
Gov. Andrew Cuomo announced Tuesday [1/23/2018]. There are 42,000 people living in New York who are currently
protected by the Obama-era DACA deportation amnesty, which makes them eligible for Medicaid in the state. Mr. Cuomo
said given the uncertainty over the program in Washington, he wanted to guarantee the migrants health coverage.
more states ready to require jobs for Medicaid enrollees. Last week, Kentucky became the first state to require
work for some Medicaid beneficiaries. The Trump administration approved a proposal from Kentucky that would require
Medicaid beneficiaries to work, volunteer or take classes as a condition of being enrolled in the program. But the
state is unlikely to be the last. Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah, and
Wisconsin have submitted their own proposals, though some will have to work with federal officials to make sure their
requests fit the guidelines laid out Thursday [1/11/2018] by the Trump administration. States have varying requests,
according to a Washington Examiner review of Medicaid waiver applications filed to CMS.
Work Requirements Aren't Racist or Cruel. When the Centers for Medicare & Medicaid Services (CMS) announced
that states could experiment with work requirements and volunteer community service as prerequisites for Medicaid
eligibility, the melodramatic response from the Democrats and their media allies was as predictable as it was
mendacious. House Democratic Leader Nancy Pelosi summed up the position of her congressional accomplices by vehemently
denouncing the new CMS policy as "mean-spirited," "cynical," and "spiteful." And USA Today captured the gist of
the "news" coverage with a work of fiction titled, "Medicaid work requirements are a throwback to rejected racial stereotypes."
to add Medicaid work requirement; first state to follow Trump plan. Kentucky received the green light Friday [1/12/2018] to
require many of its Medicaid recipients to work in order to receive coverage. The Bluegrass State thus becomes the first state to
act on the Trump administration's unprecedented change that could affect millions of low-income people receiving benefits. Under
the new rule, adults age 19 to 64 must complete 80 hours of "community engagement" per month to keep their care. That
includes working a job, going to school, taking a job-training course or volunteering.
home health care industry rife with fraud, tainted by unscrupulous physicians. For adults hobbled by disability
or disease who want to stay out of nursing homes or hospitals, home health care services can be a godsend. For
criminals who want to tap into federal Medicare dollars, it can represent a loosely guarded bank vault. A Tribune
investigation reveals that Illinois public health regulators proved unprepared for a surge in new home health care companies,
doling out too many home health licenses too fast and failing to provide meaningful oversight. Even today, most anyone
can own a home health care business for a $25 license fee — no criminal background check required.
sentenced to prison for $17.1 million in Medicare fraud. A Fort Bend nurse was sentenced Wednesday [11/27/2017]
to 10 years in prison for his role in a Medicare fraud scheme that deprived the government of $17.1 million over seven
years. Eric Ugorji, a registered nurse who relocated to the U.S. from Nigeria 25 years ago, made a lengthy statement to
U.S. District Judge David Hittner expressing remorse for his actions and begging the court's mercy. "I was a good nurse and
I made terrible, bad business mistakes," said Ugorji, who is 48. "Your honor, I didn't intend to defraud Medicare."
The Editor says...
How does someone end up with $17 million unintentionally?
Maine, Medicaid, and
the Gruber Principle. Maine experimented with Medicaid expansion 15 years ago, and it took the state a decade
to recover from the hangover. Nonetheless, a majority of Maine's voters approved another Medicaid expansion last Tuesday.
And it is no exaggeration to say that it took Maine 10 years to recover from its last Medicaid expansion. That debacle,
initiated in 2002 by former Governor Angus King — who has since fled to D.C. where he now "serves" as a U.S.
Senator — damaged Maine's finances so badly that there was no money to pay hospitals for services rendered to
Medicaid patients. It wasn't until 2013 that the state was able to pay off that debt, whereupon Obamacare advocates
began pimping expansion again.
Innovation Should Be Based On Competition And Choice. The negative human impact and economic costs of unchecked
expansion of Medicaid is becoming clear, and state leaders are now left grappling with increased costs, finite resources and
hard decisions. One such state is Massachusetts, where the state's previous governor, Deval Patrick, greatly expanded
Medicaid eligibility, seemingly without regard to what future elected officials, like current Gov. Charlie Baker, would
now be forced to confront. Gov. Baker is right to try to fix the problem, but increasing competition and choice
for patients is the only approach that will work. In Massachusetts, enrollment for Medicaid and the Children's Health
Insurance Program has increased by more than 350,000 people since Gov. Patrick ushered in expansion of the programs
following the passage of ObamaCare, and the state is now forced to cover 1.6 million individuals. As the number
of covered individuals and benefits afforded them have increased, obviously so have the costs.
for All Would 'Bankrupt the Nation,' Warns Bernie Sanders — In 1987. Sen. Bernie Sanders
(I-Vt.) introduced new legislation yesterday [9/13/2017] to expand Medicare to everyone in the United States. The bill,
which came with 15 Democratic co-sponsors, envisions universal coverage, paid for by tax increases, that would be far more
generous than what is offered by any other first-world government-run health care system offers. Notably absent from
Sanders' proposed single-payer system was a detailed plan to pay for it. The senator said he would lay out the tax
hikes necessary to fund his new system in separate legislation. That may be because enthusiasm for single payer tends
to die down pretty quickly once people get a sense of what sort of tax increases would be necessary to fund it. An
Urban Institute analysis of a previous version of Sanders' plan estimated that it would cost $32 trillion over a decade.
Sure You Want Medicare for All? In 2001, the Congressional Budget Office warned that spending on
retirees — specifically Social Security and Medicare — "will consume... almost as much of the economic
output in 2030 as does the entire federal government today." "Notwithstanding recent favorable developments," the
Medicare Trustees conceded in their report this year, "current-law projections indicate that Medicare still faces a substantial
financial shortfall that will need to be addressed with further legislation." The report foresees that "the trust fund
becomes depleted in 2029." In actual dollar amounts, says Michael D. Tanner of the Cato Institute, "Medicare faces
unfunded liabilities approaching $48 trillion. And, if we return to double digit health care inflation, we could see
Medicare's liabilities swell to more than $88 trillion." This is the regular Medicare system that we have now, targeted
at the growing but limited population of retirees. Medicare for All would take this existing system's promises, costs,
and unfunded liabilities, and apply them to the whole country.
Security And Medicare Are In Worse Shape Than You Think. The Social Security report finds that the "trust fund"
will run out of money in just 17 years. The news only gets worse from there. The program's unfunded liability
over the next 75 years is now $12.5 trillion, which is up from $11.4 trillion last year and $4.7 trillion a
decade ago. In other words, Social Security's long-term unfunded liability has increased by 166% in the span of 10 years.
Great American Rip-Off. Ask a politician how he wants to balance the budget and, nine times out of ten, he'll
give you a politician's answer: cutting "waste, fraud, and abuse." Normally, the correct response to this is contempt and
mockery: What drives federal spending isn't office supplies walking out the back door with a rogue secretary at the Merit
Systems Protection Board — what drives federal spending is Social Security, Medicare, and Medicaid. And you know
where there's a lot of waste, fraud, and abuse? Social Security, Medicare, and Medicaid. Identifying small-ball
efficiencies at obscure federal agencies would not do very much to get federal spending under control, but getting a grip on
the shenanigans that plague the major entitlements — especially the health-care entitlements — could
mean substantial savings, "substantial" here meaning hundreds of billions of dollars.
Obamacare Is Killing People. Opiate deaths have been
on the steady increase, with fatal drug overdoses tripling since 1999. Much of that growth has come in the last few years. From 2010 to 2015,
the opiate death rate in the U.S. increased from 12.3 per 100,000 population in 2010 to 16.3 in 2015, according to a study by the Centers for Disease
Control. Of the 52,404 fatal US drug overdoses in 2015, 63 percent of them involved an opioid. Obamacare's Medicaid expansion and
individual insurance exchanges both went into effect in 2014. In just the next year, the fatal opioid overdose rate increased by 15.6 percent,
CDC found. Correlation, of course, is not causation, but the pattern is persistent. The increase isn't uniform. It's clearly happening
in 30 states, most of which accepted the Medicaid expansion. But overdose deaths have remained steady in 19 other states, according to the CDC.
Robs Medicare of $716 Billion to Fund Itself. [Scroll down] In total, Obamacare raids Medicare by $716 billion
from 2013 to 2022. Despite Medicare facing a 75-year unfunded obligation of $37 trillion, Obamacare uses the savings from
the cuts to pay for other provisions in Obamacare, not to help shore up Medicare's finances. The impact of these cuts
will be detrimental to seniors' access to care. The Medicare trustees 2012 report concludes that these lower Medicare payment
rates will cause an estimated 15 percent of hospitals, skilled nursing facilities, and home health agencies to operate at a loss
by 2019, 25 percent to operate at a loss in 2030, and 40 percent by 2050. Operating at a loss means these facilities are
likely to cut back their services to Medicare patients or close their doors, making it more difficult for seniors to access these services.
Enrolled in Medicaid/CHIP. As of April, there were 74,531,002 people enrolled in Medicaid and the Children's
Health Insurance Program as of April, according to the latest data released by the Centers for Medicare and Medicaid
Services. That is up 16,705,235 in the 49 states that reported their Medicaid/CHIP enrollment numbers for both the
July-to-September period of 2013 (the last quarter before the Obamacare exchanges opened) and this April. The
74,531,002 enrolled in Medicaid/CHIP as of April includes the numbers for all 50 states and the District of Columbia.
Can't Stop These Medicaid Reforms From Happening. Trump's budget called for reforms of Medicaid, food stamps and other
entitlement programs with a goal of moving as many as possible out of these government programs and toward jobs and self-reliance.
Chief among the changes is a push to add work requirements to able-bodied adults as a condition of getting benefits.
Blows $109 Billion on Promotional "Demonstrations". Medicaid is administered by states and is jointly funded by
the federal government and states. Millions of low-income adults, children, pregnant women and people with disabilities
are covered under the program, which cost American taxpayers an eye-popping $545.1 billion in 2015, according to government
figures. A little-known section of the Social Security Act gives the Secretary of Health and Human Services (HHS)
authority to approve experimental, pilot or demonstration projects that promote the objectives of Medicaid and its
counterpart, the Children's Health Insurance Program (CHIP), as if they really need to be further publicized. The
purpose of the demonstrations, according to the Social Security Act, is to expand eligibility to individuals who are not
otherwise Medicaid or CHIP eligible, provide services not typically covered by Medicaid and use innovative service delivery
systems that improve care, increase efficiency and reduce costs. Ultimately, the goal is to increase and strengthen
states' overall coverage of low-income individuals, enhance access to provider networks that serve low-income populations and
boost the efficiency and quality of medical care through "initiatives" that "transform service delivery networks."
This could mean anything.
Hard Truths about Health
Care. Medicare is not a success. [...] Medicare is undoubtedly popular, especially with its beneficiaries. It should be.
The average two-earner couple pays about $150,000 over their lifetime in Medicare taxes and premiums, while collecting almost $450,000 in benefits.
Jackpot! But that disparity is one of the reasons why Medicare is running some $58 trillion in the red, after totaling all projected future
liabilities. A program facing more long-term debt than most countries probably isn't begging to be expanded.
24 States, 50% or More of Babies Born on Medicaid; New Mexico Leads Nation With 72%. In 24 of the nation's 50
states at least half of the babies born during the latest year on record had their births paid for by Medicaid, according to
the Kaiser Family Foundation. New Mexico led all states with 72 percent of the babies born there in 2015 having their
births covered by Medicaid. Arkansas ranked second with 67 percent; Louisiana ranked third with 65 percent; and three
states — Mississippi, Nevada and Wisconsin — tied for fourth place with 64 percent of babies born there
covered by Medicaid. New Hampshire earned the distinction of having the smallest percentage of babies born on Medicaid.
In that state, Medicaid paid for the births of only 27 percent of the babies born in 2015.
Take Obamacare repeal/replace one step further. With many people today wanting Republicans to keep their
promise to repeal and replace Obamacare, one seniors group is making an additional request. Besides pushing for end of
the so-called "Affordable Care Act," 60 Plus Association also wants Republicans to keep their promise and restore money cut
from Medicare. "They took funds out of the Medicare program to pay for Obamacare," 60 Plus Association Chairman Jim
Martin asserts. "Who got hurt by that? ... Senior citizens." Martin pointed out that many hospitals in rural America
have closed in recent years — due, in part, to the cuts to Medicare.
judge blocks Texas' move to kick Planned Parenthood out of Medicaid. A federal judge on Tuesday [2/21/2017]
said Texas can't remove Planned Parenthood from Medicaid, issuing a temporary block of the state's ouster that will allow the
provider to continue to care for patients through the program. U.S. District Court Judge Sam Sparks issued a preliminary
injunction and said the state didn't have grounds to conclude that Planned Parenthood "warranted termination from the Medicaid
program as unqualified." His temporary block will stay in place until a full trial is scheduled, argued and decided.
Study Finds Medicaid Has
No Effect on Measured Health Outcomes. A randomized-controlled study
published in the New England Journal of Medicine by a group of the nation's top
health policy scholars has found that Medicaid has no measurable effect on any of the
objectively measured physical health outcomes the study examined. In its second-year
results, the Oregon Health Insurance Experiment, which randomly selected 10,000 people in
Oregon to get Medicaid (only about 6,300 actually got the benefit), and then compared them
with a randomly selected control group, found that those who got Medicaid did not on average
have healthier blood pressure, cholesterol levels, or diabetic blood pressure control than
those who did not get Medicaid.
failed to recover up to $125 million in overpayments, records show. Six years ago, federal health officials
were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage
insurance plans that allegedly overcharged the government for medical services. An initial round of audits found that
Medicare had potentially overpaid five of the health plans $128 million in 2007 alone, according to confidential government
documents released recently in response to a public records request and lawsuit. But officials never recovered most of
that money. Under intense pressure from the health insurance industry, the Centers for Medicare and Medicaid Services
quietly backed off their repayment demands and settled the audits in 2012 for just under $3.4 million —
shortchanging taxpayers by up to $125 million in possible overcharges just for 2007. The centers are part of
the Department of Health and Human Services.
isn't actually going bankrupt. New medical findings give plenty of reason for optimism about the cost of caring for
the elderly. Medicare spending on end-of-life care is dropping rapidly, down from 19 percent to 13 percent
of the Medicare budget since 2000. Living to a ripe old age shouldn't be treated like it's a problem. It's a
bargain. Someone who lives to 97 consumes only about half as much end-of-life care as someone who dies at 68.
firm fined over taxpayer-funded birth care for illegals. A major Obamacare provider has been fined more than a
half billion dollars for using bribes to cash in on illegal immigrant mothers who get taxpayer-funded Medicaid birth
services, according to the Justice Department. Dallas-based Tenet Healthcare agreed to pay $513 million in the bribery
scandal. According to Justice, Tenet and two subsidiaries paid Hispanic health care providers to refer pregnancy cases to
their hospitals, where they could run up the Medicaid tab by calling the maternity cases emergencies
Nasty Surprise for Seniors. On March 23, 2010, when President Obama signed the Affordable Care Act he signed into
law a bill that wiped out more than $50 trillion in Medicare's unfunded liability. That's not a misprint. That's
trillion with a "t". The savings are almost three times the size of our entire economy. But ObamaCare is supposed to
be about insuring the uninsured. It's about health insurance exchanges and the expansion of Medicaid. What has that
got to [do] with the elderly and the disabled? A lot, it turns out. One of the most important sources of funds
that are being used to pay for ObamaCare comes from cuts in future Medicare spending.
busts largest Medicare fraud in history. Using "data driven" law enforcement techniques, the Department of
Justice has busted the largest Medicare fraud case in history. More than a billion dollars in fraudulent Medicare
claims over a decade were filed by a Miami-based health care provider.
Clinton Destroys Medicare.
Hillary Clinton is taking a sledgehammer to Medicare. In a move calculated to fire up the extreme left wing of the
Democratic Party, presidential candidate Hillary Clinton pledges to open Medicare to people 55 to 64, and make a "public
option" insurance plan for all ages. The 65-and-overs are already having a hard time finding a doctor willing to accept
Medicare's stingy payments. Clinton's proposals will suddenly invite in millions more patients competing for the same
doctors. Seniors, brace yourselves for long waits to see a doctor.
Parenthood Caught Engaging in $28 Million in Medicaid Fraud Loses Bid to Stop Lawsuit. Just one Planned
Parenthood affiliate in Iowa allegedly committed $28 million in medicaid fraud. And now a federal appeals court has
ruled that it can't stop the lawsuit a former Planned Parenthood clinic director filed against it. Former Planned
Parenthood clinic director Sue Thayer filed the lawsuit against the abortion giant's Iowa affiliate accusing it of submitting
"repeated false, fraudulent, and/or ineligible claims for reimbursements" to Medicaid and failing to meet acceptable
standards of medical practice. Alliance Defending Freedom filed the suit for Thayer in March 2011. The lawsuit
claims that Planned Parenthood's Iowa affiliate submitted "repeated false, fraudulent, and/or ineligible claims for
reimbursements" to Medicaid and failed to meet acceptable standards of medical practice.
