Someone on the left will soon claim this is a positive result … imagine how bad it could be if we did not pass Obamacare! </sarc> From the Washington Times and AP writer Shannon McCaffrey.

Nearly every state has proposed or implemented a plan in its current budget to rein in costs, and many are considering additional cuts in the year ahead.

For the tens of millions of poor and disabled who rely on the program — approaching nearly one in five Americans — the cuts translate into longer waits for doctors, restrictions on prescription drugs, a halt to vision and dental care, staff cuts at nursing homes and dwindling access to home health care.

On top of that, the article notes some seniors in southern New Jersey are being “assigned” doctors in Philadelphia.

General practitioners do not have to participate in the Medicare or Medicaid programs, and if they are losing money on each patient they see, they can either demand higher fees from private health insurers (good luck) or just stop accepting seniors as they become eligible for the program.

Do you think mandates on physicians requiring them to ensure a minimum percentage of their patients are one one of these government programs could be around the corner? I’m almost certain of it.

Of course, seniors are hoping the final answer is “not at all” as they know, or should know, that Medicare, per a report issued earlier this year by the Trustees of Social Security and Medicare Trust Funds, will go broke in 2024.  And, once it does, by law, annual benefits must be cut to match annual revenues.  Of course, the same can be said for Social Security, but, at the moment, Social Security has a slightly longer “shelf life”.

Yet, the President is continuing to champion this defunding of Social Security and Medicare, as are the Democrats in Congress. 

I’ve always been told that it is only the Republicans who want seniors to eat dog food and die quickly.

Did I miss something?

Congressional Democrats and the President seem to have forgotten that Social Security and Medicare are going broke.  This forgetfulness has resulted in their demand that the one year payroll tax (which funds Social Security and Medicare) cut be extended for another year.  The result will be to lower the amount of money collected by Social Security and Medicare by something like $123 billion next year, making both programs even less solvent.

Rather than hand the President a campaign issue, Republicans in the House have agreed to the extension, but only if the bill includes a provision that forces the President to make a decision on the Keystone XL pipeline within 60 days.

As you recall,  in November, the administration decided that even after years of study, and, decisions by every administrative agency involved that the pipeline would not harm the environment, we should wait until 2013 to make a final decision. 

The Keystone codicil is now being negotiated in the Senate, where at least eight Democrats have said publicly they hope the project goes forward: Jon Tester and Max Baucus of Montana, Kent Conrad of North Dakota, Joe Manchin of West Virginia, Mary Landrieu of Lousiana, Mark Begich of Alaska, Ben Nelson of Nebraska and Claire McCaskill of Missouri.

And, as of Friday evening, it appeared that this “deal” would be enacted.  But, here is something curious.

Democrats were set to concede, in part because they believe the administration can find a way around the provision, if need be. [emphasis supplied]

Fascinating…Democrats believe the President can simply ignore the law.  Of course he has already shown his willingness to do so if it will secure votes, (see: the Defense of Marriage Act), but this will hand the Republicans a campaign issue.

It will be interesting to see how this turns out.

Of course, as we now know, it “boosted” nothing, while at the same time it did lower the revenue collected by two federal programs that are in serious financial difficulty.

The bill pending before the Senate is nothing more than another President Obama campaign issue, courtesy of Senator Harry Reid (D. Nv.).  It will never pass, but, before you “blame” the evil Republicans, you need to understand why the bill will never pass.

The announced plan is to “offset” the decreased revenues to Medicare and Social Security by a 3.25% surtax on millionaires.  As best I can tell, the Senate defines a “millionaire” as an individual actually earning $1 million a year.  This is unlike the President’s definition of “millionaire” which is an individual making more than $200,000 a year.

Digging down into the weeds of this bill, you learn that the revenue from the 3.25% surtax is not going to bolster Social Security and Medicare, but rather is being placed in “general revenues”, I suppose to be spent on who knows what. 

The Republicans will vote against this bill, as well they should.  But understand why.

Social Security and Medicare are still going broke, but will do so only faster if this bill passes.  The proposed surtax is not designed to offset anything, other than other government excessive spending.  Americans are still on the hook for massive Social Security and Medicare “entitlements” that we can’t begin to afford.

