Medicare & Medicaid Outlays - WOWSER!

[adios]

Sometime check out table 16 regarding Federal Health Spending at the following:

Federal Budget Data (http://www.whitehouse.gov/omb/budget/fy2004/pdf/hist.pdf)

Medicare and medicaid as a percentage of GDP are increasing yearly and projected to do so for the coming years. Spending on these programs is out of control. In order to fix dedicit spending these outlays have to be fixed first. Defense spending is NOT out of control IMO when looking at the data. What say you all on how to fix Medicare and Medicaid out of control costs?

[Jimbo]

"What say you all on how to fix Medicare and Medicaid out of control costs?

They shoot horses Don't they? (http://www.amazon.com/exec/obidos/ASIN/B00000K3C6/ref%3Dnosim/lksmsubsite-sub-dv-asin-20/103-1549370-5031019) This would either get the oldtimers in better physical condition or eliminate the associated medical costs.

[Boris]

Why do you say that spending on Medicare is out of control? Good health is one of the most important things you can have.

If your truly concerned about Medicare expenses there is an easy solution. Kill everyone above the age of 65.

[adios]

"Why do you say that spending on Medicare is out of control?"

Because of the following which shows the growth of Health outlays (vast majority Medicare and Medicaid) as a percentage of GDP:

<ul type="square"> 1962 0.4
1963 0.4
1964 0.5
1965 0.4
1966 0.5
1967 0.9
1968 1.2
1969 1.3
1970 1.4
1971 1.4
1972 1.6
1973 1.5
1974 1.6
1975 1.9
1976 2.1
1977 2.1
1978 2.1
1979 2.1
1980 2.4
1981 2.5
1982 2.7
1983 2.8
1984 2.7
1985 2.8
1986 2.8
1987 2.9
1988 2.9
1989 2.9
1990 3.1
1991 3.4
1992 3.8
1993 4.0
1994 4.1
1995 4.2
1996 4.2
1997 4.2
1998 4.1
1999 4.0
2000 4.0
2001 4.3
2002 4.6
2003 estimate 4.8
2004 estimate 4.9
2005 estimate 5.0
2006 estimate 5.2
2007 estimate 5.3
2008 estimate 5.4
[/list]

"Good health is one of the most important things you can have."

I agree 100%. Does slowing the growth of Medicare and Medicaid outlays necessarily mean that good health is relegated to being less important? I say no.

"If your truly concerned about Medicare expenses there is an easy solution. Kill everyone above the age of 65."

I hope you're not implying that if I believe that being opposed to arresting the growth of Medicare and Medicaid is somehow being cruel to the over 65 age group. First of all when looking at the data, in the mid 90's the Clinton administration started getting tougher IMO about Medicare and Medicaid fraud for instance and the data shows that outlays remained constant as a percentage of GDP. I would think that there is a reasonable chance that there still is much fraud inherent in the system. Surely cleaning up the system would INCREASE it's effectiveness and provide better health benefits to those that need it. Medicare and medicaid reform is a hotly debated topic in Congress I believe these days due to the nature of the increasing costs. Would tort reform regarding medical malpractice litigation help? I've also read where the system is outdated in that it only covers costs after contracting an illness and doesn't cover costs in prevention of illness all that well. Admittedly I'm educating myself on the details of these programs but I think it's fairly clear that if the rise in cost outstripping growth in GDP and revenues continue, health care for those that require these programs will certainly suffer at some point in the future.

[Boris]

Medicare costs are largely a demographic problem. Of Medicare is taking a larger chunk of the Federal budget. There are more old people and old people are living longer. Of course it's easy to bitch about the system, talk about the inefficiencies of big gov't and blah, blah, blah. But I would argue that the US has relatively little gov't sponsored healthcare and that Medicare is a highly valuable program, right up there with national defense. I think your statement, about Medicare spending being out of control, needs some serious rhetorical and factual support. Just because it is increasing doesn't mean it is out of control.

[Pot-A]

One other thing you might not have considered. Many afflictions which can be cured or treated at great expense today were cheap in the late '60s because there wasn't anything to be done.

That effect will probably increase as time goes on.

[adios]

"Medicare costs are largely a demographic problem."

I agree but I'm not convinced that the rise in medical costs can't be moderated. I'm also not convinced that there fraud in the system is not a serious problem. I'm also not convinced that the system can't be improved. In fact I'm fairly certain that Congress is going to pass some sort of Medicare reform. The question is what should they, Congress, do. As I pointed out previously, I find very interesting that during the Clinton administration the growth rate of Federal Health spending was more or less constant when the Clinton administration got tough on fraud in the system and made much ado about the charges that providers made.

