Medicare,  Medicaid,  and  Prescription  Drug  Benefits

Medicaid Blows $109 Billion on Promotional "Demonstrations".  Medicaid is administered by states and is jointly funded by the federal government and states.  Millions of low-income adults, children, pregnant women and people with disabilities are covered under the program, which cost American taxpayers an eye-popping $545.1 billion in 2015, according to government figures.  A little-known section of the Social Security Act gives the Secretary of Health and Human Services (HHS) authority to approve experimental, pilot or demonstration projects that promote the objectives of Medicaid and its counterpart, the Children's Health Insurance Program (CHIP), as if they really need to be further publicized.  The purpose of the demonstrations, according to the Social Security Act, is to expand eligibility to individuals who are not otherwise Medicaid or CHIP eligible, provide services not typically covered by Medicaid and use innovative service delivery systems that improve care, increase efficiency and reduce costs.  Ultimately, the goal is to increase and strengthen states' overall coverage of low-income individuals, enhance access to provider networks that serve low-income populations and boost the efficiency and quality of medical care through "initiatives" that "transform service delivery networks."  This could mean anything.

Hard Truths about Health Care.  Medicare is not a success. [...] Medicare is undoubtedly popular, especially with its beneficiaries.  It should be.  The average two-earner couple pays about $150,000 over their lifetime in Medicare taxes and premiums, while collecting almost $450,000 in benefits.  Jackpot!  But that disparity is one of the reasons why Medicare is running some $58 trillion in the red, after totaling all projected future liabilities.  A program facing more long-term debt than most countries probably isn't begging to be expanded.

In 24 States, 50% or More of Babies Born on Medicaid; New Mexico Leads Nation With 72%.  In 24 of the nation's 50 states at least half of the babies born during the latest year on record had their births paid for by Medicaid, according to the Kaiser Family Foundation.  New Mexico led all states with 72 percent of the babies born there in 2015 having their births covered by Medicaid.  Arkansas ranked second with 67 percent; Louisiana ranked third with 65 percent; and three states — Mississippi, Nevada and Wisconsin — tied for fourth place with 64 percent of babies born there covered by Medicaid.  New Hampshire earned the distinction of having the smallest percentage of babies born on Medicaid.  In that state, Medicaid paid for the births of only 27 percent of the babies born in 2015.

Seniors: Take Obamacare repeal/replace one step further.  With many people today wanting Republicans to keep their promise to repeal and replace Obamacare, one seniors group is making an additional request.  Besides pushing for end of the so-called "Affordable Care Act," 60 Plus Association also wants Republicans to keep their promise and restore money cut from Medicare.  "They took funds out of the Medicare program to pay for Obamacare," 60 Plus Association Chairman Jim Martin asserts.  "Who got hurt by that? ... Senior citizens."  Martin pointed out that many hospitals in rural America have closed in recent years — due, in part, to the cuts to Medicare.

Federal judge blocks Texas' move to kick Planned Parenthood out of Medicaid.  A federal judge on Tuesday [2/21/2017] said Texas can't remove Planned Parenthood from Medicaid, issuing a temporary block of the state's ouster that will allow the provider to continue to care for patients through the program.  U.S. District Court Judge Sam Sparks issued a preliminary injunction and said the state didn't have grounds to conclude that Planned Parenthood "warranted termination from the Medicaid program as unqualified."  His temporary block will stay in place until a full trial is scheduled, argued and decided.

Study Finds Medicaid Has No Effect on Measured Health Outcomes.  A randomized-controlled study published in the New England Journal of Medicine by a group of the nation's top health policy scholars has found that Medicaid has no measurable effect on any of the objectively measured physical health outcomes the study examined.  In its second-year results, the Oregon Health Insurance Experiment, which randomly selected 10,000 people in Oregon to get Medicaid (only about 6,300 actually got the benefit), and then compared them with a randomly selected control group, found that those who got Medicaid did not on average have healthier blood pressure, cholesterol levels, or diabetic blood pressure control than those who did not get Medicaid.

