Someone named Wendell Potter is apparently one of the more senior senior haters in the Democratic Party's War on Seniors because he opens a recent column at the Orwellian-named Center for Integrity with the words "As one of an estimated 78 million baby boomers in this country, I was delighted to hear that Medicare’s Hospital Trust Fund won’t run out of money until 2030..." Of course if he is a baby boomer born in 1960, he's into self hate because the Trust Fund "runs out of money"1 the year he turns 70. So I am not sure why he would be delighted by the fund running out of money just a few years after he is eligible to use it (unless he plans on dying before age 70)
Potter claims "it’s uncertain how much of that (supposedly) good news (that the money "runs out" in 2030) can be attributed to the health care law." But it's not uncertain if you read the Trustee Report. The report very clearly explains that current law requires cutting home health care spending and skilled nursing facitity spending -- that's right, both -- in order to give the money to people not on Medicare and the more of those things you cut (increasing senior's out of pocket cost), the longer the fund stays positive. Of course, in the back of the Trustee's report, the Medicare actuaries say they think these cuts are unlikely to happen so so much for being delighted.
I can't quite follow the rest of his article but basically he seems to be saying that he wants to change Part B trust fund accounting also by drastically altering Medicare Part D -- which is paid for out of the B trust fund and was not affected by the Patient Protection and Affordable Care Act -- to make the D drug program more like the VA drug program. Wow! Really? Make something like the VA! He also wants to change the practice that doctors themselves set their prices for Medicare. They have nicely set them about 30% below the going market rate for the last couple of decades but apparently Potter thinks the doctors could go lower. (Don't feel bad for the doctors taking a 30% hair cut on seniors; they make up for it with the prices they charge people that are not seniors.). Potter also throws in the trivial charges from the Center of Integrity about alleged overpayments to the public Part C Medicare Advantage program... but with a twist.
Up until now the Center of Integrity based its allegations on a risk-scoring rule that the the Medicare bureaucracy started in 2008 and changed three times since because it knows it is not working... and that the GAO and MedPAC say is trivial if true. Potter has added that the 3% incentive payment that managed Medicare gets is also a waste2. He plays a game with the wording on this charge; he gives the entire cost of the program -- $160 billion -- that serves 16,000,000 Medicare beneficiaries as if that is the wasteful amount. The incentive only cost under $5 billion in 2014 (not that $5 billion isn't real money but in the scale of Medicare fraud and waste it's way down the list).
1Potter actually does not seem to know how the Part A trust fund works. It actually runs out of money every year... or every month... or every day depending on how you want to do the accounting. What the Trustees said in their recent report was that starting in 2030 the amount raised in Part-A-designated payroll taxes plus the so-called interest the trust fund gets from the government bonds it supposedly owns won't cover likely 2030 expenses.
2I believe the Part C incentive payments are unfair but reams of research have demonstrated that the incremental payments are not a waste. The most recent example of such research came out recently and was highly publicized in the New York Times.
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