But, the bill’s certain defeat does make a wonderful campaign issue for the President…unless you understand what the bill actually says.

This is good news for anyone who is on Medicare, or, for that matter, anyone who, like my brother, is ill and about to be forced into Obamacare.  In case you have forgotten, let me remind you of a few marvelous quotes from the good Doctor that we told you about  here.

It may therefore be necessary to set a legislative target for the growth of spending at 1.5 percentage points below currently projected increases and to grant the federal government the authority to reduce updates in Medicare fees if the target is exceeded.

Then we have,

A progressive policy regime will control and rationalize financing—control supply.

Parenthetically, “control supply” is government speak for rationing.

And,

Young doctors and nurses should emerge from training understanding the values of standardization and the risks of too great an emphasis on individual autonomy.

Or, my personal all time favorite,

I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.

I suppose that philosophy is fine, as long as you are one of the “leaders”.

And, all this time, I thought the far left was caring and compasionate…didn’t former Speaker of the House, Nancy Pelosi (D. Ca.) tell us that when Obamacare was passed?

Last year the WSJ did a series detailing certain irregularities it had discovered by digging through Medicare’s claims database.  In doing so, it identified a doctor whose billing practices seemed more than suspicious.  At the time, the WSJ did not know the identity of the doctor as Medicare refused to provide names.  But, here is what the WSJ found out.  The doctor in question,

performed or supervised 29 separate sleep, neurological, ultrasound and other diagnostic tests on her patients.  Looking at all 811,785 providers in the database, the Journal found that no other provider of any speciality conducted all 29 of those tests in 2008.

Looking at that, one could conclude that the doctor was either incredibly talented, or something was definitely not on the up and up.

This week, the U.S. Attorney’s Office for the Eastern District of New York indicted this doctor…Dr. Emma Poroger, and eleven other health care providers for (in separate schemes) fraudulently billing Medicare to the tune of over $95 million.

Another doctor referred to in the WSJ article entered a guilty plea in May to Medicare fraud, notably, performing services that were not necessary, and billing for services not performed.  Another was suspended by the Texas Medical Board, and a third, under orders from the Oregon Medical Board, is no longer allowed to perform surgery unless he is under the supervision of another doctor.  Were I to need surgery, I am not sure this last doctor would be my first choice.

Call me cynical, but, I am left wondering why Medicare, which has access to its own database on a daily basis, couldn’t have figured this out on its own?  And, perhaps, since this database exists, would it be too much trouble to ask Medicare to review it before they pay a claim?

On Friday, the Centers for Medicare and Medicaid Services announced it would cut payments to skilled nursing homes by 11.1%, or $3.87 billion annually, while, of course, proclaiming its commitment to “high quality care”.  Whether this is part of Obamacare’s $500,000 billion cut to Medicare (used both to “strengthen” Medicare, and to pay for the costs of insuring the uninsured) is not something the administration has shared with us, but, we are told it is in response to “unexpected increases in nursing home payments this fiscal year”.

Is anyone getting as tired of the word “unexpected” as I am?  More and more Baby Boomers are turning 65 every day, and Americans are living longer than ever before.  What part of that is unexpected?

Meanwhile, on Monday the Department of Health and Human Services announced that beginning in August, 2012, all health insurers must cover the full cost of any FDA approved birth control…no copay, no deductible, no nothing.  As the pharmaceuticals and medical device manufacturers are not providing their products for free, your insurance premiums will rise to cover this extra cost, whether you use birth control or not.  And, whether you believe in birth control or not, you will be subsidizing someone else’s birth control.

This is merely the tip of the Obamacare iceberg.  As medical costs rise “unexpectedly”, the government will cut payments to providers until they can no longer survive as we now know them, and when that fails, the next step is rationing.

And, as the administration requires more mandates be included in Obamacare’s “qualified insurance plans”, your premiums will increase far more than they otherwise would.

The federal government doesn’t have to play by the same accounting rules as does any publicly traded company.  For a corporation, any future liabilities, such as future pension and health care costs promised to employees, must be listed on the company’s balance sheet.  Those items can be ignored by the federal government as, under their rules, nothing is recorded until the federal government writes a check.