Medicare failed to recover up to $125 million in overpayments, records show.  Six years ago, federal health officials were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage insurance plans that allegedly overcharged the government for medical services.  An initial round of audits found that Medicare had potentially overpaid five of the health plans $128 million in 2007 alone, according to confidential government documents released recently in response to a public records request and lawsuit.  But officials never recovered most of that money.  Under intense pressure from the health insurance industry, the Centers for Medicare and Medicaid Services quietly backed off their repayment demands and settled the audits in 2012 for just under $3.4 million — shortchanging taxpayers by up to $125 million in possible overcharges just for 2007.  The centers are part of the Department of Health and Human Services.

Why Medicare isn't actually going bankrupt. New medical findings give plenty of reason for optimism about the cost of caring for the elderly.  Medicare spending on end-of-life care is dropping rapidly, down from 19 percent to 13 percent of the Medicare budget since 2000.  Living to a ripe old age shouldn't be treated like it's a problem.  It's a bargain.  Someone who lives to 97 consumes only about half as much end-of-life care as someone who dies at 68.

Obamacare firm fined over taxpayer-funded birth care for illegals.  A major Obamacare provider has been fined more than a half billion dollars for using bribes to cash in on illegal immigrant mothers who get taxpayer-funded Medicaid birth services, according to the Justice Department.  Dallas-based Tenet Healthcare agreed to pay $513 million in the bribery scandal.  According to Justice, Tenet and two subsidiaries paid Hispanic health care providers to refer pregnancy cases to their hospitals, where they could run up the Medicaid tab by calling the maternity cases emergencies

ObamaCare's Nasty Surprise for Seniors.  On March 23, 2010, when President Obama signed the Affordable Care Act he signed into law a bill that wiped out more than $50 trillion in Medicare's unfunded liability.  That's not a misprint.  That's trillion with a "t".  The savings are almost three times the size of our entire economy.  But ObamaCare is supposed to be about insuring the uninsured.  It's about health insurance exchanges and the expansion of Medicaid.  What has that got to [do] with the elderly and the disabled?  A lot, it turns out.  One of the most important sources of funds that are being used to pay for ObamaCare comes from cuts in future Medicare spending.

DoJ busts largest Medicare fraud in history.  Using "data driven" law enforcement techniques, the Department of Justice has busted the largest Medicare fraud case in history.  More than a billion dollars in fraudulent Medicare claims over a decade were filed by a Miami-based health care provider.

Clinton Destroys Medicare.  Hillary Clinton is taking a sledgehammer to Medicare.  In a move calculated to fire up the extreme left wing of the Democratic Party, presidential candidate Hillary Clinton pledges to open Medicare to people 55 to 64, and make a "public option" insurance plan for all ages.  The 65-and-overs are already having a hard time finding a doctor willing to accept Medicare's stingy payments.  Clinton's proposals will suddenly invite in millions more patients competing for the same doctors.  Seniors, brace yourselves for long waits to see a doctor.

Planned Parenthood Caught Engaging in $28 Million in Medicaid Fraud Loses Bid to Stop Lawsuit.  Just one Planned Parenthood affiliate in Iowa allegedly committed $28 million in medicaid fraud.  And now a federal appeals court has ruled that it can't stop the lawsuit a former Planned Parenthood clinic director filed against it.  Former Planned Parenthood clinic director Sue Thayer filed the lawsuit against the abortion giant's Iowa affiliate accusing it of submitting "repeated false, fraudulent, and/or ineligible claims for reimbursements" to Medicaid and failing to meet acceptable standards of medical practice.  Alliance Defending Freedom filed the suit for Thayer in March 2011.  The lawsuit claims that Planned Parenthood's Iowa affiliate submitted "repeated false, fraudulent, and/or ineligible claims for reimbursements" to Medicaid and failed to meet acceptable standards of medical practice.

Hundreds arrested for $900 million worth of health care fraud.  The Justice Department announced Wednesday [6/22/2016] it's charging hundreds of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars.  It's the largest takedown in history — both in terms of the number of people charged and the loss amount, according to the Justice Department.  The majority of the cases being prosecuted involve separate fraudulent billings to Medicare, Medicaid or both for treatments that were never provided.