"Of course it's easy to bitch about the system, talk about the inefficiencies of big gov't and blah, blah, blah. But I would argue that the US has relatively little gov't sponsored healthcare and that Medicare is a highly valuable program, right up there with national defense. I think your statement, about Medicare spending being out of control, needs some serious rhetorical and factual support. Just because it is increasing doesn't mean it is out of control. "

Basically I agree about it's value. Currently Health outlays consumes about 25% of the budget. By 2008 given the current long term growth rate in costs is maintained it will consume about 33% of the budget. By 2020 these outlays will consume about 70% of the budget. The year 2020 may seem like a long ways away but I submit that many baby boomers will be eligible for these benefits at that time. I don't think that health care spending that consumes 70% of the budget is feasible. The data I posted shows the growth rate of these outlays as an ever increasing portion of GDP and not absolute costs. In other words the growth rate of the Federal Health Spending is non-linear. For those that want a balanced budget it I submit that it will be impossible without containing the growth rate in costs of Federal Health Care outlays.

[John Cole]

Tom,

I've spoken to some people in local government positions who have said that Medicare fraud makes welfare fraud pale in comparison, yet the average voter is much more concerned about the latter when, in reality, it's hardly a problem.

[scalf]

john...

a few years ago in atlanta, a child psychiatrist got busted for medicare/medicaid fraud....billing over 2 million/year....you gotta realize about the max a psychiatrist can bill these services is around 200/hr....

the only reason he got caught was a disgruntled former employee made a real beef about it...turns out this m.d. had been billing like this for 3 years....you gotta remember it would just about be physically impossible for a shrink to bill out more than 1million/yr...even if she billed 24 hr/day...365/yr

the article also quoted a government employee that without the persistent whistle-blowing...she'd a never been caught...they had no computerized screen to check for obvious abnormalities...

word is there is better control now...lol...at least it ain't worse...

gl /forums/images/icons/smile.gif /forums/images/icons/club.gif

[nicky g]

Something I found odd:
I grew up in Belgium and the healthcare there is fantastic. It works on a compulsory social insurance scheme; doctors are private (ie they don't work for the governemnt,as they do in England), and you have to pay them up front, but you can claim 80% or more of the costs back under the insurance. The insurance is heavily subsidised by the governement, but the doctors themselves aren't - they charge you full cost. The insurance doesn't cover everything, but pretty much all procedures essential to your health.

Now, here's the odd thing. I no longer live in Belgium but I often go back for medical related things and just pay the doctors, as the service is much better than here in England (where you can wait forever for an appointment and the doctors never seem to find out what's wrong with you). I went to the dentist recently over there, and for a check-up and cleaning she charged me 25 Euros, about 30 bucks. Now I know that there are a lot of jokes aabout European dental health in the states ("freshen yer drink guv'nor" - class), but this is a fine dentist. Now, my wife did the same in the States and it cost her $100. We found similar disparities in the costs of going to the doctor for a routine check-up, tests etc. Remember this is unsubsidised health care, and prices in Belgium are not generally lower than in the states - higher for a lot of things, I'd say. So why is their such a huge disparity in the cost of health treatments? Or are my wife's dentist and doctor just ripping her off? I don't know if charges are capped/regulated (probably they are) in Brussels. I suppose also doctors in the US have to recoup the huge costs of medical training (my wife's sister, who has just started med school, is looking at debts of $200 grand (!!!), on top of her undergraduate debts), whereas in Brussels it is effectively free, so it is indirectly subsidised. But I found it interesting that the prices could be so different. Note that the US spends vastly more money than any other country on health care, and still has huge mumbers of people without access to it; it strikes me from that kind of anecdotal evidence that a lot of that money seems to be being spent on over the odds charges. But I don't really know anything about it - be interested to hear more.

[adios]

Very interesting post and much appreciated. Clinton essentially wanted to bring some uniformity and regulation to medical procedures and costs as well.

[adios]

I would be totally shocked if welfare fraud was a bigger problem than medicare problem. Welfare has undergone a procss of reform in the nineties.

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It can't get any worse can it /forums/images/icons/crazy.gif

[scalf]

/forums/images/icons/frown.gif just read article in newspaper today....,
but these facts pretty similiar year after year...

u.s. ranked by world health organization as between 23 and 33 of top 40 nations...

in spite of the highest percapita spent on health care by a large margin...

summing up, u.s. spends more per person on health care and is not ranked in the top half of industrilized countries in health care delivery...

gotta get better m.d.'s /forums/images/icons/shocked.gif /forums/images/icons/club.gif