Hundreds arrested for
$900 million worth of health care fraud. The Justice Department announced Wednesday [6/22/2016] it's charging hundreds
of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars. It's the largest
takedown in history — both in terms of the number of people charged and the loss amount, according to the Justice
Department. The majority of the cases being prosecuted involve separate fraudulent billings to Medicare, Medicaid or
both for treatments that were never provided.
Justice Dept unveils
'largest takedown ever' to combat Medicare fraud. U.S. law enforcement officials have charged 301 suspects with
trying to defraud Medicare and other federal insurance programs in 2016, marking the "largest takedown" involving health care
fraud allegations, the Justice Department said on Wednesday [6/22/2016]. The national sweep resulted in charges against
doctors, nurses, pharmacists and physical therapists accused of fraud that cost the government $900 million, the department
said. The cases involved an array of charges, including conspiracy to commit health care fraud, money laundering and
violations of an anti-kickback law.
Obama is gutting Medicare.
The American Journal of Public Health reports that a man turning 65 can expect to live almost five years longer than he would
have in 1970 — and almost all of it in good health. What a priceless gift. A gift Obama is snatching
away. The president's Medicare reforms make it harder for seniors to get joint replacements. His new payment
rules shortchange doctors, discouraging them from accepting Medicare in the first place. New ER rules clobber seniors
with bills for "observation care." Under ObamaCare, hospitals get bonuses for spending less per senior, despite having higher
death rates and infection rates.
fast lane to rationed care. When the Obama administration first proposed its massive overhaul of the nation's
healthcare system, opponents raised concerns that government officials would be making decisions about healthcare not on the
basis of a patient's needs, but based on bureaucratic spending limits and one-size-fits all political decrees. Critics
were especially alarmed over a provision in the Affordable Care Act that creates an agency called the Independent Payment
Advisory Board and charges it with limiting the growth of Medicare spending. The board will set the payment rates
healthcare providers will receive for treatments and services of Medicaid patients.
to hospitals: Perform 'sex-change' operations or lose federal funding. President Obama's Department of
Health and Human Services implemented a rule change to the Affordable Care Act (a.k.a. Obamacare) last week mandating
that all health providers receiving taxpayer dollars must perform sex-change operations or lose their federal funding.
The final rule states that, under Title IX, any hospital receiving funding from HHS must "treat individuals consistent with
their gender identity." The rule provides no religious exemption. In other words, religious hospitals that receive
taxpayer dollars via Medicaid or Medicare will be required to perform sex-change operations or get cut off financially.
The rule change is not the only directive from the Obama administration forcing individuals to embrace the transgender agenda.
Latest Executive Overreach Is in Medicare. The Obama administration has proposed regulatory changes in payment
for Medicare Part B drugs. They're looking to impose a broad, multi-year change through a demonstration project.
Medicare demonstrations routinely test payment or delivery models in pilot programs, make a report to Congress, and the
lawmakers either enact or reject the model as a statutory basis for Medicare payment. But Obama's proposal goes well
beyond a normal pilot program, testing to see what does and doesn't work among a relatively small, randomly selected, group
Medicare Cuts Killing
Seniors. President Obama's Medicare cuts are killing seniors. His health law changed Medicare, adding
bonuses for hospitals that spend the least per senior. The result? Hundreds of hospitals are skimping on care to
win bonuses. Seniors at these hospitals aren't getting the right antibiotic or other treatments they need.
They're dying from pneumonia, heart attacks and heart failure at higher rates than patients in other hospitals that provide
Health Care Regulators Are In A Last-Minute Frenzy To Do More Damage. [Scroll down] As the article
explains, ObamaCare created a little-known agency called the Center for Medicare and Medicaid Innovation with the mission of
testing "innovative payment and service delivery models to reduce program expenditures." [...] Just last month, the center
ordered almost 800 hospitals in 67 regions to accept bundled payments for knee and hip replacements. If the total cost
of a procedure — including follow-up physical therapy outside the hospital — exceeds a certain cap, these
hospitals face a penalty. If the bill comes in below the cap, they get a bonus. But these bundled payment schemes
have a very checkered history, and the new one is likely to force hospitals to scrimp on follow-up treatments, since doing
anything more than sending patients home will likely push costs over the cap.
expansion costs top $7.5 billion. Ohio Medicaid expansion costs sailed farther past Gov. John Kasich's
projections in March, as total spending on the program topped the $7.5 billion mark. Expansion cost $411 million
last month, making March the most expensive month yet. For the past six months, expansion costs reported by the Ohio
Department of Medicaid averaged $394 million — dwarfing other state programs. Kasich's budget office
reported $312 million in primary and secondary education expenditures, $186 million in higher education expenditures,
and $170 million in justice and public protection expenditures in March.
Donors Plead Guilty to $33 Million Medicare Fraud Scheme. Five individuals who have donated to Democratic
politicians pleaded guilty to a scheme that drained Medicare out of $33 million dollars. Two physicians and three
owners of hospice and home care companies based out of Detroit, Mich., were charged on June 18, 2015 as part of the largest
Medicare fraud case in history for submitting fraudulent claims for home health care and hospice services that were either
not provided or deemed medically unnecessary. The elaborate operation revolved around Muhammad Tariq, Shahid Tahir, and
Manawar Javed — the owners of the home health care and hospice companies — paying kickbacks and bribes
to physicians for referrals to their companies that included A Plus Hospice and Palliative Care, At Home Hospice, and
At Home Network Inc.
Enrolled in Medicaid and CHIP; Up 14,478,342 Since Obamacare Exchanges Opened; 1 for Every 2 Americans With a Job. As of
the end of 2015, there were 71,777,758 individual in the United States enrolled in Medicaid or the Children's Health Insurance Program
(CHIP), according to data published by the federal Centers for Medicare and Medicaid Services. The 71,777,758 people enrolled in
Medicaid and CHIP as of December, according to CMS, was an increase of 14,478,342 from the average monthly enrollment of 56,274,369 in
the period of July through September 2013, just before the "State-Based Marketplaces" opened in October 2013 under the terms of the
Affordable Care Act (AKA Obamacare). That means overall Medicaid and CHIP enrollment has increased 25.7 percent since the
Obamacare marketplaces opened.
The Obama Republican:
John Kasich's Medicaid expansion is a $7 billion disaster. Ohio Gov. John Kasich's expansion of Medicaid under the 2010
federal health law has cost taxpayers $7 billion in a little more than two years. The federal government — which
is $19 trillion in debt — paid $390 million for Ohio Medicaid expansion benefits in February, bringing the program's
total cost since January 2014 to $7.1 billion. Kasich frames his Obamacare expansion as a fiscally responsible way to keep
drug addicts and the mentally ill out of prison, even as costs zoom past his projections. The expansion was $1.5 billion over
budget after 18 months.
Sanders' Medicare-For-All Plan Has Even Liberals Crying Foul. [As Bernie] Sanders has gained traction with an
increasingly out-of-the-mainstream Democratic Party, more grounded liberals among them have started to publicly denounce his
plans, particularly his "Medicare for all" plan, as wildly unrealistic. How unrealistic? Just look at the details
of his health plan. First, he would abolish all private health insurance, forcing everyone into a government-run health
system. And the government would pay for everything, from dental work to annual checkups to brain surgery, with no deductibles
or co-pays. It would, he says, be entirely free. Well, not free. By Sanders' own admission his health plan is
massively expensive — its $1.4 trillion price tag would increase an already out-of-control federal budget by
more than a third.
I don't like Bernie because his "Medicare For
All" plan will destroy our health and economy. My college-age child introduced me to a website called I Like Bernie, But... which is particularly appealing
to young voters. The website offers short answers to concerns pro-Bernie voters might still be harboring about his policies and his ability to win. With few exceptions,
these answers are just plain wrong. You can see my rebuttals at a website I set up as a counterweight (I Don't Like Bernie, Because...). I've republished those
same articles here, at my own blog, addressing Bernie's socialism, his tax plans, and his Second Amendment stance. Today I'm tackling everything that's wrong with Bernie's
plan to socialize American medicine.
5 of Bernie Sanders' Most Ridiculous Ideas. [#1] "Medicare for All." As one of the sections on Sanders'
website explains, the presidential candidate is calling for a single-payer healthcare system. Medicare is an example of a
single-payer system, which is why Sander calls for "Medicare for All." The problem is that Medicare already faces
$43 trillion in unfunded liabilities and denies healthcare claims at a higher rate than any private insurer.
"Medicare for all" would drive the country into bankruptcy.
Billed $27 Million for Hoveround Wheelchairs That Weren't Medically Necessary. Taxpayers were billed $27 million for
thousands of power wheelchairs that were not medically necessary for their users. Hoveround was the subject of an audit released
last week by the Department of Health and Human Services inspector general, which faulted the company for failing to meet Medicare
requirements before it charged the government for its electric wheelchairs. In 2010, Hoveround provided 13,025 power wheelchairs
to Medicare beneficiaries. Eighty-five percent of those who received the wheelchairs did not meet the necessary medical
requirements, according to the audit. The findings were based on a sample of 200 individuals who received a power wheelchair
Millions could see their Medicare costs
soar. The Social Security Administration told nearly 65 million retirees on Monday [10/12/2015] they will not be
getting a raise next year, because inflation is too low to trigger one. And the bad news gets worse. Unless Congress
acts, many of the more than 55 million on Medicare could see premiums rise as much as 50 percent — and higher
deductibles, as well.
Group Run by Dem Donor to Pay $118M to Settle Fraud Allegations. The Department of Justice announced on Monday
[9/21/2015] that the Florida-based Adventist Health System, a nonprofit health care organization that operates 44 hospitals
in 10 different cities, has agreed to pay $118 million to settle claims that the group had arranged an improper compensation
system that paid physicians for referrals to their hospitals. The organization provided compensation that included
leasing a BMW and Mustang for one surgeon, offering a $366,000 base salary for a family practitioner — nearly
double that of the average salary of similar practitioners in the area — and providing a bonus of $368,000 and a
total salary of $710,000 to a dermatologist who worked three days a week. Additionally, the group was accused of
submitting false claims to Medicare and Medicaid for services rendered to the patients who were referred to their system.
Obamacare Change to Medicare Is Backfiring. A provision in the Affordable Care Act requires Medicare to reduce
payments to hospitals that have high readmission rates. The goal was to improve patient care and cut the costs of avoidable
hospitalizations. Instead, the new study finds that the Obamacare change unfairly affects hospitals based on the patients
they treat. The current Medicare readmissions rate is high, with close to one in five elderly patients returning to the
hospital within 30 days of leaving, and it's also costly — readmissions cost Medicare $26 billion annually,
$17 billion of which is spent on return trips that might not have been necessary if proper care was received in the first place.
unfairly penalizes hospitals treating sickest, poorest patients, study finds. For the last four years, Medicare
has wielded a big stick: It has fined hospitals if too many of their patients returned to any hospital within weeks of being
released. But many safety-net hospitals, including academic teaching hospitals, say this is unfair because they take care
of sicker, poorer patients. Now data released Monday [9/14/2015] shows they may be right. Researchers at Harvard
Medical School found that hospitals are being penalized to a large extent based on the patients they serve.
Justice Dept. backs Planned Parenthood against La. Gov. Jindal. The Obama administration has sided with Planned
Parenthood in its effort to keep its contract with Louisiana, arguing in a court filing that the state's decision to defund
the organization may be in violation of the federal Medicaid Act. The Justice Department filed a "statement of interest"
late Monday in favor of Planned Parenthood Gulf Coast, arguing that "thus far, Louisiana has not proffered sufficient reasons
to terminate Planned Parenthood Gulf Coast Inc. ("PPGC") from its Medicaid program."
The Union That Rules New York.
One of the many crises that overwhelmed David Paterson's brief, hapless term as governor of New York was a surge in Medicaid
costs. Every recent New York governor has tried but failed to rein in Medicaid. Yet Paterson's opportunity to address the
problem appeared promising. Government spending had to be cut during the 2009 budget cycle because of that year's historic
collapse in revenues. Accordingly, Paterson proposed $3.5 billion in cuts to the state's Medicaid program — the
second-greatest burden on New York taxpayers, after K-12 education — and sought to shift monies away from inpatient
hospitals to less expensive outpatient clinics. Hospitals would have seen a revenue reduction of less than 2 percent.
But Medicaid is one of the primary sources of funding for the hospitals employing workers from 1199 SEIU, the powerful hospital and
nursing-home employees' union.
Medicare Fraud is Government Run Amok. In today's world, federal agencies in the Obama era are the spending
equivalent to Genghis Khan. So why is the administration dragging its to stop Medicare fraud and save the taxpayer
billions? Two words: Hospital. Lobby.
Medicaid: A Fifty-Year-Old Flimflam. [T]he
poor medical outcomes endured by Medicaid patients is one of the best documented yet least known aspects of the program. The most
comprehensive study of this phenomenon was the "Oregon Experiment." The state of Oregon chose enrollees for its Medicaid program by
lottery, which gave researchers an unprecedented opportunity to compare the outcomes of Medicaid patients to those who remained without
insurance. The results, published by the New England Journal of Medicine, were startling: "This randomized, controlled
study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes."
There is no entitlement crisis. [Quoting Barack H. Obama:] Today, we're often told
that Medicare and Medicaid are in crisis. But that's usually a political excuse to cut their
funding, privatize them, or phase them out entirely — all of which would undermine their
core guarantee. The truth is, these programs aren't in crisis. Nor have they kept us from
cutting our deficits by two-thirds since I took office.
The Editor says...
If you triple the budget deficit and then reduce it by two thirds, you have accomplished nothing.
Nevertheless, you can fool some of the people all of the time.
and Medicaid At 50: One Is Going Bankrupt, the Other Is Bankrupting States. When
President Johnson signed Medicare into law on June 30, 1965, he said, "If it has a few defects, I
am confident those can be quickly remedied." Fifty years later, a Government Accountability Office
report found that an eye-popping $60 billion — fully 10% of Medicare's budget —
was lost to waste, fraud, abuse or improper payments last year. Among the glaring defects, the GAO
found 23,400 fake or bad addresses on Medicare's list of providers. Between those two events,
Medicare has repeatedly suffered vast cost overruns, has been "reformed" countless times and has imposed
a seemingly endless serious of price controls on doctors and hospitals.
funding well to dry up in 2030. The fund Medicare uses to pay hospitals will run out in the
next 15 years, and experts say there are no easy answers to solve it. The independent Board of
Trustees for Medicare found the trust fund used for Medicare payments to hospitals would become insolvent in 2030
unless something is done. The board issued its annual report to Congress on the entitlement program's
finances on Wednesday [7/22/2015].
Prognosis Is Far Worse Than Dr. Obama Says. Medicare is still a fiscal time bomb. As
the nearby chart shows, its hospital insurance deficits will hit $110 billion in 2031 —
the first year after its trust fund runs out of money. Annual deficits will eventually top $1 trillion
a year. Even that is a fantasy, since it assumes ObamaCare's steep Medicare provider payment cuts actually
happen. Even Medicare's trustees are skeptical. Buried in an appendix, the report admits that "there
is substantial uncertainty" regarding the likelihood that those cuts will be feasible.
Medicaid Expansion Is Blowing Up. Two dozen states immediately took the bait, lured by
the promise the federal government would pay 100% of costs in the first three years and 90% for the
newly eligible on into the future. Several more have joined since. An analysis by the
Associated Press finds that this was short-sighted folly. At least 14 of these states have
seen enrollment surge unexpectedly, forcing at least half to increase their cost estimates.
And we're not talking about a few percentage points.
Medicare's midlife crisis: Catastrophic
finances pit doctors against patients. July 30 marks the 50th anniversary of President
Lyndon Johnson signing Medicare into law. At the time it was signed, government actuaries had
predicted that the portion of the program that covers hospital insurance would cost $9 billion by
1990. In reality, it ended up costing $67 billion by that point — or more than
7 times the original estimate. Since its inception, the program has been dramatically expanded
by both parties — even when President George W. Bush had a Republican Congress, he twisted
arms to add a prescription drug benefit in 2003. This year, the government will spend $626 billion
on the Medicare program as a whole — more than is spent on national defense. In fact, more is
spent on Medicare than any government program other than Social Security. A combination of the aging of
the population and rising healthcare costs will cause Medicare costs to explode even further in the coming decades.
enrollment surges, stirs worry about state budgets. More than a dozen states that
opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond
projections, raising concerns that the added costs will strain their budgets when federal aid is
scaled back starting in two years.
'Medicare and Social Security Are Not In Crisis'. In a White House speech directed at seniors, President Obama
re-assured them that Social Security and Medicare were not in crisis, contrary to the message signaled by Republicans.
