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Author Topic: Medicare Savings
IrishTD
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Claimed by the administration:

From Obama's address to Congress:
quote:
The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud
The OMB (White House budget office) mentions a savings of $622 billion in Medic{are,aid} over the next ten years in their mid-session review (available here).

What IrishTD wants to see:
A bill from Congress that puts these savings into place. Not next month, not next year, not part of a larger reform bill. NOW. Today. On it's own merits. Get it done, end of discussion. If the cuts are logical/reasonable/etc, a bill of this type should pass with a massive majority.

If there's $60+ billion that can be saved per year in these programs, its (practically) criminally negligent not to do it.

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Greg Davidson
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Promises of future savings due to cutting "waste, fraud, and abuse" have traditionally been broken. I was surprised at Obama setting that as a goal, and going out on a limb with the "not one dime more" target. Even my conservative friends on this site would be impressed if Obama can get universal health care coverage at no additional cost (that is, nothing above current projections - which have significant growth built in, but the past 20 years have demonstrated that high future growth is highly likely).

My one hope is that they might actually be addressing the root causes of why American health care costs so much more than health care everyone else in the world. In that context, if we are currently 50% more expensive per person than the next most expensive health care, it might be possible to reduce that to 35% more expensive.

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cb
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That makes perfect sense Greg. What I don't understand is why anyone is accepting at face value the idea that the projected cost of this program is actually going to come in as projected.

JOINT ECONOMIC COMMITTEE
Senator Sam Brownback, Ranking Republican Member
July 31, 2009

Are Health Care Reform Cost Estimates Reliable?
History Shows True Costs Are Often Significantly Understated

Since the end of World War II, major health care reform proposals have generally always cost
more—sometimes significantly more—than the highest cost estimates published while the legislation was pending.

Health Service. In 1946, the British government estimated that the first-year cost of its proposed National Health Service, which would provide free health care to all citizens at the point of service, wouldbe £260 million.

The actual expenditures of the NHS in its
first year of operation (1948-49) were £359 million—38% more than predicted. Britain’s official assessment of what happened is typically
understated: “Architects of the NHS underestimated the immediate public demand and the consequent costs.”

A more vivid assessment, from the British Health Minister in May 1949 to his Cabinet colleagues:
"If the present [budget] estimates are not to be exceeded, services must be withheld which
the community has proved it urgently needs—dental treatment and spectacles must be
refused, beds must be closed, staff dismissed, and waiting lists already appallingly long
must grow even longer. I do not think my colleagues will wish this to happen; I hope they
will share my view that the additional money must be found to prevent its happening.
But if they do not, I shall need their assistance in determining which services should be withheld and which developments cancelled."

In 1988, Congress added a catastrophic coverage benefit to Medicare, to take effect in 1990. In July 1989, the Congressional Budget Office (CBO) doubled its cost estimate for the program, for the four-year period 1990-1993, from $5.7 billion to $11.8 billion. CBO explained that it had received newer data showing it had significantly under-estimated prescription drug cost growth, and it warned Congress that even this revised estimate might be too low. This was a principal reason Congress repealed the program before it could take effect.

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hobsen
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Senator Brownback has been around a long time, and he knows programs usually cost more than projected. I should hesitate to bet against him on that, as it would probably lose me money.
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Mariner
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Ignoring the actual facts about the Health bill and focusing just on Irish's topic:

This is one of the many reasons why I hate these sorts of "comprehensive" bills and would prefer Congress to pass things in a bunch of smaller packages. Every bill contains some good ideas and some bad ideas. Every bill contains things with bipartisan agreement and things that don't. Unfortunately, the party in charge will try to put the things with broad agreement in a larger bill with partisan ideas as a lever to beat over the head of the other party or of their own moderates. It's a political way of doing things rather than a practical way.

Same thing happens with State budgets. Rather than approach it piece by piece and then see where you stand, why do they all go for the massive budget plan and use the threat of a government shutdown to scare everyone into going along with it? If a state is looking at a billion dollar hole, and everyone knows that there's $200 million that could be eliminated without any problems whatsoever, why not just agree to that and move on to the rest of it? Why hold the $200 million hostage to get the rest of what you want?

Irish is right; it is criminally negligent.

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Greg Davidson
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Criminally negligent would be if there were known, guaranteed savings, but there is some uncertainty here until specific hypotheses have been proved. American health care should be able to deliver similar outcomes to those of other countries for the same amount of money. We may be making some changes to make American more like those better* alternatives, but we might make the wrong changes, or not enough changes

* Better = costs less and produces equal or better outcomes

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IrishTD
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quote:
Criminally negligent would be if there were known, guaranteed savings, but there is some uncertainty here until specific hypotheses have been proved.
Your statement seems to imply that there is no fraud/waste/abuse in the Medicare/Medicaid. Most parties (watchdogs, DoJ, DoHHS, etc.) seem to think there are billions of dollars lost to these aspects; not providing additional funding to curb these problems is criminally negligent by your definition (and even more so if the ROI is greater than 1).
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