Justice Dept unveils 'largest takedown ever' to combat Medicare fraud.  U.S. law enforcement officials have charged 301 suspects with trying to defraud Medicare and other federal insurance programs in 2016, marking the "largest takedown" involving health care fraud allegations, the Justice Department said on Wednesday [6/22/2016].  The national sweep resulted in charges against doctors, nurses, pharmacists and physical therapists accused of fraud that cost the government $900 million, the department said.  The cases involved an array of charges, including conspiracy to commit health care fraud, money laundering and violations of an anti-kickback law.

Obama is gutting Medicare.  The American Journal of Public Health reports that a man turning 65 can expect to live almost five years longer than he would have in 1970 — and almost all of it in good health.  What a priceless gift.  A gift Obama is snatching away.  The president's Medicare reforms make it harder for seniors to get joint replacements.  His new payment rules shortchange doctors, discouraging them from accepting Medicare in the first place.  New ER rules clobber seniors with bills for "observation care." Under ObamaCare, hospitals get bonuses for spending less per senior, despite having higher death rates and infection rates.

The fast lane to rationed care.  When the Obama administration first proposed its massive overhaul of the nation's healthcare system, opponents raised concerns that government officials would be making decisions about healthcare not on the basis of a patient's needs, but based on bureaucratic spending limits and one-size-fits all political decrees.  Critics were especially alarmed over a provision in the Affordable Care Act that creates an agency called the Independent Payment Advisory Board and charges it with limiting the growth of Medicare spending.  The board will set the payment rates healthcare providers will receive for treatments and services of Medicaid patients.

Obama to hospitals:  Perform 'sex-change' operations or lose federal funding.  President Obama's Department of Health and Human Services implemented a rule change to the Affordable Care Act (a.k.a.  Obamacare) last week mandating that all health providers receiving taxpayer dollars must perform sex-change operations or lose their federal funding.  The final rule states that, under Title IX, any hospital receiving funding from HHS must "treat individuals consistent with their gender identity."  The rule provides no religious exemption.  In other words, religious hospitals that receive taxpayer dollars via Medicaid or Medicare will be required to perform sex-change operations or get cut off financially.  The rule change is not the only directive from the Obama administration forcing individuals to embrace the transgender agenda.

Obama's Latest Executive Overreach Is in Medicare.  The Obama administration has proposed regulatory changes in payment for Medicare Part B drugs.  They're looking to impose a broad, multi-year change through a demonstration project.  Medicare demonstrations routinely test payment or delivery models in pilot programs, make a report to Congress, and the lawmakers either enact or reject the model as a statutory basis for Medicare payment.  But Obama's proposal goes well beyond a normal pilot program, testing to see what does and doesn't work among a relatively small, randomly selected, group of providers.

Medicare Cuts Killing Seniors.  President Obama's Medicare cuts are killing seniors.  His health law changed Medicare, adding bonuses for hospitals that spend the least per senior.  The result?  Hundreds of hospitals are skimping on care to win bonuses.  Seniors at these hospitals aren't getting the right antibiotic or other treatments they need.  They're dying from pneumonia, heart attacks and heart failure at higher rates than patients in other hospitals that provide more care.

Obama Health Care Regulators Are In A Last-Minute Frenzy To Do More Damage.  [Scroll down]  As the article explains, ObamaCare created a little-known agency called the Center for Medicare and Medicaid Innovation with the mission of testing "innovative payment and service delivery models to reduce program expenditures." [...] Just last month, the center ordered almost 800 hospitals in 67 regions to accept bundled payments for knee and hip replacements.  If the total cost of a procedure — including follow-up physical therapy outside the hospital — exceeds a certain cap, these hospitals face a penalty.  If the bill comes in below the cap, they get a bonus.  But these bundled payment schemes have a very checkered history, and the new one is likely to force hospitals to scrimp on follow-up treatments, since doing anything more than sending patients home will likely push costs over the cap.

Ohio Medicaid expansion costs top $7.5 billion.  Ohio Medicaid expansion costs sailed farther past Gov.  John Kasich's projections in March, as total spending on the program topped the $7.5 billion mark.  Expansion cost $411 million last month, making March the most expensive month yet.  For the past six months, expansion costs reported by the Ohio Department of Medicaid averaged $394 million — dwarfing other state programs.  Kasich's budget office reported $312 million in primary and secondary education expenditures, $186 million in higher education expenditures, and $170 million in justice and public protection expenditures in March.

