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Comments
It's interesting to note that SS was originally intended to have a trust fund large enough to generate interest to sustain payouts when there's increased volatility in revenue. Of course, like many things over the course of history, this money was not used for its intended purpose and now we're on a trajectory where we can only expect 80% of the current payout by 2035 (time value of money considered).
This is another example why, IMO, you shouldn't trust government to take care of you. I have no issue with social safety nets but the slippery slope occurs when what's intended to be a supplemental backup starts being depended upon as your primary livelihood.
This is absolutely true....however, would you lift the caps on the payouts too?? Or are you OK with richer seniors subsidizing the poorer seniors....I'm not judging, just asking.
You can't reduce the rate of spending on Medicare without reducing medical inflation or cutting services drastically.
The rate of inflation along with the aging of the massive baby boomer generation combined with healthcare now being a corporate industry is the problem. The notion that anybody gets their kicks by having medical procedures they don't need seems absurd.
The system we have now subsidizes the rest of the 1st world western nations by not allowing capping payments to providers. A company like Pfizer sells most of the goods out of country, but most of their profit is made off Americans because they along with many other companies charge far more for the same products here than they are allowed to in other developed nations.
And my point of medical research and innovation? Medical advancements come with a cost. For every successful drug or device that people say make obscene amount of profit, there are 30 others that have flopped....and lose money (I have a personal friend who invented a clever medical device, dropped his life saving of $200K but has seen no return yet, and maybe never will. Is he bitter? Absolutely not) But some companies and entrepreneurs are willing to take the risk because of the potential reward. If there is no prize at the end, guess what, no innovation, no improvement. And everyone who is on Medicare want the latest, greatest, and most expensive treatment cuz the gubment pays for it
And circling back to Herschel's original post....add to the above statistics the 10 to 20 million illegal immigrants that are here with now the state of California, giving them free MediCal (California Medicaid) as soon as they cross the border....madness!!!
Am I missing something here? Under your scenario, isn't next years decrease from 20M to 12M payouts still more than this years 10M? Are you OK with tripling the Medicare taxes to adjust for the growth?? Cuz seniors today are spending 3 times more than they put in
As for the hospital bureaucracy, they are governed by rules promulgated by CMS (Center for Medicare and Medicaid services). These rules then have to be adopted by commercial insurance. I'm in the industry...I could go on and on with the ridiculous, inane heaps of new regulations heaped upon front line healthcare workers, but you would be bored.
This will not be popular but to retain sustainability you would have to keep the cap on the payouts. Not fair I know but that is the only way I could see it working.
One other place to look for cost cutting is disability. How many people are drawing disability that are in no way disabled?
Three features of managing health insurance drive BIR costs at the provider level. The first is complexity. The insurance process has multiple steps, often demanding precise accuracy and attention to detail. BIR steps include contracting with insurers and subcontracted providers; maintaining benefits databases; determining patient insurance and cost sharing; collecting copayments, formulary, and prior authorization; coding of services delivered; checking and submitting claims; receiving and depositing payments; appealing denials and underpayments; collecting from patients; negotiating end-of-year resolution of unsettled claims; and paying subcontracted providers.
The second burdensome feature of managing insurance is variation. Due to consolidation of insurers in recent decades, a provider practice likely has fewer payers to deal with. However, each payer offers multiple products and often further customizes products to individual purchasers (such as a large employer). Each provider may have to deal with dozens to hundreds of different plans. Providers must track plan-specific benefits and reimbursement rules, maintain special databases and benefit experts, and conduct time-consuming checks of plan details prospectively and in response to claims denials. This situation is in stark contrast to privately administered plans in other developed countries, where there is typically a single primary benefits package.
The third feature is friction. Many BIR steps slow and complicate the process of getting paid. These include priority authorizations and formulary restrictions, high rates of nonpayment for initial submissions (10 to 15 percent), underpayments, and ultimate non- and underpayment (5 to 10 percent) (Gans, 2009). Providers express frustration and occasionally a suspicion that the process is kept complicated to lower ultimate payment levels.
Where does Medicare come into play as the sole driver for these factors?
First of all is 10 to 12 NOT an increase in your eyes??
Secondly, everything else you say is somewhat true. But most of the burgeoning hospital bureaucracy is done because of need to follow government mandates like: HITECH, MACRA, HIPAA, EMR, Obamacare regulations, conversion to ICD 10....all of which were passed by Congress and mandated by CMS. Go on any healthcare blog and read some of the biggest complaints in today's healthcare world...
Why in the world would HW's opinion mean anything more than Johnny Walker - black or red?
A classic example of government interference. As part of ObamaCare, he forced thru HITECH act which mandated quick conversion to electronic medical records for all hospitals and he literally threw BILLIONS $$$ at these companies, all in the name of patient safety and easy access to medical records. Despite warnings that the technology for digitization of very complex medical records was not ready, he rammed it through anyway (remember Louisiana Purchase, Cornhusker Kickback and the like?). Of course, the warnings proved correct. Typical government: issue mandates without clear implementation guidelines and proven technology and you had all these companies receive BILLIONS of federal largesse and they purposefully created EMR system that does NOT communicate with each other so the hospitals would be held captive to a single company at a high cost.
The result? Have you gone to a doctor recently that doesn't have his back turned to you clicking away at inane boxes or checks on the computer screen? Have you been in a hospital where the nurse spends twice as more time on a computer clicking **** check off screens and not physically caring for patients. HUGE increase in number of hospital employees to for compliance of these rules. NO cost savings, NO patient safety improvement, NO easy access to medical records. This was government malpractice at its finest...
Your spot on about the regulations and what not. It's insane and growing like a cancer. It's almost like they've set you up to fail, which gives them control over you.
Some morons in New England were compounding some high risk epidurals (this is extremely rare). They did this in a room that actually had bird poop in it. Some people got infected and died from their products. Horrible, ****, lazy. Except fast forward about 10 years to now and the bureaucrats have passed these immense sweeping changes to all IV and compounding room. There was never a problem before, but now we have to do a 10 million dollar construction project just to meet the new "must have" standards they've deemed necessary. Then we have to pay for a team of folks to go around to every single hospital in America and make sure these standards are followed. If they're not, they lose more money. Each of these hospitals now have to hire additional staff to make sure they can follow this encyclopedia of new regs. They also have to buy additional (and not cheap) equipment such as sterile gloves, disposable clothing, new cleaning chemicals, etc. This is just one small little area. This kind of overreach is happening at all kinds of levels in all kinds of fields. How could anyone start a new business in mountain of red tape? It's just never enough. They just keep piling on more and more and more, because no one is paying the bills directly. They just keep taking it from American taxpayers. And all of this was specifically born from a couple of bozos really messing up some higher risk compounds. They take one isolated incident, and then make massive expensive and power changing rules and justify it with the one incident. The cynic in me says it's a massive power and money grab by the powerful because they can.
It just seems more and more they're making things more difficult for people to do the right thing, and easier for people that do nothing. The latter is attracting illegals by the millions. Millions.... that's not an exaggeration. There should be consequences for doing nothing, and rewards for doing something. And we seem to be slowly sliding away from this mindset.
Another thing not really being discussed is the money that is encouraging and helping illegals migrate here. They're not all from just central america either. Some are getting boat rides from oversees. I seriously want to know who is doing this and why. It's a form of attack on our sovereignty, our identity. Who will benefit from our system collapse?
I work for an animal health pharmaceutical company. We are regulated by the FDA, USDA, and EPA. Ya'll have no idea what hoops we have to jump through just to bring one product to market. It is unreal and very expensive.