Tag Archives: Medicare

Explaining the High Cost of US Health Care: No Skin in the Game, by Mike Mish Shedlock

Here’s a radical idea. Why not try the same system for health care and medical insurance that brings you a superabundance of reasonably priced groceries at any one of thousands of grocery and superstores: the free market. We’ve tried everything else and all we have is a gigantic mess. From Mike Mish Shedlock at moneymaven.io:

Costs are expensive because there is almost no skin in the game. Graft has taken over.

The Wall Street Journal has an interesting article on healthcare: Why Americans Spend So Much on Health Care—In 12 Charts.

The U.S. spends more per capita on health care than any other developed nation. It will soon spend close to 20% of its GDP on health—significantly more than the percentage spent by major Organization for Economic Cooperation and Development nations.

What is driving costs so high? As this series of charts shows, Americans aren’t buying more health care overall than other countries. But what they are buying is increasingly expensive. Among the reasons is the troubling fact that few people in health care, from consumers to doctors to hospitals to insurers, know the true cost of what they are buying and selling.

Contributions to employer-sponsored health coverage aren’t taxed, which makes it less expensive for companies to pay workers with health benefits than wages. Generous benefits lead to higher spending, according to many economists, because employees can consume as much health care as they want without having to pay significantly more out of their own pockets.

The prices of many medicines are hidden because pharmacy-benefit managers—the companies that administer drug benefits for employers and health insurers—negotiate confidential discounts and rebates with drugmakers.

Price Growth Since 2000

Hospitals are becoming more consolidated and are using their market clout to negotiate higher prices from insurers.

Tax Benefits

Contributions to employer-sponsored health coverage aren’t taxed, which makes it less expensive for companies to pay workers with health benefits than wages. Generous benefits lead to higher spending, according to many economists, because employees can consume as much health care as they want without having to pay significantly more out of their own pockets.

The tax benefit is the country’s biggest single income-tax break, costing billions to government revenue.

To continue reading: Explaining the High Cost of US Health Care: No Skin in the Game

Opinion: The next bear market in stocks will spark a retirement crisis, by Howard Gold

A bear market in stocks would substantially reduce the Baby Boomers’ already inadequate savings. From Howard Gold at marketwatch.com:

A recession could decimate even substantial retirement portfolios, and Social Security and Medicare are facing shortfalls
AFP/Getty Images

Almost lost amid the torrent of recent news was a sobering item that will surely have far-reaching consequences.

The U.S. government announced that for the first time since 1982, it is tapping into Social Security trust funds to pay current benefits to recipients and it is dipping into Medicare’s reserves to cover the costs of that program.

The trustees also projected that the trust fund will run out of money by 2034 and that Medicare’s fund for paying costly hospital bills will be depleted by 2026.

That may ultimately force a cowardly Congress to cut benefits, raise taxes, increase the eligibility age, or some combination of the three. For the 52% of Americans who rely on Social Security for more than half their retirement income and the 25% of retirees who get more than 90% of their income from the program, that would be a disaster.

Read: Fixing Social Security starts with us, the voters

But the 10,000 baby boomers who will turn 65 every single day from now until 2029 face an even broader retirement crisis that could cause big social and political fallout.

Over the next few years, we will almost surely confront a bear market and recession that could decimate even substantial retirement portfolios, not to mention financially dicey state and local pension plans and the federal government itself. And those governments will have few tools to fight it. Consider:

• We are in the 10th year of an economic recovery and bull market in stocks. The S&P 500 index SPX, -0.86%   has more than quadrupled from its March 2009 bottom, for a compound annual growth rate of 17.5% during that time. Since the S&P 500 has averaged a 10% annual gain over the past 89 years, at some point there has to be a reversion to the mean.

It’s official: Medicare trust fund will run out of money in 8 years, by Simon Black

Don’t worry, the soon to be broke Medicare and Social Security funds will be backstopped by an insolvent government. From Simon Black at sovereignman.com:

Two days ago the respective Boards of Trustees for Medicare and Social Security released their annual reports for 2018.

As usual, the numbers are pretty gruesome… and the reports plainly stated what we’ve been talking about for years: the trust funds for both Social Security and Medicare are going to run out of money.

Soon.

In the case of Medicare, the Trustees project that its largest trust fund will be fully depleted in 2026, just eight years away. In the context of retirement, that’s right around the corner.

