Oh boy, the 2012 MedPAC Data Book is out. It doesn't get any better than this for a health care statistics geek. Of course, most of the 2012 MedPAC Data Book information about Medicare beneficiaries is for 2010 or earlier but it's the latest/greatest. It's ALMOST MUTUTALLY EXCLUSIVE AND COLLECTIVELY EXHAUSTIVE (see a few questions I have below) and is truly non-partisan. It's the best look anywhere at the United States' senior-citizen health care insurance market.
The following graph in particular puts the lie to the recent highly partisan CommonWealth Fund's deceit that most seniors choose Medicare over "private insurance." (Of course, CommonWealth Fund's own data put the lie to that but that didn't stop the Democratic-Party think tank from making the claim.)
Most of the MedPAC demographic data is up to date only through 2008 but it is not surprising that even this old data shows that the trend away from traditional Fee for Service (FFS) Medicare, "Medicare as we know it" as the Democrats like to call it to scare seniors, continued. As illustrated, in 2008 the percentage of Medicare beneficiaries choosing traditional Medicare as opposed to private options slipped to single digits, 9% from 10% in 2006 and 2007. More recent non-collectively exhaustive and non-mutually exclusive data suggests the numbers has gone down further since 2008 to 8%. (Of course, that's a percent drop in an ever increasing size pie, mind you, but I'm SWAGing the number of the drop at 500,000 on the assumption there are now about 50,000,000 of us seniors total on some variation of traditional Medicare or private Medicare.) In other words, 90% of us seniors and growing choose private Medicare approaches like those proposed by Wyden/Ryan.
"Managed care" has continued to boom to 23% of beneficiaries (reportedly to 28% in 2012). This is mostly at the expense of Medigap as well as at the expense of the previous 10% of the group who use only traditional Medicare. Unfortunately the Congressional Budget Office predicts that the Patient Protection and Affordable Care Act (PPACA) will force half of those seniors back to typically higher-cost, less beneficial FFS Medicare plans. (Then ironically PPACA will force millions of these new forced FFS Medicare subscribers along with those already on FFS Medicare into Accountable Care Organizations, which operate basically like a "managed care" plan. Go figure.)
-- Dennis Byron
Notes: There are some problems with MedPAC's definitions and categories
- By "Managed Care" does MedPAC mean all of Medicare Part C or have they split out those on a Medicare Part C Fee for Service (FFS) plans and accounted for that group in Medigap (doing the latter would be the most apples to apples comparison but the MedPAC presentation does not seem that precise)
- The MedPAC Data Book also shows a category called Medigap-Employer which I combined into Employer to simplify the visual. But does that category also include Medicare Part C plans offered by employers? If so, it would be interesting to know how much is Part C and how much is Medigap and account for them in the appropriate bucked.
- What does Medicaid mean? It appears to be too high a percentage of the Medicare beneficiary total to mean people on no other health plans except Medicaid, even to the exclusion of Medicare. My guess is that it includes all Medicare beneficiaries on a Medicare Savings Program--which depending on income and assets limits pays Part B premiums and/or Part B premiums, Part A deductibles and Part B co-pays. However many Medicare Savings Programs enrollees also sign up for private insurance so it would be useful to know the size of that group (if my assumption concerning what MedPAC means by Medicaid is true).