"Now, we're often told that Medicare and Social Security are in crisis," said Obama pointing out that it was used as an "excuse"
by Republicans to cut spending. "But here's the truth. Medicare and Social Security are not in crisis, nor have they
kept us from cutting our deficits by two-thirds since I took office."
Dems want Medicaid to cover abortion. House Democrats are renewing their attack on the
Hyde Amendment, the controversial budget provision that bars federal funds from paying for
abortions. Reps. Barbara Lee (D-Calif.), Diana DeGette (D-Col.) and Jan Schakowsky (D-Ill.)
introduced a bill Wednesday [7/8/2015] that would require Medicaid to cover abortion
services — currently banned under the Hyde Amendment.
confront doctor who falsely diagnosed them with cancer. The government says a man who
took an oath to do no harm instead turned more than 500 of his patients into victims in a shocking
case of medical fraud. [...] Courtroom sketches could not adequately capture the anguish of the
victims Tuesday [7/7/2015] as one by one, they confronted the cancer doctor who prescribed
aggressive chemotherapy for patients he knew were not ill, and for those who were, ordering
treatments that were excessive while billing medicare $34 million.
The Editor says...
Chemotherapy is miserable enough without finding out later that it wasn't necessary.
Despite the Supreme Court's repeated attempts to prop it up, Obamacare is collapsing. This is
obvious not merely to the majority of Americans who have always disapproved of the law, but also to
an increasing number of progressives. Consequently, we are once again hearing calls for single-payer
health care. Most advocates of this system, including Hillary Clinton's main competitor for the 2016
Democrat presidential nomination, favor Medicare-for-All. They want, in other words, to put all
Americans on the government program that covers the elderly and disabled.
Accused of Medicare Fraud Donated $450K to Democrats. A cardiologist in Florida who
has donated more than $450,000 to Democrats has been suspended from receiving Medicare reimbursement
payments over "credible allegations of fraud" after reimbursements as far back as 2012 came under
scrutiny. Dr. Asad Qamar, a cardiologist based out of Ocala, Fla., was officially suspended from
participating in the program in March, though the suspension was only recently made public. In
January, the government intervened in a lawsuit against Qamar filed by whistleblowers who alleged
the doctor had defrauded the government.
Transfer of Wealth. According to the CBO's annual Long-Term Budget Outlook, if current
laws were to remain unchanged, government spending as a share of gross domestic product would reach
22.2 percent in fiscal 2025, up from 20.5 percent today. By then, even under a very rosy GDP
growth scenario, the debt would amount to 78 percent of the economy. [...] The deterioration comes fully from
the explosion of major health care programs, Social Security and escalating interest on debt costs. More
precisely, Medicare, Medicaid, Affordable Care Act subsidies, and Social Security are the drivers of our future
debt. Spending on these programs alone could reach 11.8 percent of GDP in fiscal 2025 and
14.2 percent of GDP in 2040, up from 10.1 percent today.
the Supreme Court Rules, ObamaCare Is In Deep Financial Trouble. By 2025, the CBO
says, ObamaCare will cut Medicare spending by $153 billion. That's equal to 73% of what the CBO
expects the exchange subsidies and the Medicaid expansion will cost in that year. By comparison,
planned Medicare spending cuts will cover only 24% of ObamaCare's subsidy costs in 2016.
No one believes these Medicare cuts — which involve mainly payment cuts to doctors
and hospitals — will happen. Medicare's board of trustees, the Government Accountability
Office and Medicare's chief actuary have all warned they are unrealistic and unsustainable over the long term.
announce nationwide health care fraud sweeps. Health care fraud sweeps across the country have led to charges
against 243 people, including doctors, nurses and pharmacy owners accused of bilking Medicare and Medicaid, the government
announced Thursday [6/18/2015].
Sued for Attempted Blackmail, Other States Join In. The state of Florida has now filed
a lawsuit against Barack Obama who attempted to force Florida to bend to his will using blackmail.
Florida had refused to accept Obama's demand to expand their Medicaid program to include able bodied
adults with no children. [...] Florida's program is called LIP and Obama has informed Florida that
contrary to the ruling by SCOTUS, that he will be cutting them off. That would force Florida to
either fund LIP exclusively by themselves or end the program for millions who depend on it for their
healthcare coverage. The expansion of Medicaid in Florida comes at a steep price. The leftwing
Urban Institute in 2012 estimated that the expansion of Medicaid would cost Florida 82 billion
dollars over the next 10 years, but Lip will only cost them 22 billion over the same period.
All this so shiftless bums can get free medical from the government.
Gov. Kasich on Medicaid Expansion: 'It's my money'. Anytime Gov. Kasich opens his
mouth to talk about Medicaid expansions, you can be sure either an absurd canard or an outright
falsehood will spew forth. Ohio's governor, who is positioning himself to run for president, brags
incessantly about his history as a budget hawk during his time in Congress in the '90s, but apparently
sees no contradiction between claiming to be a fiscal conservative and expanding Medicaid to hundreds
of thousands of able-bodied working, childless adults. Nevermind that he did so by circumventing
the state legislature, adding to the federal debt and imperiling the benefits of the most vulnerable
Ohioans — because it's his money.
AIDS foundation scammed feds for millions. The nation's largest supplier of HIV and
AIDS medical care is accused of bilking Medicare and Medicaid in an elaborate $20 million scam
that spanned 12 states, according to a lawsuit filed in South Florida federal court.
arrested in massive Medicare-Medicaid fraud scheme. A 199-count indictment against 23 doctors,
nurses, and medical supply companies was unsealed in Brooklyn, NY yesterday, revealing a massive scheme to defraud
Medicare and Medicaid of millions of dollars. Hundreds of poor people were recruited with the promise of new
sneakers to visit a couple of clinics in the Bronx, where bogus tests and procedures were performed. The
criminals would then bill government insurance programs for millions.
Is Doomed — Save the Patients. Medicare "as we know it" is doomed. It never
had a chance. What was originally intended as a vital safety net for seniors has become a massive
boondoggle that is collapsing under its own weight. In 1965, Medicare started as a medical
savings program for retirees. The government would take a small amount out of your paycheck each
month for forty years. This would be placed in a virtual lockbox with your name on it, and would
grow at some nominal but safe rate, say three percent. At retirement, the average American would
have well over $100,000 in today's dollars in a virtual individual Health Savings Account to cover old
age medical costs. Things did not work out that way at all.
shelled out $125B in bogus payments last year. The government paid out $124.7 billion
in potentially bogus payments last year, the government's chief watchdog said Monday [3/16/2015], blaming a
controversial tax credit for the poor as well as increased bad payments in Medicare and Medicaid.
One major problem is tracking when Americans die — the Social Security Administration
admitted last week that its rolls are filled with names of more than 6 million folks who are
listed as 112 years of age or older.
Crinel, former Zulu queen, charged in alleged $30 million Medicare fraud scheme.
Prominent New Orleans businesswoman Lisa Crinel, the 2004 Zulu Queen, faces federal charges in a
scheme prosecutors say defrauded Medicaid for $30 million for bogus home health care fees,
according to an indictment announced Thursday (March 12) by U.S. Attorney Kenneth Polite.
Crinel, 51, the owner of Abide Home Health Services, was one of 20 people named in the 26-count
indictment alleging that from 2008 until charges were filed Thursday [3/12/2015], her company was
the centerpiece of a scam that charged Medicaid program for services clients either didn't need or
were never performed.
budget: Slash Medicaid to help close massive $1.8B gap. The state is staring down a
$1.8 billion budget gap entering next fiscal year, Gov. Charlie Baker will announce today [3/4/2015] when he
unveils his first budget — a $38 billion proposal that includes deep cuts to the state's
Medicaid program but keeps his vow not to raise taxes. The deficit, which Baker is expected to
detail at an afternoon press conference, is driven in part by nearly a $1 billion in new net
spending at MassHealth and exceeds even the projections of the Massachusetts Taxpayers Foundation,
which had pegged the total gap at $1.5 billion in recent weeks.
York, Louisiana, Texas top Medicaid fraud recoveries in 2014 ranking. Law enforcement
nationwide recovered more than $2 billion through Medicaid fraud investigations in 2014, with New
York state representing almost one-fifth of the money. The Department of Health and Human
Services inspector general released a state-by-state breakdown of money recovered by Medicaid Fraud
Control Units, law enforcement tasked to act against individuals or entities taking advantage of
Medicaid. New York had the most success with more than 100 convictions. It also
recovered $378 million, one and a half times more than Louisiana, which compiled the second
highest total of recoveries.
find out why Medicaid expansion is bad idea. I hate to say "I told you so," but in
this case I actually did. Back in August, I wrote a column for this paper calling on governors to
say no to the massive boondoggle that is Obamacare's expansion of Medicaid. It traps people in
yet another government program and does nothing to help improve the health outcomes of the people it
claims to serve. But for some reason, governors in states like Illinois and Ohio jumped at the
possibility of more "free" money from Washington.
is broken and expansion won't fix it. Medicaid is administered jointly by the state
and federal government, offering health coverage to Americans earning up to about $16,000 in the
states participating in Obamacare's expansion of the program and up to roughly $12,000 in the states
that do not. Providing these benefits comes at a great cost to taxpayers. In fiscal 2013 (even
before the program expanded) federal and state governments spent nearly $460 billion combined on
Medicaid. Nearly a quarter of money spent by states went to finance the program in 2013, putting it
ahead of elementary and secondary education as the biggest component of state budgets, according to the
National Association of State Budget Officers.
Medicaid hinders growth costs jobs. Expanding Medicaid through President Obama's healthcare law
hinders economic growth and costs jobs, according to a study from the American Action Forum released on Thursday
[12/11/2014]. The finding runs counter to the argument that the Medicaid expansion is an economic stimulus,
one that many supporters of the law's expansion have been making to convince states to participate in it.
"[W]e find that Medicaid expansion, if adopted by all states, would result in a direct net loss of up to
$174 billion in economic growth nationwide over ten years, and would result in the loss of over 206,000
full-year-equivalent jobs for the years 2014 to 2017," wrote economist Robert A. Book, the report's author.
Spending by the Numbers, 2014 (Including 51 Examples of Government Waste). Where Does
All The Money Go? Forty-nine percent, or almost half of all spending, paid for Social Security and
health care entitlements (primarily Medicare and Medicaid). In 2002, the entitlement share of the
budget was 25 percent, about half of what it is today. Without reform of these massive and growing
programs, Washington will have to borrow increasing amounts of money, piling debt onto younger generations
and putting the nation on a dangerous economic course. Social Security is the largest federal spending
program and has held this position since surpassing defense spending in 1993. Medicare is one of the
largest and fastest-growing programs in the entire federal budget.
Destroying Public Education. One of the truly unheralded disasters caused by Obamacare
is the sharp reduction in spending on public education as Medicaid costs eat up an ever-larger share
of state budgets. When Obama took office, the proportion of state spending that went to Medicaid
was smaller than that for public education (K-12). In 2008, states spent 22.0 percent of their
funds on education and only 20.5 percent on Medicaid. But now the situation has reversed and
health care has vaulted ahead of education spending in the states. This year, only 20.0 percent
of state funds will go to K-12 schools while almost a quarter — 24.5 percent —
will go to Medicaid.
still doing business with firm that twice defrauded Medicare. A Tennessee home
healthcare company was forced to pay $25 million to settle its second fraud case in two years.
CareAll, a collection of home nursing and rehabilitation companies, defrauded both Medicare and Medicaid by
billing inflated and falsified costs to the federal programs for home healthcare services, the Department of
Justice said. From 2006 to 2013, CareAll exaggerated the severity of patient illnesses to pad its
billings and sought reimbursements for medically unnecessary services that were administered to patients
who weren't even homebound, according to the Justice Department.
42 percent of new Medicaid signups are immigrants, their children. Immigrants and
their U.S.-born children make up more than 40 percent of new Medicaid recipients at a cost of
$4.6 billion, according to an analysis of government data. The Center for Immigration Studies, a
low-immigration advocacy group, released a report early Thursday [11/13/2014] that found both legal and illegal
immigrants and their minor children made up 42 percent of Medicaid growth from 2011 to last year.
42 Percent of New Medicaid Recipients in the Last Two Years Were Immigrants. Almost
half of the low-income Americans who have enrolled in Medicaid in the past two years are immigrants
to the United States, according to a new report, suggesting that Obamacare's large expansion in the
program will disproportionately benefit immigrants as well. "The data show that immigrants and
their children accounted for 42 percent of the growth in Medicaid enrollment from 2011 to 2013," the
CIS report says. Because immigrants are more likely to have low incomes or lack insurance from
their jobs, they're much more likely to be eligible for the existing Medicaid program —
and Obamacare's expansion of it, which began this year.
Bought Meds For Dead People. A report released Friday [10/31/2014] by the Health and
Human Services Department's inspector general said the Medicare rule allows payment for prescriptions
filled up to 32 days after a patient's death — at odds with the program's basic
principles, not to mention common sense.
the Washington Version. The Medicare Act was signed into Law by President Lyndon
Johnson in January, 1965. It was intended as a national Health Savings Account with individual
accounts called lockboxes. [...] Sometime between 1965 and 1970 (I could not discover precisely
when), Congress broke open all those tens of millions of lockboxes, confiscated tens of billions of
dollars, and dumped them into the General Account, to spend on anything Congress wanted. They
replaced all the cash with government-issued IOUs.
Committee Behind Our Soaring Health Care Costs. In 2012, national health care spending
in the United States reached $2.8 trillion, or more than 17 percent of the country's gross domestic
product — more than any other industrialized country. [...] Another explanation, debated
by experts in health policy circles but less known to the public, lies with a secretive committee
run by the American Medical Association (AMA) which, with the assent of the government, has enormous
power to determine Medicare prices by assessing the relative value of the services that physicians perform.
Star Ratings Allow Nursing Homes to Game the System. The lobby of Rosewood Post-Acute
Rehab, a nursing home in this Sacramento suburb, bears all the touches of a luxury hotel, including
high ceilings, leather club chairs and paintings of bucolic landscapes. What really sets Rosewood
apart, however, is its five-star rating from Medicare, which has been assigning hotel-style ratings
to nearly every nursing home in the country for the last five years.
Transportation Company Owner Pleads Guilty to Billing Medicaid for Dead People's Rides. Unfortunately
for Cynthia Keegan, dead men do tell tales. Keegan, 51, owns a van company that provided nonemergency rides for
wheelchair-bound MassHealth patients. Some of the patients she billed MassHealth for, it turned out, had not
used the service. Because they were dead. In September, Keegan was indicted on seven counts of larceny
and seven counts of making false claims to Medicaid for billing MassHealth for nearly 10,000 rides that never
happened, using the names of a dozen nursing home patients and 47 people who had previously ceased to be.
Those rides never actually happened because Keegan's Cross Roads Trolley is a wheelchair van company, not a
Obscure Drug With a Growing Medicare Tab. An obscure injectable medication made from
pigs' pituitary glands has surged up the list of drugs that cost Medicare the most money, taking a
growing bite out of the program's resources. Medicare's tab for the medication, H.P. Acthar Gel,
jumped twentyfold from 2008 to 2012, reaching $141.5 million, according to Medicare prescribing data
requested by ProPublica. The bill for 2013 is likely to be even higher, exceeding $220 million.
shows $6.7 billion in improper Medicare payments. Medicare paid out $6.7 billion in
2010 for health care visits that were improperly coded or lacked documentation, a report released
Thursday [5/29/2014] found. That's 21% of Medicare's total budget for diagnostic and assessment
visits, according to the Department of Health and Human Services inspector general. They found
that 42% of diagnostic and assessment claims were improperly coded and 19% were improperly
documented. This comes after a 2010 report found that 1,669 physicians consistently billed for
the two highest-paying codes. In the new report, 56% of claims for those high-coding physicians
physicians were incorrect, with 99% being up-coded in the provider's favor, and with 1% of the
"errors" being down-coded. Those providers cost $26 million in 2010 in incorrect coding.
Ban on Sex Reassignment Surgery Lifted. Medicare can no longer automatically deny coverage requests for
sex reassignment surgeries, a federal board ruled Friday [5/30/2014] in a groundbreaking decision that recognizes the
procedures are medically necessary for some people who don't identify with their biological sex.
Begin Fingerprinting 'High Risk' Medicare Providers and Suppliers. Four years after Obamacare
became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers
of new fingerprint-based background checks. [...] The provision is part of the Medicare, Medicaid, and CHIP
Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad
discretion in applying the background check requirements depending on the potential for abuse, fraud, and/or waste.
on Medicaid Exceed Population of UK. The number of Americans who were enrolled in Medicaid at any time
during fiscal 2013 exceeded the entire population of the United Kingdom, according to new data published by the federal
government's Medicaid and CHIP Payment Access Commission (MACPAC). Were Medicaid a nation instead of a U.S.
entitlement program it would be the 20th most populous country on earth.
of Medicare Doctors Get Big Share of Payouts. A tiny fraction of the 880,000 doctors and other
health care providers who take Medicare accounted for nearly a quarter of the roughly $77 billion paid out
to them under the federal program, receiving millions of dollars each in some cases in a single year, according
to the most detailed data ever released in Medicare's nearly 50-year history.
shows U.S. doctors reap millions from Medicare. In 2012, an enterprising ophthalmologist in south
Florida received $20.8 million in Medicare payments, the highest amount the government health plan for the
elderly paid an individual provider that year, according to a preliminary analysis of federal data.