Dem Donors Plead Guilty to $33 Million Medicare Fraud Scheme.  Five individuals who have donated to Democratic politicians pleaded guilty to a scheme that drained Medicare out of $33 million dollars.  Two physicians and three owners of hospice and home care companies based out of Detroit, Mich., were charged on June 18, 2015 as part of the largest Medicare fraud case in history for submitting fraudulent claims for home health care and hospice services that were either not provided or deemed medically unnecessary.  The elaborate operation revolved around Muhammad Tariq, Shahid Tahir, and Manawar Javed — the owners of the home health care and hospice companies — paying kickbacks and bribes to physicians for referrals to their companies that included A Plus Hospice and Palliative Care, At Home Hospice, and At Home Network Inc.

71,777,758 Enrolled in Medicaid and CHIP; Up 14,478,342 Since Obamacare Exchanges Opened; 1 for Every 2 Americans With a Job.  As of the end of 2015, there were 71,777,758 individual in the United States enrolled in Medicaid or the Children's Health Insurance Program (CHIP), according to data published by the federal Centers for Medicare and Medicaid Services.  The 71,777,758 people enrolled in Medicaid and CHIP as of December, according to CMS, was an increase of 14,478,342 from the average monthly enrollment of 56,274,369 in the period of July through September 2013, just before the "State-Based Marketplaces" opened in October 2013 under the terms of the Affordable Care Act (AKA Obamacare).  That means overall Medicaid and CHIP enrollment has increased 25.7 percent since the Obamacare marketplaces opened.

The Obama Republican: John Kasich's Medicaid expansion is a $7 billion disaster.  Ohio Gov. John Kasich's expansion of Medicaid under the 2010 federal health law has cost taxpayers $7 billion in a little more than two years.  The federal government — which is $19 trillion in debt — paid $390 million for Ohio Medicaid expansion benefits in February, bringing the program's total cost since January 2014 to $7.1 billion.  Kasich frames his Obamacare expansion as a fiscally responsible way to keep drug addicts and the mentally ill out of prison, even as costs zoom past his projections.  The expansion was $1.5 billion over budget after 18 months.

Bernie Sanders' Medicare-For-All Plan Has Even Liberals Crying Foul.  [As Bernie] Sanders has gained traction with an increasingly out-of-the-mainstream Democratic Party, more grounded liberals among them have started to publicly denounce his plans, particularly his "Medicare for all" plan, as wildly unrealistic.  How unrealistic?  Just look at the details of his health plan.  First, he would abolish all private health insurance, forcing everyone into a government-run health system.  And the government would pay for everything, from dental work to annual checkups to brain surgery, with no deductibles or co-pays.  It would, he says, be entirely free.  Well, not free.  By Sanders' own admission his health plan is massively expensive — its $1.4 trillion price tag would increase an already out-of-control federal budget by more than a third.

I don't like Bernie because his "Medicare For All" plan will destroy our health and economy.  My college-age child introduced me to a website called I Like Bernie, But... which is particularly appealing to young voters.  The website offers short answers to concerns pro-Bernie voters might still be harboring about his policies and his ability to win.  With few exceptions, these answers are just plain wrong.  You can see my rebuttals at a website I set up as a counterweight (I Don't Like Bernie, Because...).  I've republished those same articles here, at my own blog, addressing Bernie's socialism, his tax plans, and his Second Amendment stance.  Today I'm tackling everything that's wrong with Bernie's plan to socialize American medicine.

Here are 5 of Bernie Sanders' Most Ridiculous Ideas.  [#1] "Medicare for All."  As one of the sections on Sanders' website explains, the presidential candidate is calling for a single-payer healthcare system.  Medicare is an example of a single-payer system, which is why Sander calls for "Medicare for All."  The problem is that Medicare already faces $43 trillion in unfunded liabilities and denies healthcare claims at a higher rate than any private insurer.  "Medicare for all" would drive the country into bankruptcy.

