Sunday, November 21, 2010

Medicare Costs Projected to Bankrupt Budget. Deficit Commission Chairs Kidding?

Tags: Medicare Costs Break Budget, Healthcare Guaranteed, Ezekiel Emanuel, Value Added Tax Fund Healthcare, Everyone in One System to Reduce Costs, Medicare Pool for the Sickest

I am even more convinced that Rahm Emanuel’s older brother’s book Healthcare Guaranteed by Ezekiel J. Emanuel, explains what we need to do. The funding of all heathcare has to come from a Value Added Tax which can be decreased or increased depending on the costs. Regulators or laws must also be included with changes as needed to prevent the Healthcare companies from playing the system.

Only the private healthcare companies can cut costs because they need to make profits. It is too hard to do politically even if there is a law to cut Medicare put in by Republicans. It keeps getting extended.

Combining everyone excluding seniors into one system is necessary to balance out costs as most insurance companies do. The young do not get as sick as the old once we solve the fatty problem. Two Thirds of Medicare Costs come from seniors over 75.

Overtreatment of Medicare and other patients can be reduced more easily by a for profit system if the insurance companies have laws to protect them. Regulations or laws must be there to prevent these companies from arbitrarily excluding patients from life-saving treatments. What these are must be determined over time. The healthcare insurers tried to do this wholesale but gave up because they got all the blame and congress might enact laws to prevent them from doing this. Now doctors and hospitals get more money by doing more procedures. Why not pay them more for good outcomes instead.

Technology does help if they are not abusively overused such as Cat Scans, MRI, and X-rays. Many physicians and hospitals have crippled those with back pain because MRI sees too much effects on the spine such as aging and they operate instead of letting the patient rest which cures almost all back pains. Hysterectomies mushroom in areas with more doctors with at least half unnecessary and prevents many younger women from having babies and have other side effects.

Corporations act on incentives for profit. Because health is so important for our lives, it must be regulated by laws or regulations so they do not stop necessary operations and treatments. It is ridiculous that some patients spend $50,000 on prostate cancer when a $10,000-$15,000 treatment works just as well and may be safer.

Most prostate cancers are very slow growing and operations and radiations makes most men impotent and need to live with diapers. Only the deadly surface cancers on the prostate gland kill fast and is mostly detected too late to save the patient. Europeans and others use the procedure of watching it rather than operating or radiating it no matter the state of the cancer.

Every male has some cancer there anyway. Just keep your vitamin D levels between 40-75 nanograms per milliliter of 25-hydroxyvitamin D metabolite and its likely it will not progress very fast. Another Reagan deregulation sunscreen heavy use without checking for side-effects disaster? I think so.

Jim Kawakami, Nov 21, 2010,

Columbia Journalism Review, Ryan Chittum Audit, Nov 17, 2010,

Overplayed: Audit Deputy Chief Ryan Chittum says The Wall Street Journal and The New York Times misplayed the report out of the deficit commission panel.The Journal led its front page with the big headline "Deficit Panel Pushes Cuts"; The Times was worse, going with a three-line screamer over two columns. But it wasn't even the "panel" that reported, just its co-chairs, and prospects for their ideas are dubious.

Small Deficit --or Government? CJR's Peterson Fellow Felix Salmon writes that the most clear-eyed view of the deficit commission report came from Kevin Drum, who points out that at heart it says much less about reducing the size of the deficit than it does about reducing the size of the government. The distinction is a crucial one, since the mathematics of the deficit are simple, and overwhelmingly a function of Medicare expenditures.

Medicare Costs Projected to Bust the Budget in Future Kevin Drum, Mother Jones, Nov 10, 2010, I've been trying to figure out whether I have anything to say about the "chairman's mark" of the deficit commission report that was released today. In a sense, I don't. This is not a piece of legislation, after all. Or a proposed piece of legislation. Or even a report from the deficit commission itself. It's just a draft presentation put together by two guys. Do you know how many deficit reduction proposals are out there that have the backing of two guys? Thousands. Another one just doesn't matter.

But the iron law of the news business is that if people are talking about it, then it matters. So this report matters, even though it's really nothing more than the opinion of Alan Simpson and Erskine Bowles. So here's what I think of it, all contained in one handy chart from the Congressional Budget Office:


Here's what the chart means:

  • Discretionary spending (the light blue bottom chunk) isn't a long-term deficit problem. It takes up about 10% of GDP forever. What's more, pretending that it can be capped is just game playing: anything one Congress can do, another can undo. So if you want to recommend a few discretionary cuts, that's fine. Beyond that, though, the discretionary budget should be left to Congress since it can be cut or expanded easily via the ordinary political process. That's why it's called "discretionary."
  • Social Security (the dark blue middle chunk) isn't a long-term deficit problem. It goes up very slightly between now and 2030 and then flattens out forever. If Republicans were willing to get serious and knock off their puerile anti-tax jihad, it could be fixed easily with a combination of tiny tax increases and tiny benefit cuts phased in over 20 years that the public would barely notice. It deserves about a week of deliberation.
  • Medicare, and healthcare in general, is a huge problem. It is, in fact, our only real long-term spending problem.

To put this more succinctly: any serious long-term deficit plan will spend about 1% of its time on the discretionary budget, 1% on Social Security, and 98% on healthcare. Any proposal that doesn't maintain approximately that ratio shouldn't be considered serious. The Simpson-Bowles plan, conversely, goes into loving detail about cuts to the discretionary budget and Social Security but turns suddenly vague and cramped when it gets to Medicare. That's not serious.

There are other reasons the Simpson-Bowles plan isn't serious. Capping revenue at 21% of GDP, for example. The plain fact is that over the next few decades Social Security will need a little more money and healthcare will need a lot more. That will be true even if we implement the greatest healthcare cost containment plan in the world. Pretending that we can nonetheless cap revenues at 2000 levels isn't serious.

And their tax proposal? As part of a deficit reduction plan they want to cut taxes on the rich and make the federal tax system more regressive? That's not serious either.

Bottom line: this document isn't really aimed at deficit reduction. It's aimed at keeping government small. There's nothing wrong with that if you're a conservative think tank and that's what you're dedicated to selling. But it should be called by its right name. This document is a paean to cutting the federal government, not cutting the federal deficit.

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