According to a study done by USA Today, “what you don’t know” is far more troubling than “what you do know”.  We currently owe an additional $61.6 trillion to pay for future “promises” we have made, and have absolutely nothing “in the bank” to pay for that.

Our future unfunded obligations to Medicare…$24.8 trillion…to Social Security $21.4 trillion…to federal debt…$9.4 trillion…to retired military $3.6 trillion, and the list goes on.

Believe it or not,

The government has promised pension and health benefits worth more than $700,000 per retired civil servant. The pension fund’s key asset: federal IOUs. [emphasis supplied]

The total for all unfunded liabilities amounts to $534,000 per American household.

We have over promised, and over spent, adding an additional $1.5 trillion in new “recognized” debt last year alone.  Meanwhile, I for one, get the sense that our president is unconcerned about this.  Rather than taking the lead, as presidents usually do, he is, once again “leading from behind” and hoping Congress can figure something out.

That is the real tragedy.

Friday the Trustees of the Social Security and Medicare Trust Funds issued their annual report.  You can read a summary here, but it isn’t pretty.

Medicare will run out of money in 2024.

Last year’s report had extended the life of the Medicare fund by 12 years — to 2029 – to reflect the savings they say would be found in the massive overhaul of health care that President Obama got Congress to pass in 2010. [emphasis supplied]

Remember, that was the $500 billion taken from Medicare over the next ten years allegedly to “extend” Medicare’s life.  Of course, that same $500 billion was targeted to cover the cost of the uninsured, but, who’s counting. 

It now seems that Medicare needs that money back.  Or, maybe it is still counted as “Medicare money”, in which case, the program is in worse shape than projected.

Last year, Medicare paid out $32.3 billion more than it collected in taxes. Based upon this report, if we leave things as they are, we will fail to meet our “promises” to seniors, whether they are currently on Medicare or not, in 2024.

On the Social Security front, the Social Security Disability Trust Fund will run out of money in 2018, and the Retirement Trust Fund will run out of money in 2038.  One plan to extend the disability fund is to “divert” funds from the retirement fund and move them to the disability fund.

If nothing is done, under federal law, when all of the government IOU’s are exhausted (remember, the government spent your money as soon as it was received, and gave the trusts IOU’s), the trusts are required to pay out no more each year than they collect in taxes. 

That means that without some change to the law, benefits would be slashed to roughly 75% to 80% of what is currently covered.

And yet, the Democrats will continue to pound any Republican who advocates  Medicare or Social
Security  reform as, “telling old people to die”. 

Without some sort of reform, at least on the Medicare front, come 2024, they just might.

In early April, the Department of Health and Human Services issued it’s draft regulations covering ACO’s.  Although the comment period for proposed regulations is still open, the early results are not encouraging.

Yesterday,

…in an unusual rebuke, an umbrella group representing premier organizations such as the Mayo Clinic wrote the administration…saying that more than 90 percent of its members would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed.

A little bit of information on this “umbrella group”.  It is the American Medical Group Association.  Other than the Mayo Clinic, it,

represents nearly 400 large medical groups around the country providing care for roughly 1 in 3 Americans. Its members, including the Cleveland Clinic, Intermountain Healthcare in Utah, and Geisinger Health System in Pennsylvania, had been seen as the vanguard for accountable care. [emphasis supplied]

And, here is the problem.

The medical groups say they are worried they will be left holding the bag for losses, that the government has designed things so there is no easy way to tell which patients are part of the program [I think this is the "assigned" part], and that there’s no reliable way to adjust for patients who are sicker and require closer follow-up and more expensive treatments.

This is somewhat problematical for the administration which had anticipated some $960 million in savings over the first 3 years from ACO’s.  And, as you may recall,

[m]any in the health care industry were silent partners backing Obama’s overhaul law, but disappointment over the accountable care rules has put a chill into the relationship. During the congressional debate, Obama extolled Mayo and Geisinger, holding them up as a model of what he wanted to achieve for the nation. Industry criticism of his administration’s proposal has been building up for weeks in online forums.

So, another piece of Obamacare (see: waivers) is falling flat on its face.

Bottom line…the government has no earthly idea how to run a business.  This administration wants to regulate how things “should be”, without any understanding of how things “are”.