Data uncover nation's top Medicare billers. The Medicare program
is the source of a small fortune for many U.S. doctors, according to a trove of government records that reveal unprecedented
details about physician billing practices nationwide. The government insurance program for older people paid nearly
4,000 physicians in excess of $1 million each in 2012, according to the new data. Those figures do not include what
the doctors billed private insurance firms.
Obamacare's Medicaid Trap.
The technology behind a huge part of Obamacare's efforts to expand insurance coverage — the part aimed at low-income
Americans — remains far from fixed, and the glitches are keeping some of the nation's most vulnerable patients from
getting insured. The administration launched a "tech surge" to improve the HealthCare.gov experience for those shopping
for private insurance, but the website's process for enrolling in Medicaid remained mired in glitches. And for President
Obama's efforts to expand health coverage that's a major problem.
Ties of Top Billers for Medicare. Two Florida doctors who received the nation's highest Medicare reimbursements in 2012
are both major contributors to Democratic Party causes, and they have turned to the political system in recent years to defend themselves
against suspicions that they may have submitted fraudulent or excessive charges to the federal government. The pattern of large
Medicare payments and six-figure political donations shows up among several of the doctors whose payment records were released
for the first time this week by the Department of Health and Human Services.
cuts canceled after Dem complaints. The Obama administration announced Monday [4/7/2014] that planned cuts to Medicare
Advantage would not go through as anticipated amid election-year opposition from congressional Democrats. The cuts
would have reduced benefits that seniors receive from health plans in the program, which is intended as an alternative to
Medicare. Under cuts planned by the administration, insurers offering the plans were to see their federal payments
reduced by 1.9 percent, which likely would have necessitated cuts for customers. Instead, the administration
said the federal payments to insurers will increase next year by .40 percent.
updates Medicare enrollment rules for same-sex couples. The Obama administration on
Thursday [4/3/2014] announced that it was updating Medicare rules to allow partners in same-sex
marriages to apply for benefits during special enrollment periods. The Department of Health and
Human Services said that the Social Security Administration would now be able to take applications for
special enrollment periods for Medicare Part A and Part B and reduce late penalties for some
eligible same-sex couples. The move is the latest step taken by HHS after the Supreme Court in 2013
struck down a key part of the federal Defense of Marriage Act, which defined marriage as a union between
one man and one woman.
you want single payer? Medicare has 375,000 case appeals backlog. And that sort of a backlog has Democrats
worried. [...] This sort of a problem is also visible in another government run health care system. VA currently
has almost 400,000 disability claims pending. It claims to be on track to erase that in 2015, but observers are
skeptical of that claim. While it claims to have shed 200,000 previously backloged claims, new claim backlog
numbers continue to rise.
The Obama Administration's About-Face on
Medicare. The Obama administration seems determined not to rock the boat before the midterm congressional election this fall.
It's already delayed Obamacare mandates that could cause outrage. Now it has stopped proposed Medicare changes that weren't even part of
Obamacare — and with good reason. The administration had proposed new rules for seniors' prescription drug plans in Medicare
Part D. This is significant because Part D is unusual for a government program: People love it.
subcommittee chairman: Obama administration policy would eliminate half of all existing Medicare Part D plans. The
Obama administration's new proposed rule for Medicare Part D would eliminate half of all Medicare Part D plans and raise
prescription drug premiums for millions of seniors by up to 20 percent, according to a U.S. House subcommittee chairman.
"Today, the average senior has 35 different [Medicare Part D] plans to choose from this year. This rule would reduce that
choice to two plans. 50% of the plans offered today will be gone, and the health care that seniors like may go with it," House
Energy and Commerce Health Subcommittee chairman Rep. Joe Pitts said in a statement at a Feb. 26 hearing attended by a top
administration health official.
drops controversial proposed Medicare changes. The Obama administration says it's pulling the plug on proposed changes to
the Medicare prescription program that ran into strong opposition on Capitol Hill. Among other changes, the regulation proposed
to remove three classes of drugs from a special protected list that guarantees seniors access to a wide selection of critical medications.
Drug rule is ditched by Obama.
Medicare chief Marilyn Tavenner alerted lawmakers Monday that her agency would not go forward with a proposal to give insurers more
leeway to limit the number of drugs they cover for Medicare beneficiaries. Critics argued that making the change, which was
designed to save money, would have hampered seniors' access to necessary drugs. Democrats worried the issue would hurt them
in the midterm elections, and House Republicans had scheduled a vote this week on a bill blocking the regulation from going forward.
Not-So-Secret War On Private Medicare Plans. To say that President Obama is not an enthusiastic backer of the
two Medicare programs that offer seniors private insurance options would be something of an understatement. Over the years,
Obama has repeatedly derided Medicare Advantage — the program that lets seniors enroll in subsidized, private insurance.
He once called it "wasteful," and said it amounted to "giveaways that boost insurance company profits but don't make (seniors) any
healthier." Obama has been equally harsh when it comes to Medicare Part D — the drug benefit President Bush signed
into law that relies on privately run plans.
Insurers: Medicare Advantage cuts cost
seniors $900 per year. The health insurance industry fighting proposed cuts to Medicare Advantage payments argued they will raise seniors'
out-of-pocket costs next year. America's Health Insurance Plans (AHIP), a trade group, blasted the reductions with a report Thursday finding that
beneficiaries could pay as much as $900 more in 2015 if the cuts take effect.
Fraud: Who's in on the Act and How They're Getting Away With It. A single mom with five kids living in Brooklyn with no income on
record and struggling to make ends meet sounds like an eligible candidate for government subsidy programs. She signs up for the SNAP
(Supplemental Nutrition Assistance Program) and Medicaid for herself and her children and gets government assistance to help cover her rent.
But in reality, she's married, her husband has an all-cash business, which allows her to rake in thousands of dollars a month via welfare
programs and remain undetected by the government.
Feds to fine state over limit on
Medicaid patients' ER visits. Florida has been limiting Medicaid patients to six emergency room visits a year even
though federal officials consider such a cap illegal. As a result, the federal government intends to penalize the state by
withholding a portion of Medicaid funding. "We hope the state will realign their Medicaid program with federal standards
to avoid this penalty," said Emma Sandoe, a spokeswoman for the Centers for Medicare and Medicaid Services.
The Editor says...
Mr. Obama apparently wants Medicaid "clients" to continue to use hospital emergency room physicians as their
family doctors — without any limits.
flaw in Maryland health site may mean $30 million in unnecessary Medicaid payments. The cost to taxpayers of flaws in Maryland's
online health insurance exchange is coming into focus, with officials estimating at least $30.5 million in unnecessary Medicaid spending
and conceding that they have no idea how much it will take to get a system that works. The state has paid $65.4 million to the
contractor hired to build the system and fired this week because of the protracted problems. Costs are likely to keep rising as Maryland
figures out how to fix or replace the system.
Medicaid Overpays Millions for Diapers. A lack of
competitive bidding processes among state Medicaid agencies caused the program to overpay for diapers by about $62 million in 2012,
according to a report released by federal auditors on Monday. Only five state Medicaid agencies have implemented competitive bidding
programs for "disposable incontinence supplies," according to the inspector general for the department of Health and Human Services.
Those states reported saving up to of 50 percent on those supplies, the IG report found.
death debt? States can seize assets to recoup Medicaid costs. Though many may not realize it, states are allowed to recover
the cost of health care after someone's death by seizing their assets. It applies to Medicaid recipients who are between the ages of
55 and 64. The law has been in place since 1993, when Congress realized states were going broke over rising Medicaid expenses.
But under ObamaCare, Medicaid eligibility has expanded dramatically along with the promise that the federal government will pick up the
cost of the higher tab — at least for the first few years, after which states will be on the hook for a portion of the increase.
Millions more are entering the system, perhaps without knowing that their assets could be at risk.
How Obamacare will hurt doctors.
A study just published in the prestigious journal Science reveals that new Medicaid patients in Oregon were 40% more likely to use the
emergency room than the uninsured were. This finding is not a surprise to me or most physicians — we have known that
truth for years. But it does undermine one of the basic philosophical and practical underpinnings of Obamacare: the notion
that expanding insurance will invariably unclog ERs, improve primary and preventive care, prevent diseases and lower costs.
Single Payer: We've Been There, Done
That. Medicare is a single payer health care system for seniors, and it is Exhibit A in the case against government-run
health care. "Medicare-for-All" is what single payer advocates usually mean when they refer to universal health care. Most of
these people naïvely believe that such a system could be paid for with a few modest tax increases.
Surprise! Medicaid isn't free — it's a poorly advertised predatory loan. It's
called "estate recovery" and although it's been around for 20 years, most Americans have never heard of it. Sadly, this arcane bit of Medicaid
fine print is about to become much more familiar. Basically, what it says is this: If you're over 55 and are on Medicaid, when you die
the state can seize your assets in an effort to repay the cost of your care.
Expanding Medicaid doesn't reduce ER trips, it increases them. As the health-care law expands Medicaid to cover millions more Americans,
a new Harvard University study finds that enrollment in public program significantly increases enrollees' use of emergency departments. The
research, published Thursday in the journal Science, showed a 40 percent increase in emergency department visits among those low-income adults
in Oregon who gained Medicaid coverage in 2008 through a state lottery. This runs counter to some health-care law supporters' hope that Medicaid
coverage would decrease this type of costly medical care, by making it easier for low income adults to see primary care providers.
Emergency Visits Seen
Increasing With Health Law. Supporters of President Obama's health care law had predicted that expanding insurance coverage for the
poor would reduce costly emergency room visits because people would go to primary care doctors instead. But a rigorous new experiment in
Oregon has raised questions about that assumption, finding that newly insured people actually went to the emergency room a good deal more often.
firms draining billions from Medicare. Hospice patients are expected to die: The treatment focuses on providing
comfort to the terminally ill, not finding a cure. To enroll a patient, two doctors certify a life expectancy of six months or less.
But over the past decade, the number of "hospice survivors" in the United States has risen dramatically, in part because hospice companies
earn more by recruiting patients who aren't actually dying, a Washington Post investigation has found. Healthier patients are more
profitable because they require fewer visits and stay enrolled longer.
Diplomats' Medicaid Fraud Raises Questions About Foreign Officers Accessing Taxpayer Benefits. According to the U.S. Attorney for the
Southern District of New York, 25 current and former Russian diplomats and 24 of their spouses allegedly participated in a scheme to illegally
obtain Medicaid benefits for prenatal care and related costs by underreporting their income or falsely claiming that their children were citizens of the
United States, [Congressman Ed] Royce noted. Over the course of nearly a decade, they milked the system of $1.5 million in benefits.
Surprise! Obamacare Includes A Medicaid Death
Tax. Before Obamacare there was a Medicaid provision allowing the state to recuperate funds spent on a Medicaid patient over 55 years
old from his/her estate. The end result of that policy, for those on Medicaid dying with assets, would see the government seizing the assets of an
estate forcing family members to purchase back any items they'd want to keep. It's called estate recovery, and it's not exactly advertised as one
of the terms for Medicaid enrollment. But pre-Obamacare there weren't many people who were a) on Medicaid and b) had many assets of value
Obamacare's expanded Medicaid asset seizure bonanza.
Basically, the problem is that the Democrats, in their infinite wisdom, decided to drastically expand the Medicaid rolls without considering the
consequences — one of which being, state governments have been long in the habit of trying to get at the remnants of Medicaid recipients'
estates in order to cut costs. [...] You see, in order to get a subsidy for an Obamacare plan people have to be making neither too much, nor too little.
People who make too little are expected to go onto Medicaid by the federal government; they certainly aren't going to get any kind of subsidy for their new
health care plan.
ObamaCare created a Medicaid time bomb. The good news, if you
want to call it that, is that roughly 1.6 million Americans have enrolled in ObamaCare so far. The not-so-good news is that
1.46 million of them actually signed up for Medicaid. If that trend continues, it could bankrupt both federal and state governments.
Dozens of Russian diplomats have been
ripping off Medicare for years. Almost 50 Russian diplomats and members of their families have been charged in a massive health care fraud
scheme, officials announced Thursday [12/5/2013]. Federal officials allege that 58 of the 63 births to Russian officials living in New
York between 2004 and 2013 were fraudulently paid for by Medicare at a cost of roughly $1.5 million to US taxpayers. The Russians were applying
for these benefits while emptying their pockets at famed stores such as Bloomingdale's, Jimmy Choo's, Prada and Tiffany & Co, officials said.
Medicaid Fraud: Obamacare promise of free quality healthcare. It
may be the biggest Obamacare lie of all. Not that you can keep your health care plan if you like your plan. Not that
you can keep your doctor if you like your doctor. Not all of the phony cost estimates and supposed efficiencies. The
biggest lie of all is that 15-30 million additional people who will be enticed or shoved onto Medicaid will receive quality
health care. In reality, they will receive health care "insurance," but there will be few doctors willing to see them because
the reimbursement rates are so low.
Obama Trashes America to
Save ObamaCare. The U.S. is hugely generous to those who can't afford to pay for health care. Hospitals spend more than $40 billion
a year doing so. Doctors generously provide billions of dollars worth of free or discounted care to those who need help. There are various
philanthropies that raise billions each year for charity care. And that's to say nothing of the existing government programs. Taxpayers fork
over $415 billion a year so Medicaid can provide health care for the poor, and another $500 billion for Medicare. There's the VA for
veterans and various state-run programs as well. So, no, the health care system isn't now and never has been the cold, cruel, heartless disaster
that the Obamas make it out to be.
ObamaCare Forced Mom Into Medicaid.
Countless individually insured Americans have received such letters; many are seeing more radical increases in premiums and deductibles.
White House attempts to shame
Republican governors into Medicaid expansion. The White House stepped up its effort Thursday night to shame more Republican governors
into accepting an expansion of Medicaid rolls, calling on Florida and Louisiana to add more than 1 million uninsured residents under Obamacare.
"We should be about putting people over politics," said presidential adviser David Simas. "It is reckless that some governors are so determined
to see that the health care law not succeed, that they have even refused to expand Medicaid coverage for millions upon millions of working families."
Audit reveals half
of people enrolled in IL Medicaid program not eligible. [A] review of the Illinois Medicaid program confirms massive waste and fraud.
A review was ordered more than a year ago — because of concerns about waste and abuse. So far, the state says reviewers have examined
roughly 712-thousand people enrolled in Medicaid, and found that 357-thousand, or about half of them shouldn't have received benefits. After further
review, the state decided that the percentage of people who didn't qualify was actually about one out of four.
Watchdogs: Government Paid Millions
in Medicare to Deceased, Illegal Immigrants. The Department of Health and Human Services' Centers for Medicare and Medicaid Services paid
out $23 million to beneficiaries after their deaths in 2011, according to one report from HHS' inspector general. Another report tallied more
than $28 million in payments from 2009 to 2011 to individuals who were in the country illegally. In all, CMS paid Medicare benefits to 4,139
illegal immigrants and 17,403 deceased people, according to the two reports.
Medicare paid millions to dead patients,
illegal immigrants, probe finds. Medicare paid $23 million for dead patients in 2011 and $29 million for drug benefits for illegal
immigrants from 2009 to 2011, according to a report Thursday [10/31/2013] from the Health and Human Services inspector general. The investigators
said Medicare has safeguards to try to stop payments to dead patients, but it still ended up sending out the $23 million anyway. The
Centers for Medicare and Medicaid Services (CMS) — the same agency that is struggling to fix the broken Obamacare website —
acknowledged the problems and said it will try to take steps to fix them.
CMS Spent More Than
$1 Trillion in Less Than 1 Year. The Centers for Medicare and Medicaid Services (CMS), which runs the federal government's major health-care
programs, and which was responsible for developing the Obamacare health-insurance exchange website, spent more than $1 trillion in just the first
eleven months of fiscal 2013, according to the Treasury. From October 2012 through August 2013, according to the Treasury, this one federal agency
Medicaid covers pregnant women, individuals with disabilities, children of low-income households, some of the poorest elderly, and parents meeting specific income
thresholds, generally those at or below the federal poverty level — $958 gross income per month for one person, or $1,963 gross income per month for a
family of four. (Children above the threshold for Medicaid can qualify for a separate program, the Children's Health Insurance Program; North Dakota's CHIP
program covers children up to 160 percent of the poverty level, and New York's goes up to 400 percent of the poverty level.)