Taxpayers Billed $27 Million for Hoveround Wheelchairs That Weren't Medically Necessary.  Taxpayers were billed $27 million for thousands of power wheelchairs that were not medically necessary for their users.  Hoveround was the subject of an audit released last week by the Department of Health and Human Services inspector general, which faulted the company for failing to meet Medicare requirements before it charged the government for its electric wheelchairs.  In 2010, Hoveround provided 13,025 power wheelchairs to Medicare beneficiaries.  Eighty-five percent of those who received the wheelchairs did not meet the necessary medical requirements, according to the audit.  The findings were based on a sample of 200 individuals who received a power wheelchair from Hoveround.

Millions could see their Medicare costs soar.  The Social Security Administration told nearly 65 million retirees on Monday [10/12/2015] they will not be getting a raise next year, because inflation is too low to trigger one.  And the bad news gets worse.  Unless Congress acts, many of the more than 55 million on Medicare could see premiums rise as much as 50 percent — and higher deductibles, as well.

Mystery ambulance rides cost Medicare $30M: auditors.  Medicare paid $30 million for ambulance rides for which no record exists that patients got medical care at their destination, the place where they were picked up or other critical information.

Health Group Run by Dem Donor to Pay $118M to Settle Fraud Allegations.  The Department of Justice announced on Monday [9/21/2015] that the Florida-based Adventist Health System, a nonprofit health care organization that operates 44 hospitals in 10 different cities, has agreed to pay $118 million to settle claims that the group had arranged an improper compensation system that paid physicians for referrals to their hospitals.  The organization provided compensation that included leasing a BMW and Mustang for one surgeon, offering a $366,000 base salary for a family practitioner — nearly double that of the average salary of similar practitioners in the area — and providing a bonus of $368,000 and a total salary of $710,000 to a dermatologist who worked three days a week.  Additionally, the group was accused of submitting false claims to Medicare and Medicaid for services rendered to the patients who were referred to their system.

An Obamacare Change to Medicare Is Backfiring.  A provision in the Affordable Care Act requires Medicare to reduce payments to hospitals that have high readmission rates.  The goal was to improve patient care and cut the costs of avoidable hospitalizations.  Instead, the new study finds that the Obamacare change unfairly affects hospitals based on the patients they treat.  The current Medicare readmissions rate is high, with close to one in five elderly patients returning to the hospital within 30 days of leaving, and it's also costly — readmissions cost Medicare $26 billion annually, $17 billion of which is spent on return trips that might not have been necessary if proper care was received in the first place.

Medicare unfairly penalizes hospitals treating sickest, poorest patients, study finds.  For the last four years, Medicare has wielded a big stick:  It has fined hospitals if too many of their patients returned to any hospital within weeks of being released.  But many safety-net hospitals, including academic teaching hospitals, say this is unfair because they take care of sicker, poorer patients.  Now data released Monday [9/14/2015] shows they may be right.  Researchers at Harvard Medical School found that hospitals are being penalized to a large extent based on the patients they serve.

Obama Justice Dept. backs Planned Parenthood against La. Gov. Jindal.  The Obama administration has sided with Planned Parenthood in its effort to keep its contract with Louisiana, arguing in a court filing that the state's decision to defund the organization may be in violation of the federal Medicaid Act.  The Justice Department filed a "statement of interest" late Monday in favor of Planned Parenthood Gulf Coast, arguing that "thus far, Louisiana has not proffered sufficient reasons to terminate Planned Parenthood Gulf Coast Inc. ("PPGC") from its Medicaid program."

The Union That Rules New York.  One of the many crises that overwhelmed David Paterson's brief, hapless term as governor of New York was a surge in Medicaid costs.  Every recent New York governor has tried but failed to rein in Medicaid.  Yet Paterson's opportunity to address the problem appeared promising.  Government spending had to be cut during the 2009 budget cycle because of that year's historic collapse in revenues.  Accordingly, Paterson proposed $3.5 billion in cuts to the state's Medicaid program — the second-greatest burden on New York taxpayers, after K-12 education — and sought to shift monies away from inpatient hospitals to less expensive outpatient clinics.  Hospitals would have seen a revenue reduction of less than 2 percent.  But Medicaid is one of the primary sources of funding for the hospitals employing workers from 1199 SEIU, the powerful hospital and nursing-home employees' union.

