On Octbober 22, The Washington Post Wonkblog ran an article about an October 20 Health Affairs article in which some right-wing Washington think tank you never heard of looked at some old Congressional Budget Office (CBO) analysis and used the CBO's numbers to credit the 2003 Part D drug program -- not the Patient Protection and Affordable Care Act (PPACA) as claimed by President Obama -- for bringing down projected Medicare spending.
It was all pretty wonky stuff but the Post lit a fire under its lefty readership with the headline: "You may want to thank George W. Bush — not Obamacare — for the remarkable Medicare cost slowdown." As you would expect the lefties that read WaPo went bonkers about the Iraq War, Guantanamo Bay, the Florida recount, Bush's National Guard service, Hurricane Katrina, the Texas Rangers, Bush's grandfather, the drought in east Texas, oil drilling, Kyoto, Tom Delay, Bush's daughter's drinking, Bush's drinking, Bush's sobriety, Bush's religion, Bush's colonoscopy (which made Cheney president for 15 minutes), and on and on... every nutty lefty thing you've ever heard but nothing of substance about Medicare.
I do have a substantive comment. My problem is not with WaPo's lefties or the cute trick the WaPo Wonker pulled to get reader interest but with the right-wing analysts.
- The difference between the 2011 CBO baseline and the curent estimate is really more a story about how bad the CBO is in estimating the cost of Part D? The patent situation and other aspects mentioned in Health Affairs (except sequestration) must have been known when the original CBO baseline(s) were calculated.
- Whichever, despite what the right-wing analysts claim (repeated by the WaPo Wonker), the Medicare spending slow down is not "excellent news" for beneficiaries. What the chart in the image shows -- if you combine it with a chart of all healthcare spending by people on Medicare (similar to charts in the annual MedPAC Databook) -- is more cost shifting on to beneficiaries. That may be OK in terms of
- Fairness (cuts to Part Cn to bring Part C rebates in line with Tradtional Medicare FFS spending; these are possibly reflected in the Part A and Part B numbers should have already been baked into the March 2011 baseline because they were passed in PPACA in 2010)
- Logic (getting rid of the crazy donut hole rules)
- Reducing fraud and waste (I assume that is what "recoveries" means?)
- Other aspects of this stupid crazy-quilt LBJ program that has long outlived its usefullness.
- But I would not call it "excellent news" for beneficiaries unless you think we beneficaries are happy that we have to pay even more than the approximately 50% of our healthcare costs that we already pay for our healthcare under LBJ Medicare.