The Great Medicaid Swindle. On
Monday [10/21/2013], the same day President Obama gave a poorly received speech defending the glitchy Obamacare rollout, there was another
unfortunate development in health-care reform: Ohio expanded Medicaid. In a controversial (and possibly illegal) move, Ohio's
Controlling Board voted to expand Medicaid coverage in the state to adults that were not previously eligible by way of accepting billions in
federal funds. That means 25 states, plus the District of Columbia, have now signed on to take part in an aspect of the Affordable
Care Act that is both optional and ill-considered.
Are they signing up for Obamacare, or for
Medicaid? How many people have tried to sign up for Obamacare? How many have completed the process? Those numbers are important,
but let's keep something else in mind here — there's another important number that a lot of publications are failing to separate out. That is,
how many people are enrolling in the private insurance plans within the Obamacare exchanges — as opposed to those applying who report
very low incomes and get steered into the Medicaid program?
Obamacaid. Democrats do have one lament about [Obamacare's]
implementation: Some states are opting out of the Medicaid expansion. Medicaid, the joint state-federal safety net intended for the poor, already covers more
than one of five Americans and pays for two of five U.S. births. And that's before ObamaCare dumps up to 20 million new dependents onto its rolls.
'Death doctor' accused of
misdiagnosing cancer patients. A Michigan oncologist charged with intentionally misdiagnosing patients with cancer as part of a
major Medicare fraud operation will remain in prison until trial, with court officials scared he will flee to the Middle East. Dr Farid
Fata — who is accused of ordering unnecessary treatments for his patients, such as chemotherapy, to enrich himself through insurance
programs — made an application in the federal court to have his bond reduced from $9 million to $500,000 so he could leave prison,
where he has been held since August 6.
Almost Half of U.S. Births Covered by Medicaid.
According to researchers from the George Washington University (GWU) School of Public Health, in 2010, almost half of all births in the United States were paid for by
Medicaid, and that rate is only going to go up. Medicaid was responsible for 48% of the 3.8 million births in 2010, an increase of 90,000 births from 2008,
which was an 8% increase during that period.
Detroit doctor charged
in $35M Medicare scam gave fake diagnoses, feds say. A Detroit-area doctor has been charged with bilking the government of tens of millions of
dollars by deliberately misdiagnosing patients with cancer and illegally billing Medicare for the treatment. Dr. Farid Fata [...] was arrested last week
on charges he ripped off Medicare for millions of dollars by giving chemotherapy to patients who didn't need it and diagnosing cancer when the illness wasn't
apparent, MyFoxDetroit.com reported.
Medicare by the Scary Numbers. The trustees report's
predicted expenditures are based on the assumption built into the law that next Jan. 1 there will be a 25 percent decrease in the
fees that Medicare pays doctors. The reason has nothing to do with ObamaCare. In the Balanced Budget Act of 1997, Congress
declared that Medicare physician fees could grow no faster than the economy as a whole. Since then, though, Congress has postponed
the cuts on 14 occasions, not allowing them to take place. Why assume things will be different now? A second problem
does stem from ObamaCare. In order to pay for the expansion of health insurance for the young, the new health law calls for steep
cuts in the growth of health care spending on the elderly.
This Thing Called ObamaCare.
It's instructive to witness the inability of politicians to accurately predict their own legislative outcomes. In 1967,
Congress predicted that Medicare spending would equal only $12 billion per year by 1990 — a paltry sum. Actual
spending for that year was $110 billion, so they were slightly off the mark. But of course, by that point, Medicare was
fully entrenched in the American political system, and the notion of even modestly reforming it was off the table (it evidently
continues to be off the table today). Thus stands the ossified character of American government, and thus will likely stand
ObamaCare twenty-five years from now, too.
raids headquarters of The Scooter Store as part of $100 million Medicare fraud investigation. More than 150 FBI agents and
local cops have raided the Texas headquarters of The Scooter Store, the nation's largest supplier of mobility vehicles, after the company
allegedly defrauded Medicare by $100 million. The company is accused of harassing doctors with constant phone calls and surgery
visits in order to wear them down to prescribe their vehicles to patients who do not need them.
Note: Federal, state and local governments spent a total of $783.8 billion on health care in
Medicare improperly paid
$120M to ineligibles. Illegal immigrants and prison inmates received more than $120 million in Medicare services from
2009-2011 despite federal law that makes them ineligible for the program, according to two new reports from the HHS inspector general.
The issue, according to the reports, is timing. When Medicare is alerted that someone is incarcerated or undocumented, its contractors
help prevent payments from going out the door. But often, Medicare's databases aren't up to date, and improper payments go out.
The Real Country-Killer in 2013.
Every week, the U.S. Treasury borrows money to keep operating, by holding auctions of "T-Bills." Institutional investors, foreign and
domestic, show up to bid on these government bonds (Treasury Bills). What if investors decide that it just isn't worth risking any more
of their money? There won't be any money. Even when the country still looks strong, investors could sit on the sidelines, worrying:
"Let someone else take the risk." If the lending stops, can the country survive when the Ponzi scheme collapses? What if there is no
money to cut social security or Medicare checks, or operate the government?
Lee: Entitlements Off The Table, They Are "Earned". Rep. Sheila Jackson Lee (D-TX): "There is no way, Mr. Speaker, that we should
raise the eligibility age for Medicare, that we should not think carefully about how we approach the reform of Medicaid. And that we don't the
American people that Social Security is solvent. [..."]
The Editor asks...
If you are entitled to receive something, it isn't necessary to earn it.
This Is Your Life under Obamacare. We couldn't
afford Medicare or Medicaid. They're unfunded liabilities by trillions of dollars, when projected into the future. And the solution
is — what? To impose a third government insurance program that we can't afford — ObamaCare? That's like a
working-class family not being able to afford their two cars, so their solution is to buy a third one.
Dems' Medicare lie. Attention, New
York's 3 million seniors: Don't be fooled. It's the Obama health law that destroyed Medicare, though the impact will not be felt for another
year or more.
Record 70.4 Million Enrolled in Medicaid
in 2011: 1 Out of Every 5 Americans. A record 70.4 million people were enrolled in the Medicaid health care program for the poor in
fiscal year 2011, according to government figures provided to CNSNews.com. That figure equals about 22 percent of the population, which
means there was one person on Medicaid for every five Americans in 2011.
Darryll Issa subpoenas documents on Medicare pilot program.
House Oversight and Government Reform Committee Chairman Darrell Issa subpoenaed the Obama administration Monday [10/22/2012] for
documents he believes will expose Medicare malfeasance by Department of Health and Human Services officials.
and Medicare Enrollees Now Outnumber Full-Time Private Sector Workers. The combined number of people enrolled in Medicaid
and Medicare — the government health-care programs for the poor, disabled and elderly — now exceeds the number of full-time
private sector workers in the United States. In 2011, according to the Centers for Medicare and Medicaid Services (CMS), there
were 70.4 million people who enrolled in Medicaid for at least one month.
The First $1 Trillion Agency. In
1965, when President Lyndon Johnson signed legislation creating Medicare and Medicaid, all federal outlays equaled $118.23 billion,
according to OMB. In fiscal 2012, according to the Monthly Treasury Statement for September, outlays for the Centers for Medicare
and Medicaid (CMS) alone hit $1.05 trillion — the third straight year they exceeded $1 trillion.
No other federal agency has ever run annual outlays in excess of $1 trillion. By comparison, total outlays for
the Department of Defense in fiscal 2012 were $650.9 billion.
stonewalling lawmakers about project that hides Obamacare cuts to Medicare. Health and Human Services Secretary Kathleen Sebelius has
ignored congressional inquiries about an expensive program, which the Government Accountability Office recommended she cancel, that hides Obamacare
cuts to Medicare Advantage until after the presidential election. HHS has spent $8.3 billion on a demonstration project that, in theory,
"test[s] whether a tiered bonus structure would produce better results" by providing bonuses to insurance companies.
The funny think about reform & fear.
That segment of the population that has the least to fear from a reform of Medicare or Social Security is the most fearful — namely, those already receiving Medicare
or Social Security benefits. It is understandable that people heavily dependent on these programs would fear losing their benefits, especially after a lifetime of paying
into these programs. But nobody in his right mind has even proposed taking away the benefits of those who are already receiving them.
50 Examples of Government Waste.
Soaring government spending and trillion-dollar budget deficits have brought fiscal responsibility — and reducing government
waste — back onto the national agenda. President Obama recently identified 0.004 of 1 percent of the federal
budget as wasteful and proposed eliminating this $140 million from his $3.6 trillion fiscal year 2010 budget request.
Aiming higher, the President recently proposed partially offsetting a costly new government health entitlement by reducing $622 billion
in Medicare and Medicaid "waste and inefficiencies" over the next decade. Taxpayers may wonder why reducing such waste is now merely
a bargaining chip for new spending rather than an end in itself.
More Obamacare Fiction.
President Obama said during his weekly radio address today that he wanted to share "some actual facts" about "a lot of accusations and
misinformation flying around" about Medicare. Let's look at the "facts" that he highlights in his address: ["]We've extended
the life of Medicare by almost a decade.["] He "extends the life of Medicare" by paying Medicare providers less and less every year
to the point that 15 percent, and eventually 40 percent, of Medicare providers will either go bankrupt or stop seeing Medicare
patients altogether, according to Medicare actuaries.
'They'll Just Lie'. On Saturday [8/25/2012],
the Obama campaign released [an] ad attacking the Romney Medicare proposal. The ad doesn't walk some sort of narrow line between misleading
and deceiving, it's just simply a pack of lies from top to bottom. The ad's most significant claim is that "instead of a guarantee, seniors
could pay $6,400 more a year" under the Romney plan — a claim attributed on the screen to the Center on Budget and Policy Priorities.
40 Reasons Not To Re-Elect Barack Obama.
[#1] Obama took 700 billion dollars out of the Medicare program and put it into his wildly unpopular health care program. This
is despite the fact that even Obama has admitted, ["]Medicare in particular will run out of money, and we will not be able to sustain that program
no matter how much taxes go up.["] Mitt Romney and Paul Ryan will put that money back into the Medicare program where it belongs, while
Medicare Jujitsu. Medicare has been a favorite
issue of the left for decades. As the program's spending has ballooned out of control, Democrats have used every Republican attempt to
rein it in as an opportunity to paint the GOP as the enemy of the elderly — telling seniors that their benefits were threatened, and
scaring Republicans away from reforms. But Democrats have grown so comfortable with Medicare demagoguery that they have neglected
to actually keep themselves on the safe side of the issue.
Have "Stepped On A Land Mine With Medicare". Charles Krauthammer: ["]I think the Democrats are discovering that they stepped on a land
mine with Medicare. The fact is that Medicare was raided for Obamacare and here's why. This isn't even a wee issue. The Obama administration
had to show — because it kept arguing that this is not going to cost anybody anything, this will be revenue neutral. It's not going to add to the budget
deficit. Remember that was the mantra for a year and a half. So they had to get half a [trillion] dollars from somewhere.["]
The Obama Bankruptcy. The end of Medicare and Medicaid as we know
them — through reform, the Ryan way, or bankruptcy, the Obama way. The direction of the country — via the Romney-Ryan right track,
or the Obama-Biden wrong track. Those are the choices, made stark by the addition of Paul Ryan to the Republican ticket.
The Closer One Looks At
Obamacare, The More It Looks Like Medicaid. So far, President Obama is withholding the final set of regulations that describe just what
health benefits the Obamacare plans will deliver. He may be waiting until after the election. But there's enough detail already in the law
to make decent estimates. The answer turns out to get a lot worse, the closer one looks. There's good reason to believe that in short order,
the health plans sold in Obamacare's heavily regulated, state-based insurance exchanges will degrade into something akin to today's Medicaid managed
The $6,400 Myth. One of President Obama's regular attacks on
Paul Ryan's Medicare reform is that it would force seniors to pay $6,400 a year more for health care. But merely because he keeps repeating this doesn't mean it's
in the same area code of accurate. The claim is based on a now out-of-date Congressional Budget Office estimate of the gap between the cost of health care a
decade from now, in 2022, and the size of the House budget's premium-support subsidy for a typical 65-year-old in 2022.
DNC Vice Chair: That $700 Billion
Isn't 'Necessary or Essential' to Medicare. Vice-chair of the DNC Hispanic Caucus, Andres Ramirez, discusses the $700 billion at issue in
the Medicare debate with King of Nevada Political Coverage Jon Ralston, and declares that, "Both campaigns are consistent that that money, in and of itself, is
not necessary or essential in the Medicare budget."
The Mediscare Boomerang. President Obama all but called
Paul Ryan's Medicare reform un-American in 2011, and Democrats have since spent 16 months running their familiar Mediscare campaign. But all of a sudden
liberals and their media bodyguards claim to be scandalized because Mitt Romney has the nerve to defend himself by describing Mr. Obama's own "Medicare cuts."
How dare he? The double standard is predictable, but the furor is also instructive. For the first time in memory, voters this year may have a choice
between two very different philosophies about how Medicare ought to evolve. The political class is spitting nails because, thanks largely to ObamaCare, a
reform agenda might finally get a fair hearing.
The Obama Medicare
Plan: Rob It and Let it Die. Gov. Romney and Congressman Ryan have something President Obama does not: A plan to save
Medicare. That's right, for all their scare tactics, President Obama and Democrats have no plan whatsoever to preserve Medicare for
future generations — or protect it for today's seniors and those nearing retirement.
Ryan Plan Would Save Medicare; Obamacare Will
Destroy It. "Who is in charge: the government or the patient?" Paul Ryan asked during a speech about health care last September at the
Hoover Institution, Stanford University. Obamacare's answer is the government -- to the detriment of today's seniors. Ryan has come up
with an alternative market-based plan that prevents Medicare from self-destructing because of out-of-control spending, without substituting government mandates
and rationing for the choices that are better left to patients, including seniors, and their doctors.
The GOP's Medicare Advantage. Predictably,
Democrats went after Mitt Romney's new running mate immediately, describing Paul Ryan as a "certifiable right-wing ideologue" whose views are "extreme"
and "radical." They focused on Medicare, warning that Republicans "would end Medicare as we know it," making it "a voucher system" that costs
seniors "thousands of dollars in health care costs." Some Republican hand-wringers moaned. They failed to consider that Democrats were
going to level these charges no matter whom Mr. Romney picked as his running mate. And they ignored the ammunition the party has to turn the
issue against Democrats.
The Five Worst Ryan Myths. [#1] The Ryan budget "ends Medicare." [...] The
oft-repeated claim is so blatantly false that the fact-checking website PolitiFact awarded it the dubious honor of "Lie of the Year 2011," having thoroughly
debunked the charge in nine separate fact-checks rated either "False" or "Pants on Fire." Ryan has proposed to restore solvency to Medicare by gradually
transforming it from a fee-for-service government program into a "premium support" system. Americans aged 55 and above would not be affected.
The Return of Mediscare. On CNN yesterday [8/12/2012], Obama
strategist David Axelrod claimed that "most of the experts who have looked at this" have said that Paul Ryan's plan to reform Medicare would put the program "in
a death spiral" and "would raise costs on seniors by thousands of dollars." A day earlier — as Representative Ryan was preparing to accept Mitt
Romney's offer to join his ticket — Obama campaign manager Jim Messina had said the plan involved "shifting thousands of dollars in health-care costs
to seniors." None of this is true. Any expert who looks at Ryan's plan — any intelligent and fair-minded person, really — can
tell you the actual worst-case scenario for how much more it could make beneficiaries pay: $0.
Southern governors secede from Medicaid. House
Republicans are lining up to repeal the Affordable Care Act on Wednesday [7/11/2012], but GOP governors in the South have a real
plan to gut the law. Govs. Rick Perry in Texas and Rick Scott in Florida have both said they won't expand Medicaid to more
of the working poor in their states — rejecting a central part of the law designed to cover 15 million more
admin to use $8.3 billion "slush fund" to fake out seniors? How does Barack Obama keep from getting ousted
by seniors who discover that their Medicare Advantage options for 2013 will be greatly reduced, if not eliminated altogether?
After all, ObamaCare's $500 billion in cuts to the highly successful private-public partnership begin in 2013, assuming that the
Supreme Court keeps the law in place this summer. Those cuts are necessary to fund the Medicaid expansion that comes
in 2014 to provide funding for coverage of many — but not all — of the currently uninsured.
Says GAO Report Is 'Just Not Accurate' Then Helps Confirm That It Is. To the Cornhusker Kickback, the Louisiana Purchase,
and Gator Aid, President Obama has now added the Senior Swindle — a ploy to spend $8.35 billion in taxpayer money to hide
the effects of Obamacare's Medicare Advantage cuts until after the election. [...] The Obama administration is claiming that this
expenditure of $8.35 billion is legal because this money is being spent, the administration claims, on a legitimate "demonstration
project" to help improve the implementation of current law.
slush fund shows Obama's abuse of power. President Obama regularly misuses executive power, often nakedly in
the service of his political interests. [...] The administration's sleight of hand on Medicare Advantage fits a pattern of
Obamacare provisions that were abandoned when they were shown to be unworkable. What makes the Medicare gambit more
distressing is that Obama is using taxpayer money for political purposes.