Unchecked Medicare Fraud is Government Run Amok.  In today's world, federal agencies in the Obama era are the spending equivalent to Genghis Khan.  So why is the administration dragging its to stop Medicare fraud and save the taxpayer billions?  Two words:  Hospital.  Lobby.

Medicaid: A Fifty-Year-Old Flimflam.  [T]he poor medical outcomes endured by Medicaid patients is one of the best documented yet least known aspects of the program.  The most comprehensive study of this phenomenon was the "Oregon Experiment."  The state of Oregon chose enrollees for its Medicaid program by lottery, which gave researchers an unprecedented opportunity to compare the outcomes of Medicaid patients to those who remained without insurance.  The results, published by the New England Journal of Medicine, were startling:  "This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes."

Obama: There is no entitlement crisis.  [Quoting Barack H. Obama:]  Today, we're often told that Medicare and Medicaid are in crisis.  But that's usually a political excuse to cut their funding, privatize them, or phase them out entirely — all of which would undermine their core guarantee.  The truth is, these programs aren't in crisis.  Nor have they kept us from cutting our deficits by two-thirds since I took office.

The Editor says...
If you triple the budget deficit and then reduce it by two thirds, you have accomplished nothing.  Nevertheless, you can fool some of the people all of the time.

Medicare and Medicaid At 50: One Is Going Bankrupt, the Other Is Bankrupting States.  When President Johnson signed Medicare into law on June 30, 1965, he said, "If it has a few defects, I am confident those can be quickly remedied."  Fifty years later, a Government Accountability Office report found that an eye-popping $60 billion — fully 10% of Medicare's budget — was lost to waste, fraud, abuse or improper payments last year.  Among the glaring defects, the GAO found 23,400 fake or bad addresses on Medicare's list of providers.  Between those two events, Medicare has repeatedly suffered vast cost overruns, has been "reformed" countless times and has imposed a seemingly endless serious of price controls on doctors and hospitals.

Medicare's funding well to dry up in 2030.  The fund Medicare uses to pay hospitals will run out in the next 15 years, and experts say there are no easy answers to solve it.  The independent Board of Trustees for Medicare found the trust fund used for Medicare payments to hospitals would become insolvent in 2030 unless something is done.  The board issued its annual report to Congress on the entitlement program's finances on Wednesday [7/22/2015].

Medicare chart
Medicare's Prognosis Is Far Worse Than Dr. Obama Says.  Medicare is still a fiscal time bomb.  As the nearby chart shows, its hospital insurance deficits will hit $110 billion in 2031 — the first year after its trust fund runs out of money.  Annual deficits will eventually top $1 trillion a year.  Even that is a fantasy, since it assumes ObamaCare's steep Medicare provider payment cuts actually happen.  Even Medicare's trustees are skeptical.  Buried in an appendix, the report admits that "there is substantial uncertainty" regarding the likelihood that those cuts will be feasible.


Medicaid boom
ObamaCare's Medicaid Expansion Is Blowing Up.  Two dozen states immediately took the bait, lured by the promise the federal government would pay 100% of costs in the first three years and 90% for the newly eligible on into the future.  Several more have joined since.  An analysis by the Associated Press finds that this was short-sighted folly.  At least 14 of these states have seen enrollment surge unexpectedly, forcing at least half to increase their cost estimates.  And we're not talking about a few percentage points.


Medicare's midlife crisis: Catastrophic finances pit doctors against patients.  July 30 marks the 50th anniversary of President Lyndon Johnson signing Medicare into law.  At the time it was signed, government actuaries had predicted that the portion of the program that covers hospital insurance would cost $9 billion by 1990.  In reality, it ended up costing $67 billion by that point — or more than 7 times the original estimate.  Since its inception, the program has been dramatically expanded by both parties — even when President George W. Bush had a Republican Congress, he twisted arms to add a prescription drug benefit in 2003.  This year, the government will spend $626 billion on the Medicare program as a whole — more than is spent on national defense.  In fact, more is spent on Medicare than any government program other than Social Security.  A combination of the aging of the population and rising healthcare costs will cause Medicare costs to explode even further in the coming decades.

Medicaid enrollment surges, stirs worry about state budgets.  More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years.

