
But isn't ObamaCare what seniors should really be scared of? Yes,
indeed. And to hide that fact, the Obama forces are telling five big
lies.
Lie Number One: Health Reform Is Good For Seniors.
Millions of taxpayer dollars (that's our dollars) have been spent on
Andy Griffith television ads
and other advertisements trying to convince seniors that they are big
winners under health reform. If the Federal Trade Commission (FTC) could
claim jurisdiction over these ads, a lot of Obama administration folks
would be headed for the hoosegow.
In fact, 40% of the cost of giving subsidized insurance to young
people is being paid for by reduced spending on the elderly and the
disabled. For the next 10 years, the spending reduction totals $716
billion. That's no small change.
The Obama ads and the White House television talking points stress
new benefits for seniors: a free annual wellness exam and the eventual
closing of the "donut hole" for drug coverage. What they conceal is that
for every $1 spent on new benefits, seniors will lose $9 in other
spending — which gives a whole new meaning to the term "bait and
switch."
Consider people reaching the age of 65 this year. Under ObamaCare,
the average amount spent on these enrollees over the remainder of their
lives will fall by about
$36,000 at today's prices.
That sum of money is equivalent to about three years of benefits. For
55 year olds, the spending decrease is about $62,000 — or the equivalent
of six years of benefits. For 45 year olds, the loss is more than
$105,000, or nine years of benefits.
In terms of the sheer dollars involved, the planned reduction in
future Medicare payments is the equivalent of raising the eligibility
age for Medicare to age 68 for today's 65 year olds, to age 71 for 55
year olds and to age 74 for 45 year olds. But rather than keep the
system as is and raise the age of eligibility, the reform law instead
tries to achieve equivalent savings by paying less to the providers of
care.
Lie Number Two: Seniors Will Not Lose Any Medicare Benefits.
To begin with, one in four Medicare beneficiaries is in a Medicare
Advantage plan. These plans may be overpaid by Medicare, but they are
required to "spend" their overpayments on extra benefits for the
enrollees. These include extra drug coverage, dental benefits, etc. Over
the next 10 years, ObamaCare will reduce spending on these plans by
$156 billionand this reduction will inevitably lead to a loss of
benefits. The remainder of the cuts in Medicare spending will mainly be
in the form of reduced payments to providers.
Although
promised benefits won't change under orthodox Medicare, in the very act of reducing provider fees, health reform will cause seniors to get
less care.
So while the White House claim that beneficiaries will not lose
benefits may not be technically a lie, surely the FTC would pounce on a
private company if it said the same things.
Remember: lower payment to providers means less access and less access means less care. One
study
of the Children's Health Insurance Program (CHIP) found that simply
enrolling children in CHIP did not result in more health care. That is,
they had the same number of doctor visits, etc. However, increasing the
fees CHIP pays to doctors does result in more care. And presumably the
converse is true as well.
According to the Medicare Office of the Actuary's
memorandum,
in about two years, Medicare payments to doctors will fall below
Medicaid rates and will fall further and further behind Medicaid with
each passing year. Medicare payments to hospitals will basically match
the Medicaid rate, indefinitely into the future. What will this mean?
Seniors will be lined up behind welfare mothers in the attempt to find
doctors who will see them and institutions that will admit them. As
Harvard University health economist Joe Newhouse has
explained,
seniors will likely have to seek care at community health centers and
safety net hospitals. As the Medicare Office of the Actuary has
explained,
in a few short years, hospitals will begin closing and senior citizens
will have increasing difficulty obtaining access to care.
Lie Number Three: Health Reform Has Made Medicare More Solvent.
Remember, all the health reform act does is pay doctors and hospitals
less money. On paper this makes the Medicare trust fund appear to last
longer because its expected expenses go down. But if you think this is a
legitimate way to make Medicare more solvent, why not be even more
aggressive? We could wipe out Medicare's $43 trillion unfunded liability
entirely if we reduce doctor and hospital fees all the way to zero!
The problem is: seniors would not be able to find a doctor who would see them or a hospital that would admit them.
Lie Number Four: ObamaCare Is Fully Paid For.
The White House claims that ObamaCare makes a small profit — that is, that it actually reduces the deficit.
Yet last Sunday on ABC's This Week, Cokie Roberts baldly asserted
that the (ObamaCare) cuts in Medicare spending will never happen. In
fact she asserted this with such an air of inside-the-Beltway authority
that none of the other talking heads on the program dared to challenge
her. She may be right.
We've already been through this exercise with a piece of Republican
legislation — the 1996 budget act. The Republicans decided to balance
the budget, in part, by slowing in the growth of Medicare doctors' fees.
However, in the following years, Congress repeatedly
stepped in at the last minute
to delay the reductions.
The next point of reckoning will come in
January, 2013, when a 10-year "doctor fix" will require about
$271 billion.
Think about that for a moment. Republicans and Democrats together
have promised various constituencies almost $1 trillion in benefits — to
be paid for by taking $1 trillion away from Medicare providers over the
next 10 years. Yet, like Cokie Roberts, no one in Washington thinks
that Congress will stick to the bargain.
If it doesn't, that means that ObamaCare was never really paid for,
that it will create a new entitlement that will add hundreds of billions
of dollars to the deficit, and that nothing has happened to make
Medicare more solvent.
By the way, neither the Congressional Budget Office nor the Office of
the Medicare Actuaries thinks the cuts are sustainable. That's why both
agencies have put out
"alternative" projections of Medicare finances for future years — which is Washington's way of telling Congress, "We don't believe you."
Lie Number Five: Health Reform Is Going to Make Medicare More Efficient.
An alternative to cutting provider fees is to slow the growth of Medicare by making the whole system more cost effective.
The goal here really isn't a partisan issue. The Obama administration
has continued a number of the pilot programs and demonstration projects
started under the Bush administration. These are designed to find ways
of making Medicare less costly through pay-for-performance, coordinated
care, managed care, home-based care, electronic medical records, etc.
The Congressional Budget Office has looked at these efforts on
three separate occasions
and each time has concluded that they are not working or, in the few
cases where there are positive signs, the performance is lackluster.
In the absence of such efficiencies, the law basically mandates a reduction in provider fees.