Is Obama Cooking the
Medicare Books? A new Obama administration report claims that health reform (ObamaCare) will save taxpayers
$200 billion in the Medicare program through 2016. To what do we owe this good fortune? A good chunk of the
savings, we are told, will be produced by lowering "excessive payments" to Medicare Advantage plans.
A bad day for the White House — and for
taxpayers. The White House did not have a good Monday [4/23/2012]. The day started with the Government Accountability Office calling
for the cancellation of an $8.3 billion program that is supposed to reward high-quality Medicare plans, but is paying off average plans instead.
That was followed by the Medicare trustees, who reported that Medicare's trust fund will be out of money five years earlier than they predicted when the
president's health reform law was enacted.
Obama's Latest Plan to Snooker Seniors. For years, the
President and his congressional accomplices have been telling us that the Medicare Advantage (MA) program is too costly. [...] This canard was the pretext
for the massive slashes in MA funding he authorized when he signed Obamacare into law.
Charged With $375-Million Healthcare Fraud. A Texas doctor was arrested Tuesday for allegedly "selling his signature" to
process nearly $375 million in fraudulent Medicare and Medicaid claims in a scheme that was carried on for half a decade;
$350 million was improperly billed for Medicare and $24 million for Medicaid. In what is being characterized as
one of the largest healthcare scams organized by a single doctor, critics are suggesting that the development only solidifies the
fact that the government's Medicare and Medicaid fraud detection system is gravely flawed.
Grandma Catches Medicare Fraud on Tape. A hidden camera recorded the undercover grandmother's visit to a doctor in
McAllen, Texas, where she told the doctor and nurses she exercised regularly and, other than some hypertension and arthritis, was
in excellent health. ... Yet the official certification sent to Medicare for home health care services indicate she was homebound
and suffered from two internal infections, incontinence and needs "assistance in all activities, unable to safely leave home,
severe sob," an abbreviation for shortness of breath.
7 accused of $375M Medicare,
Medicaid fraud. Years after Jacques Roy started filing paperwork that would have made his practice
the busiest Medicare provider in the U.S., authorities say they've found most of his work was a lie.
Hospital employee charged in $100 million Medicare case. An executive of Riverside General Hospital
was arrested and charged Wednesday [2/8/2012] in a $116 million Medicare scheme involving kickbacks to patient
recruiters and the owners of homes for the elderly and disabled in exchange for steering residents to Riverside's
mental health clinics.
Medicare Reforms: Medicare
is the third-largest federal program after Social Security and defense, and it will cost taxpayers about $430 billion
in fiscal year 2010. Medicare is one of the fastest-growing programs in the federal budget, with spending
likely to double over the next decade and to surpass Social Security spending by 2028. Numerous studies
suggest that about one-third of Medicare spending is wasted.
Plantation Masters Play Race Card Again. The more states expand their Medicaid programs, the more federal
funds they get. So they have a perverse incentive to keep growing these programs. It is unfortunately analogous
to drug pushers who get richer with each new addict. If indeed Santorum did single out blacks, it's not unreasonable
because they are disproportionately on Medicaid. Blacks comprise 12 percent of the population but they
constitute 30 percent of those on Medicaid. Medicaid is government monopolized socialized medicine for
the nation's poor. Not surprisingly, its spending is out of control while delivering increasingly shoddy care.
arrested in $90 million Medicare fraud scheme. The owners of a Houston mental health program were
arrested Wednesday [12/14/2011], charged with trying to bilk Medicare out of $90 million for treatments that
amounted to little more than patients "watching movies, playing bingo or engaging in other activities," federal
authorities contend. Mansour Sanjar, 78, and Cyrus Sajadi, 64, both physician owners of Spectrum Care in
West Houston were charged in the alleged phony treatment scheme, which involved kickbacks to the owner of an
assisted living facility in exchange for finding and funneling patients to the clinic.
system for Medicaid in trouble. Managers of one of the state's largest service contracts came
in for a barrage of criticism Tuesday after legislators were provided a copy of an audit detailing why the
project is hundreds of millions of dollars over budget and nearly two years behind schedule.
Entitlement Programs: A Plan to End
Them. America's financial situation is precarious. Over the past eight years our national debt
has doubled to $14.5 trillion, and our total unfunded liabilities now exceed an astonishing $114 trillion.
That's $1,115,000 per federal income taxpayer. Even the most unrepentant spendthrift understands that these
debts and liabilities are unsupportable, nor can they be solved by immorally targeting the rich. Instead, we
must enact immediate, across-the-board spending cuts, with special emphasis on the biggest components of our
financial wreck: Social Security, Medicare and Medicaid. These entitlement programs constitute the
majority of our unfunded liabilities, because despite being labeled "trusts" they're not actually savings plans.
Are Not Created Equal. Medicare was signed into law in 1965. It was advertised to be the
same as Social Security but was another Ponzi scheme, even less sustainable than Social Security. ... Estimates
vary but best "guesstimates" suggest that the average person who works 40 years pays $115,000 in to
Medicare, and will take out at least $375,000 in medical expenses. Anyone who has ever balanced a
checkbook knows you cannot spend more than you have, unless of course you are the federal government.
U doctor gets 11 years for Medicare fraud. A West University anesthesiologist was sentenced
Friday [10/28/2011] to at least 11 years in prison for her role in a $45 million Medicare fraud
scheme involving a bogus physical therapy clinic.
man's resolve helps uncover multimillion-dollar health care fraud. It started when
Richard West went for some dental work and was told his Medicaid benefits had somehow maxed out. ... After
checking his own medical records, West, 63, discovered the company providing him with nursing care
appeared to have overbilled Medicaid for hundreds of hours for people who were never there.
He called various government hotlines but got no help, he said — so he found his own lawyer.
O'Keefe Sting Exposes Medicaid Corruption. Conservative activist James O'Keefe traded in his
pimp hat for a Russian accent during his latest undercover sting operation, in which he pretends to be an
affluent European drug dealer attempting to obtain Medicaid benefits from an Ohio government office.
Once again, the con apparently worked. Government employees are shown on video assisting O'Keefe in
applying for medical assistance, after he tells them that he sells drugs, pimps out his underage sister and
recently purchased an $800,000 car.
Prediction Backfires? Glitches Arise in Health Law. Back in March 2010, then-House Speaker Nancy
Pelosi, D-Calif, uttered the now-famous words, "We have to pass the bill so that you can find out what is in
it, away from the fog of the controversy." Pelosi was talking about the health care law, and it appears
she was right about the fact that it was full of unknowns. It turns out that, due to a glitch in the law,
roughly three million middle-income Americans could wind up on Medicaid — which was designed to
assist the country's poorest citizens.
The best way for congressional Republicans to make the case for the Paul Ryan budget is to contrast it with
the Democrats' plan. To the extent the Democrats have one, it centers on empowering the so-called
Independent Payment Advisory Board (IPAB), a panel of 15 bureaucrats, to make cuts to Medicare.
This is a constitutionally suspect scheme that will make Medicare worse for seniors while leaving in place all
the program's perverse incentives, which distort the rest of the health-care market.
wrecks Medicare by design, but why? "We don't want to take away people's health insurance,"
Health and Human Services Secretary Kathleen Sebelius so graciously declared earlier this year. But then
she quickly qualified that with these ominous words: "before they have some realistic other choices."
is Bad Medicine for Young America. [Scroll down] Some in the media will confirm that when
changes to Medicare are debated, the response from the audience is more abrupt than almost any other topic.
Angry Americans call or write in afraid that they'll lose their health benefits; the most common response?
"I'm only getting back what I paid in." This "getting back what I paid in" mentality has long been
fostered by our paternalistic government and is difficult to argue with unless you know that it is
Medicare was a scam from the start. It had to be a scam because its ostensible purpose — providing
health insurance for the elderly — was never the objective of its proponents. Instead, Medicare
was a stepping stone to a utopia its champions dared not acknowledge: A compulsory universal-health-care
system administered by government experts. FDR's Committee on Economic Security initially intended to
issue a health-care plan in conjunction with its universal, compulsory Social Security proposal in 1934.
Reid: 'Not in Favor
of Changing Medicare' Despite Its $24.6 Trillion Shortfall. Senate Majority Leader Harry Reid
(D-Nev.) said he was not willing to change Medicare despite the fact that the program has an estimated
$24.6 trillion in unfunded liabilities — the amount of money the government is obligated to
pay, above what it gets in tax revenue, to honor future benefits under the Medicare program.
Surprising Truth. The Obama administration has repeatedly claimed that the health-reform bill
it passed last year improved Medicare's finances. Although you'd never know it from the current state
of the Medicare debate — with the Republicans being portrayed as the Medicare Grinches — the
laim is true only because ObamaCare explicitly commits to cutting health-care spending for the
elderly and the disabled in future years.
Obama, Ryan and You.
Both parties are being disingenuous about Medicare reform. So let me be the first to open Pandora's box
and reveal three unpleasant truths. First, health care spending is growing at twice the rate of growth
of our income — clearly an unsustainable and undesirable spending path.
Medicare and Medicaid
Made $70 Billion in 'Improper Payments' Last Year. The Center for Medicare and Medicaid
Services — the federal health-care agency that is a key bureaucracy in implementing
Obamacare — made at least $70.5 billion in "improper payments" last year. These
improper federal health-care payments amounted to more than the combined total of $68.3 billion
spent by the entire Homeland Security and the State departments last year, which spent $44.5 billion
and $23.8 billion respectively according to the White House Office of Management and Budget.
plays the Medi-scare card against Republicans. Medi-scare is back. This week President Obama
marched out Health and Human Services Secretary Kathleen Sebelius to start a new Democratic campaign aimed at
frightening senior citizens. Her message: They will be left with unfilled prescriptions, canceled
rehab sessions and a thousand other pains because of spending cuts being sought by the terrible, hard-hearted
Republicans in Congress.
GAO: Almost A Tenth of Medicare Spending
was Improper. An estimated $48 billion went to improper Medicare payments last year,
out of the $509 billion spent on health care for elderly and disabled patients, an audit shows.
Medicare's susceptibility to fraud, coupled with its size and complexity, has helped keep it on the GAO's
high-risk list since 1990. The GAO has repeatedly requested that Medicare make a number of changes,
and while some progress has been made, the agency has significant challenges to overcome. "Medicare
remains on a path that is fiscally unsustainable," warned Kathleen King, health care director at GAO.
Texas doctors leaving Medicare
hits record high. Texas doctors fed up with Medicare's declining reimbursements dropped out
of the government-funded program for the elderly in record numbers in 2010, according to new data.
One hundred and seventy-two doctors formally ended involvement with Medicare last year, the most yet in a
surge of "opt-outs" that has claimed more than 450 Texas doctors since 2008. Before 2007, the number
averaged a handful a year.
$24 billion black hole. Governors and state lawmakers are anxiously waiting to see whether
Congress will send them another $24 billion to help cover their ever-expanding Medicaid rolls.
America? AARP. The great question haunting Washington's budget debate is whether our elected
politicians will take back government from AARP, the 40 million-member organization that represents
retirees and near-retirees. For all the partisan bluster surrounding last week's release of President
Obama's proposed 2012 budget, it reflects a long-standing bipartisan consensus not to threaten seniors.
Programs for the elderly, mainly Social Security and Medicare, are left untouched.
Mugged by Medicare.
The Obama administration is trying to shove Medicare coverage down the throats of senior citizens who don't
want it, but it's efforts are falling flat. Five plaintiffs are suing, arguing that no
statute or regulation allows government to implement this requirement.
Running the government on
8¢: Today, the United States spends roughly 76 cents of every federal tax dollar on
just four things: Medicare, Medicaid, Social Security and interest on the $14 trillion debt.
That leaves 24 cents of revenue to pay for everything else the federal government does.
Nurses, Therapists Arrested For Medicare Fraud. Federal agents raided health care facilities in
nine states this morning [2/17/2011], arresting dozens of suspects believed to be defrauding Medicare of tens of
millions of dollars, ABC News has learned. Federal authorities say this is one of the largest —
if not the largest — take down of Medicare fraud suspects ever conducted.
and the General Welfare Clause. [Scroll down] Congress could simply provide any state
that chooses to withdraw from Medicaid a federal block grant equal to the amount that state's taxpayers
would otherwise receive for Medicaid. That would make its choice to remain in or opt out of Medicaid
truly voluntary and ensure that the Medicaid program serves the general welfare. A cynic might respond,
Congress would never offer such a block grant because then lots of states might withdraw. Exactly right.
states get bonuses for adding uninsured children to Medicaid rolls. Even states can get
performance bonuses, at least when it comes to moving kids from the "uninsured" to the "insured" list.
Health and Human Services Secretary Kathleen Sebelius announced that 15 states will be getting a little
something extra in their end-of-the-year stockings for their effectiveness at providing health insurance to
kids through Medicaid.
The Editor says...
In other words, the federal government is bribing the states to get more people dependent on welfare.
Here's a tool that
could untrack the third rail. Neither the Democratic Party nor the Republican Party has ever shown
much desire to address the problem of ever-increasing government, in part because they would pay a political penalty
if they did. Certain big-ticket programs still retain considerable support from people who have no idea of
their costs. That's especially true of those out-of-control "entitlement" programs, Social Security and
Medicare. The challenge now is to help the American people understand that their future — and
that of their children and grandchildren — depends upon their willingness to rein in these beloved
programs which the nation simply cannot afford.
'Big Lies' Get Bigger. How many "Big Lies" has Obama told? Frankly, it's becoming
difficult to keep track of them. Most recently, the top actuary at the Centers for Medicare and
Medicaid — a pair of programs that shouldn't even exist in the first place — revealed
that millions of American seniors will have to pay increased out-of-pocket health care costs next year for
"less generous benefit packages" as a direct result of Obamacare.
How To End The Doctor Dance.
If you want to know why Washington can't control entitlement spending, there's no better example than the regular ritual
surrounding Medicare payments to physicians. It has been going on for more than a decade, and it follows a
Welfare King. ObamaCare is supposed to help about 32 million uninsured Americans get
health coverage. Half of those will get it through Medicaid, a means-tested entitlement program.
Folks, Medicaid is welfare. Democrats want to put 16 million more Americans on the welfare rolls
through Medicaid — and they think that's a good thing!
Every Awful Thing You Need to Know About Obamacare.
Medicare and Medicaid are already famous for the billions in fraud in these two programs. Obamacare sharply
expands Medicaid. The Congressional Budget Office reports the Act will increase federal spending by
almost $1 trillion over the first ten years. With full implementation, starting in 2014, it will
increase spending by $2.4 trillion, making it the most expensive legislation ever approved by Congress
and signed by a president.
Dozens charged with largest Medicare
scam ever. A vast network of Armenian gangsters and their associates used phantom health care clinics
and other means to try to cheat Medicare out of $163 million, the largest fraud by one criminal enterprise
in the program's history, U.S. authorities said Wednesday [10/13/2010].
stealth ambush of senior citizens. Even Obamacare's biggest cheerleaders won't be able to ignore
Medicare chief actuary Richard Foster forever. Based on current law, Foster says, seniors who rely on
Medicare will replace Medicaid recipients at the bottom of the health care ladder as early as 2019, five years
after the individual mandate kicks in. That's when the fees Medicare pays to providers will be slashed
below Medicaid rates, which are already well below market prices.
Obama to Seniors: 'Drop Dead'.
According to surveys, no group of Americans is more skeptical of Obamacare than senior citizens —
and with good reason. While bits and pieces of the massive law are designed to appeal to seniors —
more taxpayer subsidies for the Medicare drug benefit, for example — much of the financing over the
initial ten years is siphoned off from an estimated $575 billion in projected savings to the Medicare
program. Unless Medicare savings are captured and plowed right back into the Medicare program, however,
the solvency of the Medicare program will continue to weaken. The law does not provide for that.
the Entitlement Lollipop. Two months after passing a law that supporters claimed would reduce
federal deficits, largely through Medicare cuts, the House is moving toward a temporary "doctor fix" that
would add tens of billions in Medicare costs. Even more expensive fixes are likely in the future.
Congressional leaders knew this spending would be necessary when they passed health reform in March.
Yet they didn't include this liability in the law, in order to hide the overall cost of the entitlement.
In a failing corporation, this would be a scandal, investigated by Congress. In Congress, this is known
as legislative strategy.
Obama Names Rationing Czar to Run Medicare.
Dr. Donald Berwick of the Harvard Medical School does not like free enterprise, but he does like rationing.