For Social Security, the Trustee report stated that the program will spend more money on benefits in 2018 than it will generate in income and tax revenue.

So this year will be the first time Social Security has run a deficit since 1982.

But it gets worse. Because according to the Trustees’ projections, the program will continue running larger and larger deficits until it too becomes fully depleted in 2034.

After that, recipients can expect at least a 25% cut in the benefits that they were promised and worked their entire lives to receive.

Again, these numbers come directly from the Trustees of Social Security and Medicare (which includes the US Treasury Secretary).

The reports were so dire that mainstream publications picked them up almost immediately.

Curiously, though, a number of newspapers tried to play down the bad news, dismissively telling their readers that Social Security and Medicare are just fine, and that those sobering projections don’t matter.

These are common refrains. They’ll state, for example, that there’s nothing to worry about because the government will step in and bail out the programs.

Is that so? Well, who is going to bail out the government?

According to the Treasury Department’s annual financial report, Uncle Sam is already insolvent to the tune of $20.4 trillion.

And those numbers are only getting worse too. Treasury’s own projections show annual budget deficits in excess of $1 trillion starting in 2020.

Simply put, a short-term fix of Social Security and Medicare would cost trillions of dollars. And that would just be a down payment on the long-term costs of fixing the programs.

The federal government simply doesn’t have that kind of money. Not even close.

To continue reading: It’s official: Medicare trust fund will run out of money in 8 years

Medicare Will Be Insolvent In 2026, Sooner Than Expected; Social Security To Follow In 2034, by Tyler Durden

There it is in black and white—when the two big government pension and medical funds will go broke—and like most such estimates before, these are probably optimistic. At least when they go broke it won’t come as a surprise. From Tyler Durden at zerohedge.com:

Medicare’s trust fund has just eight more years of solvency until 2026, and Social Security will be exhausted in 2034, according to Thursday projections by the trustees for the government programs.

While Social Security’s expected depletion is unchanged from last year’s projection, the date for Medicare’s demise was moved up three years.

Social Security is made up of several funds; the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) are combined for the designation OASDI, while Medicare’s Hospital Insurance trust fund is designated HI.

If allowed to expire, beneficiaries would face an immediate reduction of around 20% in benefits.

The costs of Medicare and Social Security will increase substantially as a percentage of GDP through 2035 due to a sharp rise in beneficiaries as baby-boomers retire, and lower birth rates that have persisted since the baby boom resulting in slower growth of the labor force and GDP.

Social Security’s annual cost as a percentage of GDP is projected to increase from 4.9 percent in 2018 to about 6.1 percent by 2038, then decline to 5.9 percent by 2052 before generally rising to 6.1 percent of GDP by 2092. Under the intermediate assumptions, Medicare cost rises from 3.7 percent of GDP in 2018 to 5.6 percent of GDP by 2035 due mainly to the growth in the number of beneficiaries, and then increases further to 6.2 percent by 2092. The growth in health care cost per beneficiary becomes the larger factor later in the valuation period, particularly in Part D.

To continue reading: Medicare Will Be Insolvent In 2026, Sooner Than Expected; Social Security To Follow In 2034

What Drives Long-Term National Debt Growth? from the Visual Capitalist

The US is in a world of debt trouble. From the Visual Capitalist at visual capitalist.com:

What Drives Long-Term National Debt Growth?

With the current 106% debt-to-GDP ratio, there’s no doubt that today’s government debt is high. The last time the United States reached this mark, it was during the aftermath of WWII in the late 1940s.

But despite nearly historic debt levels, it does not seem that the national debt is a key issue for most citizens and groups. What drives this accumulation of debt in the long run, and at what point does the debt level become so high that it becomes an undeniable and critical issue for the country?

Today’s infographic comes from the Peter G. Peterson Foundation, a NYC-based group that focuses on educating people about the fiscal challenges of growing government debt. The graphic illustrates the main factors driving the debt upwards, as well as the potential impact down the road.

RISING TEMPERATURES

The trouble with debt is that it delays today’s challenges well into the future, making it a tempting short-term solution when other things aren’t working. However, over time, that burden increases steadily, and the situation quickly represents the “frog and boiling water” parable.

So what’s raising the temperature of that water?

Right now, the aging of the Baby Boomers is a key factor, and the amount of people receiving social security benefits will swell from 62 million to 88 million people by 2035. At the same time, Medicare’s hospital trust fund will run out of money by 2029, and the program will only remain solvent until 2034.