Two years ago, in England, he delivered a talk celebrating the 60th birthday of Great Britain's National Health
Service, the bureaucracy that runs that nation's socialized medical system. He apparently entertained
some fear that day that the Brits might turn back to free enterprise. So ... he offered British
socialists some words of advice.
radical pick for Medicare. Controversy is mounting over Dr. Donald Berwick, President Obama's
nominee to run Medicare and Medicaid — and for good reason. Berwick's writings reveal that
he would make radical changes — seniors beware. ... A fervent ideologue, Berwick puts social
engineering ahead of the individual patient's needs. In contrast, most doctors understand that
their duty is to heal each patient who comes to them.
Berwick. President Obama will bypass the Senate's advice and consent and use a recess
appointment to install Harvard's Donald Berwick — a self-avowed admirer of Britain's National
Health Service — as head of the Centers for Medicare & Medicaid Services.
As one who generally believes that administrations should receive deference in their personnel selections, I
found the recess appointment of Dr. Donald Berwick to be the administrator of the Centers for Medicare and
Medicaid Services (CMS) disturbing.
names a health czar who favors rationing. Donald Berwick is no household name, but President
Obama just handed him immense power to shape what kind of health care will be available to every American
man, woman and child. Berwick is the president's newly appointed administrator of the Centers for
Medicare and Medicaid Services, the federal agency that is ground zero for Obamacare's politicization
of American medicine.
Obama Names Rationing Czar to Run Medicare.
Dr. Donald Berwick of the Harvard Medical School does not like free enterprise, but he does like rationing.
Two years ago, in England, he delivered a talk celebrating the 60th birthday of Great Britain's National Health
Service, the bureaucracy that runs that nation's socialized medical system. He apparently entertained some
fear that day that the Brits might turn back to free enterprise.
Spending on Medicaid can be brought
under control. [Scroll down to page 13] Next to education, Medicaid is the largest single
expense in most state budgets. Costs are rising at double-digit rates in many states, while fraud and
abuse take an alarming share of every dollar spent.
The 'Unintended Consequences' of Liberalism:
[Scroll down] According to the Houston Chronicle, doctors in that state are "opting out of Medicare at alarming
rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors
unaffordable." Again, only liberals believe doctors would be willing to lose money in order to make
government health care workable. That they won't is another one of those "unintended consequences" that
apparently mystify those who consider themselves intellectually superior to the hapless dullards known as
A house divided, again.
Now we enter our history's second stage in the struggle against the abomination of socialism. Just as
slavery had been contained in the South, so entitlement socialism has, until this week, been more or less
contained in service to only the poor and the elderly. And even those programs — Medicare
and Social Security — rested on the principle of beneficiaries paying monthly premiums for the
benefits they will get later. Only the poor under Medicaid received benefit without premium payment.
A Nation of Dependents.
The more we expect government to provide our basic needs, the more we become a nation dependent on government
largesse, rather than independent individuals personally empowered to earn the values we seek. ... It has
already happened in medical insurance for the elderly. Medicare, a wealth redistribution program misnamed
"insurance," pays for the health care of our nation's elderly and has reduced the private insurance industry
for this market segment to only 1% of seniors. None can compete with Medicare's mandatory contributions
or the IRS as its collection agency.
Welcome to the Long Run.
[Almost] no one is pushing real Medicare reform or any entitlement reform at all. If anything, politicians
simply want to add more stuff to them. Let's be clear. The real causes were not those listed by [Joel]
Achenbach. The real causes were the great "accomplishments" of the New Deal and the Great Society:
Social Security and Medicare. They were Ponzi schemes, budget time bombs. The short run is over
and I hope you all had a good time, because the long run is here and now.
Let It Burn. If Republicans
take control of the House and Senate, and if they repeal the health care bill, then they will not be able (or
likely even try) to reform Medicare or Social Security. These programs alone will bankrupt our nation.
Yet they are untouchable because a large number of Americans have come to depend upon these benefits. They
have become unknowingly hooked.
Entitlement Rip-Off. Bernie Madoff
took money from people who thought he'd invested it, gave some to others who thought it was a partial return
on their earlier investments and kept much for himself. That's called a Ponzi scheme, and his $50 billion
fraud was called the biggest ever. But it wasn't the biggest. Social Security and Medicare are much
bigger ones. These are trillion-dollar scams. Medicare has a $36 trillion unfunded liability.
Social Security's is $8 trillion. There's no money to keep those promises. But Congress isn't
investigating this scam. Congress runs it.
American Power: The United States currently spends roughly as much on defense ($661 billion
in fiscal year 2009) as the rest of the world combined. But that's a pittance compared to what we spend
on three major entitlement programs — Social Security, Medicare and Medicaid.
Federal Spending: With the
entitlement programs Medicaid, Social Security, Medicare and Medicaid and discretionary spending levels set to
consume increasing shares of national income, a challenge of unprecedented proportions looms large for
Congress and the president. Federal revenues are expected to consume 19 percent of gross domestic
product (GDP) in 2009, which constitutes a high by historical standards.
Ugly Truths Americans Will Have to Face. [#1] Entitlements must be cut. By 2030, the
Congressional Budget Office is estimating that Social Security, Medicare and Medicaid will make up 75% of our
budget spending. In other words, unless we get a handle on entitlement spending, it will be impossible to
get our deficits under control.
Accelerating the Speed of Lies:
Even Republicans know that Medicare is in need of some changes to improve the program. Tort reform and
the ability to purchase health insurance across state lines are but two improvements that make perfectly good
sense to most people. However, the reform being proffered by the White House is nothing more than a
socialist expansion of a government that is already too large and too unwieldy to serve the interests of
Americans. It would, as is often pointed out, destroy the best health system in the world and put
one sixth of the nation's economy under the control of government.
The Land of Entitlements.
[Scroll down] To put this in context, one must realize that there are no Medicare recipients alive today
who have firsthand knowledge of being without Medicare while elderly. Some may remember their parents or
grandparents surviving well into old age without Medicare, but not themselves. Very few alive today remember
a time without Social Security. Within the space of a human lifespan, our society has become a culture conditioned
to accept (and expect) entitlements as the norm without questioning the consequences. It has been a very
effective strategy to enlarge government.
Clueless in Washington.
[Scroll down] In the medium term there are only two ways to bring the deficit back to a sustainable
level — which means no more than 3% of GDP. Either taxes will have to rise, or a serious
attempt must be made to rein in the entitlements — legally mandated programmes such as
Medicare, Medicaid and Social Security — that constitute the great bulk of spending.
States Warn Congress of Possible Lawsuit Over
Nebraska's 'Cornhusker Kickback'. Thirteen state attorneys general have sent a letter to
Congress threatening legal action against health care reform unless a provision in the Senate bill given
to Nebraska is removed. The provision is known as the "Cornhusker Kickback," because it gives
Nebraska a permanent exemption from paying for Medicaid expenses that would be required of all the
other states. This means that taxpayers in other states would be paying for an increase in
Nebraska's Medicaid population. Medicaid is a federal-state health care program for the poor.
Mayo Vs. Medicare.
President Obama suggested last summer that the Mayo Clinic was the model for government medical care. On
Monday [1/4/2010], the Mayo Clinic in Arizona stopped taking Medicare patients. Now what?
The mother of all unfunded
mandates. Now that the Medicare expansion has been stripped from the Democrats' health
care legislation, we would do well to focus on the Medicaid expansion. The legislation would
expand eligibility for Medicaid to those whose income equals 133 percent or less of the poverty
level. According to Mississippi Governor Haley Barbour, this would add roughly 15 million
people to the program. ... Where will the money for the expansion come from? Not from the
shows how Medicare rewards MDs for overuse. Medicare's move in 2005 to pay doctors to do bladder cancer
surgery in their offices rather than in hospitals dramatically raised the number of procedures and overall health
costs, U.S. researchers said on Monday.
Remember December 3.
58 Democrats voted to slash half a trillion from Medicare. And those who are up for re-election next year
will hear about it over and over again.
Court clears suit to affirm voluntary Medicare, Social Security. A
federal judge has cleared the way for consideration of a class-action lawsuit in which plaintiffs — including
former House Majority Leader Dick Armey — are asking for a ruling upholding an existing law that declares
participation in Medicare and Social Security to be voluntary, not compulsory.
granny' bill. As the health-reform bills move through Congress, the prognosis for Medicare patients gets
worse and worse. The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus)
robs the elderly to cover the uninsured — like snatching purses from little old ladies. The House bills
already cut future funding for Medicare by $500 billion over the next decade.
Making the World Safe for Medicaid Fraud.
Americans expect to show a photo ID when they board a plane, enter many office buildings, cash a check or even rent a
video — but rarely in voting or applying for government benefits such as Medicaid. Many Democrats
seem to view asking citizens for proof of identity as an invasion of privacy — though what's really being
protected is the right to commit identity fraud. Exhibit A is Tuesday's 13 to 10 party-line
vote in the Senate Finance Committee rejecting a proposal to require that immigrants prove their identity
when signing up for federal health care programs.
Medicare Is No Model for Health
Reform. [Scroll down] Medicare is going bankrupt. The Medicare Trustees estimate that the
program will run short of money starting in 2017. Medicare will drown in a sea of red ink, with spending over
the next 75 years outpacing dedicated revenues by nearly $38 trillion.
At its start, in 1966, Medicare cost $3 billion. The House Ways and Means Committee, along with
President Johnson, estimated that Medicare would cost an inflation-adjusted $12 billion by 1990.
In 1990, Medicare topped $107 billion. That's nine times Congress' prediction. Today's
Medicare tab comes to $420 billion with no signs of leveling off. How much confidence can we
have in any cost estimates by the White House or Congress?
Obama's ambitious agenda:
The Social Security trustees announced this month that the program will begin running out of money in just seven years,
and the Medicare trustees said Medicare's Part A hospital fund will be insolvent one year later. Saving these
programs from financial collapse would be a major task in and of itself. Mr. Obama, however, wants to do it
all — including bail out the economy; create a government health care system; pour billions more into
education, including a new college-tuition program; and end the nation's reliance on fossil fuels. And that's
just for starters.
A 'Dear Congresswoman' Letter
Protesting ObamaCare. [Scroll down] I would be pleased if you would consider the following observations
and suggestions regarding this effort as I believe that they may better inform your considerations of legislation as it may
develop over the months ahead. First and, I believe, foremost, is the financial condition of Medicare. Without
reiterating the facts that are well known and confirmed by all of the analysts and budget watchers, this program, by itself,
is broken and will bankrupt our nation within the next generation or two.
Debt crisis must
not be 'wasted'. Trust me, I do know about the payroll tax, having been paying it for these
past 30-some years... but that's not what I was referring to when I said, "we don't have to pay for" Social
Security, Medicare and Medicaid. Instead I was talking about the fact that Congress has authorized these
benefits without being able to point to a sufficient revenue source to actually fund them. Oh yes, the
politicians talk and blather and obfuscate and promise that they will never default on their commitment to the
American voters who have paid into the system for many years. But convicted-felon financier Bernie
Madoff told his clients that their money was safe, too.
Social Security and Medicare Projections: 2009. The
2009 Social Security and Medicare Trustees Reports show the combined unfunded liability of these two programs
has reached nearly $107 trillion in today's dollars! That is about seven times the size of the U.S.
economy and 10 times the size of the outstanding national debt.
Manufactured Healthcare Crisis.
Medicaid is funded roughly 50/50 by federal and state governments. As an essentially free benefit to the poor,
Medicaid has no tax associated with it, so it is covered by state and federal income tax revenues — that's
you and me... In 2006, Medicaid spending alone totaled $314 billion. For perspective, this
is roughly equivalent to the baseline defense budget (i.e. excluding war spending like for Iraq/Afghanistan).
State Medicaid programs are the largest single recipient of all federal grants, comprising 43 percent of the
total. In 2008, federal Medicaid and Medicare spending totaled $676 billion. Comprising only
2 percent of the federal budget in 1967, these two programs today consume 23 percent of total federal
spending. This is the largest component of the federal budget, even exceeding total wartime outlays for
From 1900 to 1965, life expectancy for men in the US rose from 46 to 67 years. In 1965, health
spending in the US was 5.9% of GDP. That was the year LBJ gave us Medicare. Life expectancy
continued to go up after that, but more slowly. Today it is about 75 years for men. And
by 2007, health spending took 16.2% of GDP. Medicare is now about to go completely broke. It
paid out more than it took in for the first time in 2008. The Medicare "fund" is expected to be depleted
a day for stimulus. The federal government has made available more than $75 billion for
stimulus projects in the 10 weeks since President Obama signed the $787 billion recovery package
into law. Not all of that money has hit the streets, however. So far, $14.5 billion has been
spent, nearly all of it to help states cope with rising Medicaid costs.
Obama's LBJ Syndrome:
As Americans listen to the smooth assurances from President Obama that his health care plan would cost
$634 billion over 10 years, a look back at how liberal assurances like these actually work
out in practice is in order. Specifically, let's take a look at the smooth assurances in 1965 from
LBJ as to the costs he saw for Medicare. Medicare, of course, was the liberal health care panacea
for seniors enacted into law by LBJ and a Democrat Congress in July of 1965 and is a fixture of today's
America. So how much was Medicare supposed to cost the American people? Promised a
solemn LBJ: $500 million a year.
Social Security and Medicare Are
Unsustainable. In 2011, the first group of baby boomers in the United States will reach the age
of 65. When the last of that generation retires in 2032, 77 million of them will have ceased working
and paying taxes and will have at least begun receiving taxpayer-funded health care and pension benefits.
A similar trend is occurring throughout the developed world. In Japan, Europe, and North America, the
number of retirees will double over the next 25 years while the number of taxpayers will grow only
10 percent. The economic consequences of these changes are dire: higher taxes, slower growth,
and lower living standards.
We Can't Tax
Our Way Out of the Entitlement Crisis. The spending shortfalls in Social Security and Medicare
are large. According to the Congressional Budget Office, Social Security and Medicare spending left
unchecked would, after a generation, consume about 10 percentage points more of GDP than it does today.
Congress Must Pull the Trigger
to Contain Medicare Spending. For years, official Washington has studiously ignored
the warnings of prominent liberal and conservative analysts, as well as the Government Accountability
Office, about the entitlement crisis, particularly the exploding costs of the Medicare program.
As a result, the crisis has deepened, piling up future debt and threatening huge tax increases on
younger workers. Medicare already has unfunded costs of $34 trillion over the next 75 years
(in net present value terms).
Rethinking Social Insurance:
The single greatest threat to the fiscal health of the United States is the runaway growth of the nation's
major retirement and health care entitlement programs. Social Security and Medicare are projected to
grow from 7.5 percent of GDP today to almost 13 percent of GDP by 2030. Already, the two
programs consume over a third of the federal budget.
Mess. Congress is spending us into a hole. We hear about the cost of earmarks and the Iraq
war. But what about "entitlements"? That's the government's ironic term for programs that transfer
money from people who earned it to people who didn't. Entitlement? How can you be entitled to
someone else's money? To finance "entitlement" programs, the government threatens force against the
taxpayers who provide the money.
New warnings about entitlements shortfall.
Trustees for the government's two biggest benefit programs warned Tuesday [3/25/2008] that Social Security and
Medicare are facing "enormous challenges," with the threat to Medicare's solvency far more severe. The
trustees, issuing a once-a-year analysis, said the resources in the Social Security trust fund will be depleted
by 2041. The reserves in the Medicare trust fund that pays hospital benefits were projected to be wiped
out by 2019.
Entitlement Tsunami Threatens America's Health Care Freedom. A quarter of health spending in the
United States, about $420 billion this year, is by the Medicare program established by the government in
1965 to ensure people 65 years old and older have access to health care. Medicare is an entitlement
covering 44 million older Americans (or 14 percent of all Americans) and pays hospitals, doctors,
suppliers, drug plans, and a variety of other providers. Medicare is financed by a mix of premium payments
by beneficiaries, payments directly from federal revenues, and a payroll tax on workers and employers.
Liberals behave like a pyromaniac who sets fire to his own house, then is angered because the rest of the family
try to salvage their possessions and escape from the blaze. Like the pyromaniac, liberals feed the destructive
flames of inflation with deficit spending on new welfare programs and the mandated monsters, Social Security and
Medicare. Then they become indignant when rational investors take steps to hedge against liberal-created
Adding Passengers to the Titanic.
According to the 2006 report of the Medicare Trustees, the unfunded liability in Medicare over the next
75 years is $11 trillion. This is the gap between the promises that the system makes to
future beneficiaries and the taxes that will be collected under current law to pay for those benefits.
Medicare is the fiscal equivalent of the Titanic, and its unfunded liability is the iceberg that lies
ahead. Proposals to increase government's role in funding health care amount to adding passengers
to the Titanic.
Monster at Our Door. Unless you're a news junkie, you probably missed Mark McClellan's announcement
that he'll resign in early October, after two grueling years as head of CMS. What's CMS? Well, it's
the Centers for Medicare and Medicaid Services, which spent $515 billion in 2005 — 21 percent
of the federal budget and about $21 billion more than all defense spending.
The Medicare Mess is Guaranteed to
Grow. The real problem is that this [Medicare drug] program eventually will replace existing
public and private spending for drugs with new taxpayer financing — at a time when entitlement
costs already are growing much more rapidly than the tax receipts that are supposed pay for them.
Take Our Money,
Please! Medicare's prescription-drug benefit — with its huge costs and labyrinthine
complexities — is already a notorious entitlement program, and it just began operating a couple of
weeks ago, on Jan. 1. Little wonder, then, that its sponsor and "partners" — the federal
government, insurance companies, drug retailers — have launched a slick ad campaign on its behalf.
Letting Medicare "Negotiate" Drug
Prices: Myths vs. Reality. In 2003, Congress and President Bush enacted the "Medicare
Prescription Drug, Improvement and Modernization Act," which established a prescription drug program for
Medicare. That legislation expressly prohibited Medicare from negotiating drug prices with pharmaceutical
companies. Rather, any negotiation that takes place is to be between pharmaceutical companies and the
insurance companies that administer the Medicare prescription drug program.
Panic. Will America have to declare Chapter 11 because of $80 trillion in unfunded
entitlement promises of Medicare, Medicaid and Social Security? Economist Laurence Kotlikoff
believes the answer is perhaps yes unless we reform our fiscal institutions.
For Some, Medicare Drug Plan Pays
Off. When Lacey P. Green went to his neighborhood pharmacy to pick up five prescriptions, he
thought he heard the pharmacist say he owed $250, but he was wrong. The cost, with his new Medicare
prescription drug card, was just $50.
Opposes Delay in Medicare Drug Benefit. The administration's rejection of one of the
chief ideas from fiscal conservatives for covering the tab for Katrina marked another example of
how difficult it will be to spend billions of dollars for hurricane relief without increasing
the federal deficit.
Nigerian indicted in $42 million health
care fraud. A Nigeria native who lives in Houston was indicted Friday [7/24/2009] on charges he
sought $42 million in false Medicare and Medicaid claims by paying folks $100 each to sign blank health
care forms he would later submit for reimbursement. Umawa Oke Imo, 54, a permanent resident alien in the
United States and native of the Federal Republic of Nigeria, was indicted this week but first charged and detained
Politicians on Drugs: When
[Illinois Congressman Rahm] Emanuel and [Gov. Rod] Blagojevich first proposed I-SaveRx in 2003, the Food
and Drug Administration warned such a program would be an illegal violation of the national ban on importing
prescription drugs. … The ban on importing prescription drugs wasn't something Republicans dreamed up
to punish the poor and senior citizens. It has been the law since 1987. That law was enforced for
eight years by none other than Bill Clinton, Rahm Emanuel's former boss.
Getting rid of
reckless spending. We are less than one generation away from Congress being unable to pay
for anything other than Medicare, Medicaid, Social Security, and interest on the federal
debt — leaving not so much as a penny for defense or homeland security.
real about Social Security and Medicare. The Social Security and Medicare
trustees have just issued their annual report on the state of these programs, and the
picture is not pretty. The combined unfunded liability, the shortfall of projected
funds available to meet projected obligations, of the two programs is around
$75 trillion. For perspective, the Gross National Product
is $10 trillion.
values: The displacement of traditional values with the "do your own
thing" agenda puts perspective on the problems with which we're now wrestling on
Social Security and Medicare. The conventional explanation for today's
Social Security and Medicare problems is demographics. Our population
is "graying" as a result of longer lifespan and fewer babies.
How Big Is the Government's
Debt? As of 2001, the accumulated entitlement obligations owed
to all people (including all current workers) who have earned Social Security
and Medicare benefits is $12.9 trillion for Social Security and $16.9 trillion
for Medicare. When these obligations are combined with the debt held by the public,
the total burden equals $33.1 trillion, or 10 times the official debt measure. This
"total debt" is more than three times the size of the nation's total output in 2001, and amounts
to $116,381 for every man, woman and child in America.
How Will We Pay for Social Security
and Medicare?. Social Security and Medicare are making future promises much
greater than the taxes that will be collected at current rates. Unfortunately,
some policymakers seem to be intent on making the problem worse, not better. Reforms
are needed that create more saving today for retirement and increase the nation's
Reforming Medicare: In a few
years, as medical costs escalate and baby boomers retire, Medicare and Social Security will
place significant burdens on the federal budget. By 2030, about the midpoint of
the baby boomer retirement years, deficits in Social Security and Medicare will
require 37 percent of federal income taxes. This means that within three
decades the federal government will either have to eliminate more than one-third of
all the income-tax-funded services it currently provides or increase the income tax
burden by more than one-third.
Government Spending on the
Elderly: Social Security and Medicare. When today's 18-year-olds reach
retirement age, Social Security spending will equal 21.7 percent of
payroll — more than twice the current burden. When Medicare and
other elderly health programs are included, spending in 2050 will equal 54.4 percent
of taxable payroll. If this projection proves true, we have already pledged more
than half the incomes of future workers just to cover benefits for the elderly already
included under current law. This burden will be even greater if Congress tacks on
a new Medicare prescription drug benefit or a long-term care benefit.
Are Medicare and Social Security
really worth it? The 2004 Medicare and Social Security Trustees Reports
show that programs for the elderly are on an unsustainable course. The expenditures
exceed the revenues to be collected, and the funding gap is projected to grow through
time. Obligations to the elderly are more than six times the size of the economy and
18 times the size of the outstanding federal debt.
2006. [Lately] there has been unrelenting negative press about the Medicare drug
benefit. The persistent whine of hysteria (to quote Joan Didion) goes something like
this: People are too confused, too scared, too ignorant to make the right choice
among a "bewildering" array of plans. And if you think making Medicare choices on your own is
scary, just try using health-savings accounts. In other words, there is agreement among mostly
liberal policymakers, journalists and advocacy types that people are too stupid to make complex
health-care decisions. (Except abortion.)
Howard Dean's Abortion
Contortions: A 1994-1995 AGI survey of abortion patients found that in states where Medicaid pays for
abortions, women covered by Medicaid have an abortion rate 3.9 times that of women who are not covered, while in
states that do not permit Medicaid funding for abortions, Medicaid recipients are only 1.6 times as likely as
nonrecipients to have abortions. A more recent study by Dr. Michael New of the University of Alabama found:
"State laws restricting the use of Medicaid funds in paying for abortions reduced the abortion rate by 29.66" abortions
per 1,000 women of childbearing age.
commission? The second reason why Bush's call for an entitlement commission is laughable
is because he is largely responsible for the growing crisis of entitlement spending. That is because
he rammed a vast expansion of Medicare through a Republican Congress in 2003 that increased the unfunded
liability of that program by almost 40 percent. According to Medicare's trustees, the unfunded
liability of Medicare is $68.1 trillion. Of that, $18.2 trillion is accounted for just by
the new drug benefit.
Headed for Congress: This is much more than an expansion of Medicare. It's
a Socialist manifesto. It's also a sure-fire recipe for disaster. It encourages unlimited
demand for health care services while severely limiting the ability of physicians to
Medicaid: Waste, Fraud and
Abuse. A 2001 GAO report on Medicaid stated, "The magnitude of improper payments throughout
Medicaid is unknown. … An even more difficult portion of improper payments to identify are those
attributable to intentional fraud. … There are no reliable estimates of the extent of improper
payments throughout the Medicaid program."
muddled meddling. What if Medicare threw a really lavish party and nobody showed
up? Last week, as Medicare cheerleaders valiantly attempted to persuade, bribe or threaten
seniors to sign-up for one of dozens of different prescription drug plans, there were numerous
reports of people being so totally befuddled they might just take a pass.
Fraud and Waste
Infect New York Medicaid. The extent of Medicaid fraud in New York State
was highlighted in July by extensive news coverage in The New York Times and other
publications. A dentist operating out of a small Brooklyn storefront billed Medicaid
for 991 procedures in one day in 2003. Similarly, in a single day a school in Buffalo
received funds for referring 4,434 students to speech therapy — without actually
talking to them or reviewing their records. Over a period of about three years, a
physician prescribed $11.5 million worth of a synthetic hormone popular with
Medicaid-paid births on the rise.
Nearly half of all births in Wisconsin were paid for by the state's Medicaid program in 2005, rising 26% since
2000. In 2005, the most recent year for which figures are available, five of the top 10 hospitals that
delivered babies paid for by Medicaid were in Milwaukee.
Feeding the 800-Pound Gorilla:
Medicaid — the nation's program to reimburse hospitals and physicians for health care provided to
the poor — has become an 800-pound gorilla sitting on the back of state budgets. In 2004 it
consumed nearly a quarter of states' budgets, and its cost is expected to rise 12 percent this year.
State legislators are scrambling to find a way to slow the program's cost spiral. Reform measures include
cutting benefits and managing the use of expensive prescription drugs. While these options deserve attention,
they do not address the loophole in eligibility rules that is really draining money out of the system.
Drug Benefit: What Difference Would It Make?. That
seniors lack access to prescription drugs is offered as a rationale for
supporting a new Medicare prescription drug benefit. If many of them do in fact
lack access, spending $400 billion in general tax revenues during the next 10 years for
the benefit would increase seniors' use of drugs. The questions then are: What fraction
of the Medicare population lacks prescription drug coverage, and how much more would they
spend if they had coverage?
The Bankruptcy of
Medicare: At the end of last year George W. Bush signed the Medicare Modernization
Act of 2003 into law in the name of "honoring the commitments of Medicare to all our seniors." The
bulk of the law provided prescription drug subsidies for the elderly, at an estimated cost of between
$400 billion and more than $1 trillion over the next decade. Less than four months
later, the Medicare's Board of Trustees issued a report citing Bush's subsidy as a major reason that
the program would go bankrupt by 2019, seven years earlier than the board predicted last year.
Explaining the Growth of Medicare: Utilization of
medical care has risen dramatically since Medicare began in 1965. That year, health expenditures accounted
for 5.7 percent of the nation's output. By 2000, the size of the health care sector had risen to
13.2 percent. This dramatic rise has been hastened by Medicare's growth. In 1970, Medicare
accounted for 11 percent of all health care expenditures in the United States; but by 2000, its share
stood at 17 percent. As health care spending has grown faster than the economy as a whole, so
Medicare expenditures have grown even faster than health care expenditures in general.
Prescription Drugs for
Seniors: Despite its political popularity, Medicare violates almost all principles
of sound insurance. It pays too many small bills the elderly could easily afford
themselves, while leaving them exposed to thousands of dollars of potential
out-of-pocket expenses, including their drug costs. For instance, each
year about 750,000 Medicare beneficiaries spend more than $5,000 out-of-pocket.
We should not covet Canada's
prescription drugs. The primary value that we obtain from the higher prices we pay for our
prescription drugs is research and the development of new prescription drugs, which benefit not only us but
also people throughout the World. If it were not for the United States, we simply would not have new
prescription drugs and vaccines to combat diseases such as cancer, AIDS, and diabetes.
ignorant? Myth: Skyrocketing prescription drugs are driving health-care
spending up. Fact: According to the Bureau of Labor Statistics, as a whole, Americans
spend about 1 percent of their income on drugs. Seniors spend about 3 percent on
drugs, less than the amount they spend on entertainment. Spending on drugs, as a percent of
total health-care spending, was 10 percent in 1960. It's roughly the same today.
Quality: The High Cost of Government Drug Purchasing. Recently
revised estimates of the projected cost of the new Medicare prescription drug benefit
have re-ignited congressional debate about the merits and design of the recently enacted
Medicare legislation. One particular argument that has received renewed attention,
both in and out of Congress, is the contention that the new drug benefit will be unnecessarily
costly because the legislation does not allow the government to use the "enormous market
clout" of 41 million Medicare beneficiaries to drive down the cost of drugs.
The FEHBP as a
Model for Medicare Reform: In deciding the future of Medicare, Congress must
choose between consumer choice or legislative and bureaucratic control of benefit design,
prices, and operational decisions. A successful example of the consumer choice model
already exists: The Federal Employees Health Benefits Program meets the health
care needs of 9 million federal employees, retirees, and family members,
and should be the model for Medicare reform.
Congress Approves Huge Expansion of
Medicare: Congress approved [06/27/2003] the biggest expansion of Medicare since its creation
nearly four decades ago. Seen as a political victory for President Bush and breaking six years of
political gridlock, the Senate and House passed competing legislation to provide prescription drug benefits to
elders and give private health plans a much larger role in the program.
Uh oh, Ted Kennedy loves the
Medicare bill. Republicans in Congress seem to have convinced themselves that they have to have
a drug subsidy bill to keep control. And the Bush administration has irresponsibly signaled that it will
sign any bill, no matter how bad.
Taxpayer Group Seeks to Save Feds $12.6
Million: The National Taxpayers Union requests that the Bush administration immediately terminate
the planned $12.6 million ad campaign on behalf of the forthcoming Medicare prescription drug benefit.
Short-Term Candy: The new
Medicare legislation does include a step toward greater freedom by allowing people to set aside money in
tax-free medical savings accounts. Good idea. But it also communizes the entire prescription
drug industry for seniors. Since we tend to get sick the most when we are older, the law pretty much
communizes the whole prescription drug industry. The cost will eventually be trillions.
Blimp is Right. The bureaucrats
probably didn't realize what they were doing when they shelled out $600,000 this year to send a Medicare blimp
touring around the country. I don't mean just the money. The blimp money is just part of the $30 million
that Medicare spends annually to let Medicare recipients know they're on Medicare.
Medicare fraud: Reforming our
way to bankruptcy. The essence of the Medicare bill is a reckless expansion of a program that was
bound for bankruptcy even before the Republicans decided to steal an issue from the Democrats by pushing a huge
new prescription drug entitlement. The official price tag for the law is $400 billion over
10 years, but it will ultimately cost far more.
tyranny: No thought is given to the American taxpayer, who is
looked upon as a magic purse that never runs out of gold. House Republicans
have been working through all-night sessions to burden the federal taxpayer
with $350 billion to subsidize prescription medicines for the elderly. These
open-ended commitments make no sense financially or in terms of health care.
Socialized Medicine at the Back Door:
For patients, single-payer means less care, and lower-quality care. After being assigned to
a physician (no, you can't choose), getting in to see that physician may not be easy — just ask
patients enrolled in Medicare or Medicaid.
Drugs and politics:
In the midst of a bipartisan stampede toward "prescription drug benefits for the elderly," someone needs to ask
the question: Why should seniors be singled out to be subsidized by the taxpayers, except that their votes
are being sought by both parties?
Washington spending going wild:
[President Bush] supported the prescription-drug plan — even if it was quite a bit richer than he proposed.
And he has pretty much set the agenda for Congress' spending — since the Democrat majority has not seen fit
to formulate an actual budget. It's just been runaway, ad hoc spending — something
Counting the Cost of Prescription Drug Price
Controls: Many politicians are calling for government price controls as a way to keep prescription
drugs affordable for senior citizens. But price controls in Canada and other countries where they have been
tried have only resulted in rationing and higher prices for life-saving drugs. A better solution is to
expand the use of tax-free Medical Savings Accounts so more seniors can pay for the drugs they need.
Reforming Medicaid: Medicaid
is enormously expensive. For the second year in a row, spending on Medicaid (for
the poor) will exceed spending on Medicare (for the elderly). At $280 billion
this year, Medicaid costs almost $1,000 for every man, woman and child in the
country — or $4,000 for a family of four. Indeed, it is likely that
many taxpayers are paying more in taxes to fund health insurance for the poor than they
pay for private health insurance for themselves and their own families.
Medicare Reform and Prescription
Drugs: Ten Principles. In an election-year rush to satisfy impatient
voters, politicians of both parties are endorsing ill-considered schemes to add a
prescription drug benefit to Medicare. While the problems with the program are
bad, most of the proposed solutions are worse. Medicare deserves thoughtful
reform — reform that can greatly reduce seniors' exposure to catastrophic
prescription drug costs, improve overall health care quality and control taxpayer costs.
in critical shape: Across the nation, state governments spend nearly
as much money on health insurance for the poor as they do on public schools — more
than on welfare, prisons and roads combined. And the tab keeps rising, fast.
Health Care is Not a Right. Our only
rights … are the rights to life, liberty, property, and the pursuit of happiness. That's all.
According to the Founding Fathers, we are not born with a right to a trip to Disneyland, or a meal at
Mcdonald's, or a kidney dialysis (nor with the 18th-century equivalent of these things). We have
certain specific rights — and only these. Why only these? Observe that all legitimate
rights have one thing in common: they are rights to action, not to rewards from other
people. The American rights impose no obligations on other people, merely the negative
obligation to leave you alone.
Is Not A Bottomless Well. One of the "benefits" of the way we finance Medicare (and Social
Security), at least, is that the law requires offically appointed actuaries to report annually on the
fiscal status of the program, via the Medicare Trustees Report. Each year, the horror of Medicare's
unfunded liability grows starker and closer.