Whether it’s the growing enrollment in these programs or the rapidly escalating costs of healthcare itself, more money will be put towards Social Security and healthcare over the coming years.

By about 2045, government spending on major health programs will nearly double in size to greater than 9% of GDP.

BOILING WATER

Today, interest on the debt is equal to about 1.4% of GDP.

However, if the projected pace is maintained, it’s anticipated that interest payments could be equal to 6.2% of GDP by 2047 – this is roughly 2x the average annual amount the federal government spends on education, infrastructure, and R&D combined.

 

To continue reading: What Drives Long-Term National Debt Growth?

It’s a Right, from The Burning Platform

https://www.theburningplatform.com/2017/09/19/its-a-right/

…And Now For The Bad News, by Simon Black

To think that the federal government can pull a rabbit from its hat and painlessly solve its debt problem is to believe in a fiscal Easter Bunny. From Simon Black at sovereignman.com:

In the late 1760s and early 1770s, the government of France was in a deep panic.

They had recently suffered a disastrous and costly defeat in the Seven Years War, and the national budget was a complete mess.

France had spent most of the previous century as the world’s dominant superpower, and the government budget reflected that status.

From public hospitals to shiny monuments and museums, social programs and public works projects, overseas colonies and a huge military, France had created an enormous cost structure for itself.

Eventually the costs of maintaining the empire vastly exceeded their tax revenue.

And by the late 1760s, France hadn’t had a balanced budget in decades.

Debt was ballooning, interest payments were rising, and the government of Louis XV was desperate to do something about it.

There’s a famous story in which the Comptroller-General of Finances summoned all the government ministers to make deep budget cuts.

But no one could come up with anything substantial.

The overseas colonies were too important to cut.

And they couldn’t cut public hospitals… because too many people were now relying on them. Similarly they couldn’t cut veteran pensions either.

At the end of the session they could hardly find anything to cut that would make a meaningful difference.

All of their fancy programs and benefits had become too ingrained in society at that point; and any cut would have proven politically disastrous.

I thought of this story earlier this week when the US government released a sweeping budget proposal that aims to cut the deficit over the next ten years.

In fairness I’m always happy to see any government cutting spending.

But before uncorking the champagne bottles it’s important to understand some basic realities:

The budget slashes $3.6 trillion in spending through 2028 while proposing zero cuts to Defense, Social Security, and Medicare.

To continue reading: …And Now For The Bad News

Guns or Granny: The Looming Political Battle of the West, by Gary North

Gary North conducts a political analysis of the US’s looming fiscal problems and reaches one conclusion: granny wins. From North at lewrockwell.com:

I begin with a familiar pie chart. It is well named. It is a chart of the political pie.

This chart is from 2015. The right side of this chart is going to expand relentlessly from now on. Every day, 10,000 people go on Medicare. Medicare costs the government over $1,000 a month for each person enrolled. This inflow of eligible recipients is not going to stop for the next 20 years.

Now look at the bottom of the chart: Non-defense Discretionary. It was 16% in 2015, but you can be sure that it is closer to 14% today. This is the political battlefield in Washington: available loot. The rest of the loot is spoken for already. Politics cannot change the rest of the budget. Politics today, in terms of federal spending, is now down to under 14% of the budget, and it is probably heading toward 10% by 2022, when a new President will be in power.

Sometime before the 20’s are over, there will be no more discretionary slice of the budgetary pie. At that point, there is going to be a guerilla war in Washington. It will be a battle over the size of the slices of pie. Political voting blocs that thought the size of their slice was guaranteed will find that it isn’t.

This outcome of battle is going to change the nature of civil government in the United States. A series of battles that parallel ours will take place in Western Europe, where it all began in the 1880’s: Bismarck’s welfare state.

THE BUREAUCRATIZATION OF AMERICA

The greatest single threat to liberty in the West is what it has been for at least a century: the expansion of administrative law. This system is extending the power of central governments into every nook and cranny of the West. Bureaucracies have created administrative law courts that have been substituted for civil courts all over the West. Bureaucratic agencies provide their own judges. They serve as their own juries. Then they execute the laws that they have interpreted autonomously. This process is well developed, and it appears to be irresistible. It is the overturning of the Western legal tradition, as described by Harold Berman in his Introduction to Law and Revolution (1983).

This process is relentless. It is not affected by politics. It is protected in the United States by Civil Service rules. All over the West, comparable protections exist. These people are tenured. They cannot be fired. Their word is the law. This system is manifested in the United States by the Federal Register, which publishes over 80,000 pages of fine-print regulations every year.

To continue reading: Guns or Granny: The Looming Political Battle of the West

Humor: Medicare Part G?

From zerohedge.com, source unknown:

Given today’s vote fiasco, this seemed highly appropriate…

If you are an older senior citizen and can no longer take care of yourself and need Long-Term Care, but the government says there is no Nursing Home care available for you, what do you do?

You may opt for Medicare Part G.

The plan gives anyone 75 or older a gun (Part G) and one bullet.
You may then shoot one worthless politician.
This means you will be sent to prison for the rest of your life where you will receive three meals a day, a roof over your head, central heating and air conditioning, cable TV, a library, and all the health care you need.
Need new teeth? No problem. Need glasses? That’s great. Need a hearing aid, new hip, knees, kidney, lungs, sex change, or heart? They are all covered!
As an added bonus, your kids can come and visit you at least as often as they do now!

And, who will be paying for all of this? The same government that just told you they can’t afford for you to go into a nursing home. And you will get rid of a useless politician while you are at it.

And now, because you are a prisoner, you don’t have to pay any more income taxes!

Is this a great country or what?

Now that you have solved your senior Long-Term Care problem, enjoy the rest of your week!

Obama Claims Power to Make Illegal Immigrants Eligible for Social Security, Disability, by Terence P. Jeffrey

From Terence P. Jeffrey on a guest post at theburningplatform.com:

Does the president of the United States have the power to unilaterally tell millions of individuals who are violating federal law that he will not enforce that law against them now, that they may continue to violate that law in the future and that he will take action that makes them eligible for federal benefit programs for which they are not currently eligible due to their unlawful status?

Through Solicitor General Donald Verrilli, President Barack Obama is telling the Supreme Court exactly this right now.

The solicitor general calls what Obama is doing “prosecutorial discretion.”

He argues that under this particular type of “prosecutorial discretion,” the executive can make millions of people in this country illegally eligible for Social Security, disability and Medicare.

On April 18, the Supreme Court will hear arguments in the case. Entitled United States v. Texas, it pits President Obama against not only the Lone Star State, but also a majority of the states, which have joined in the litigation against the administration.

At issue is the policy the administration calls Deferred Action for Parents of Americans and Lawful Permanent Residents, which would allow aliens in this country illegally who are parents of citizens or lawful permanent residents to stay in the United States.

“The Executive Branch unilaterally created a program — known as DAPA — that contravenes Congress’s complex statutory framework for determining when an alien may lawfully enter, remain in, and work in the country,” the attorney general and solicitor general of Texas explained in a brief submitted to the Supreme Court on behalf of the states seeking to block the policy.

“DAPA would deem over four million unlawfully present aliens as ‘lawfully present’ and eligible for work authorization,” says the Texas brief. “And ‘lawful presence’ is an immigration classification established by Congress that is necessary for valuable benefits, such as Medicare and Social Security.”

In the administration’s brief, the solicitor general admits that the president’s DAPA program does not convert people illegally in the United States into legal immigrants. He further asserts that the administration at any time can decide to go ahead and remove these aliens from the country.

“Deferred action does not confer lawful immigration status or provide any defense to removal,” he says. “An alien with deferred action remains removable at any time and DHS has absolute discretion to revoke deferred action unilaterally, without notice or process.”

Despite this, he argues, the administration can authorize aliens here illegally on “deferred action” to legally work in the United States.

“Without the ability to work lawfully, individuals with deferred action would have no way to lawfully make ends meet while present here,” says the administration’s brief.

Nonetheless, the solicitor general stresses that “deferred action” does not make an illegal immigrant eligible for federal welfare.

“In general,” he says, “only ‘qualified’ aliens are eligible to participate in federal public benefit programs, and deferred action does not make an alien ‘qualified.’… Aliens with deferred action thus cannot receive food stamps, Supplemental Security Income, temporary aid for needy families, and many other federal benefits.”

But, he says, aliens here illegally with deferred action will be eligible for “earned-benefit programs.”

To continue reading: Obama Claims Power to Make Illegal Immigrants Eligible for Social Security, Disability