Obama: 'Medicare and Social Security Are Not In Crisis'.  In a White House speech directed at seniors, President Obama re-assured them that Social Security and Medicare were not in crisis, contrary to the message signaled by Republicans.  "Now, we're often told that Medicare and Social Security are in crisis," said Obama pointing out that it was used as an "excuse" by Republicans to cut spending.  "But here's the truth.  Medicare and Social Security are not in crisis, nor have they kept us from cutting our deficits by two-thirds since I took office."

House Dems want Medicaid to cover abortion.  House Democrats are renewing their attack on the Hyde Amendment, the controversial budget provision that bars federal funds from paying for abortions.  Reps. Barbara Lee (D-Calif.), Diana DeGette (D-Col.) and Jan Schakowsky (D-Ill.) introduced a bill Wednesday [7/8/2015] that would require Medicaid to cover abortion services — currently banned under the Hyde Amendment.

Patients confront doctor who falsely diagnosed them with cancer.  The government says a man who took an oath to do no harm instead turned more than 500 of his patients into victims in a shocking case of medical fraud. [...] Courtroom sketches could not adequately capture the anguish of the victims Tuesday [7/7/2015] as one by one, they confronted the cancer doctor who prescribed aggressive chemotherapy for patients he knew were not ill, and for those who were, ordering treatments that were excessive while billing medicare $34 million.

The Editor says...
Chemotherapy is miserable enough without finding out later that it wasn't necessary.

Medicare's Victims.  Despite the Supreme Court's repeated attempts to prop it up, Obamacare is collapsing.  This is obvious not merely to the majority of Americans who have always disapproved of the law, but also to an increasing number of progressives.  Consequently, we are once again hearing calls for single-payer health care.  Most advocates of this system, including Hillary Clinton's main competitor for the 2016 Democrat presidential nomination, favor Medicare-for-All.  They want, in other words, to put all Americans on the government program that covers the elderly and disabled.

Doctor Accused of Medicare Fraud Donated $450K to Democrats.  A cardiologist in Florida who has donated more than $450,000 to Democrats has been suspended from receiving Medicare reimbursement payments over "credible allegations of fraud" after reimbursements as far back as 2012 came under scrutiny.  Dr. Asad Qamar, a cardiologist based out of Ocala, Fla., was officially suspended from participating in the program in March, though the suspension was only recently made public.  In January, the government intervened in a lawsuit against Qamar filed by whistleblowers who alleged the doctor had defrauded the government.

America's Coming Transfer of Wealth.  According to the CBO's annual Long-Term Budget Outlook, if current laws were to remain unchanged, government spending as a share of gross domestic product would reach 22.2 percent in fiscal 2025, up from 20.5 percent today.  By then, even under a very rosy GDP growth scenario, the debt would amount to 78 percent of the economy. [...] The deterioration comes fully from the explosion of major health care programs, Social Security and escalating interest on debt costs.  More precisely, Medicare, Medicaid, Affordable Care Act subsidies, and Social Security are the drivers of our future debt.  Spending on these programs alone could reach 11.8 percent of GDP in fiscal 2025 and 14.2 percent of GDP in 2040, up from 10.1 percent today.

However the Supreme Court Rules, ObamaCare Is In Deep Financial Trouble.  By 2025, the CBO says, ObamaCare will cut Medicare spending by $153 billion.  That's equal to 73% of what the CBO expects the exchange subsidies and the Medicaid expansion will cost in that year.  By comparison, planned Medicare spending cuts will cover only 24% of ObamaCare's subsidy costs in 2016.  No one believes these Medicare cuts — which involve mainly payment cuts to doctors and hospitals — will happen.  Medicare's board of trustees, the Government Accountability Office and Medicare's chief actuary have all warned they are unrealistic and unsustainable over the long term.

Feds announce nationwide health care fraud sweeps.  Health care fraud sweeps across the country have led to charges against 243 people, including doctors, nurses and pharmacy owners accused of bilking Medicare and Medicaid, the government announced Thursday [6/18/2015].

Obama Sued for Attempted Blackmail, Other States Join In.  The state of Florida has now filed a lawsuit against Barack Obama who attempted to force Florida to bend to his will using blackmail.  Florida had refused to accept Obama's demand to expand their Medicaid program to include able bodied adults with no children. [...] Florida's program is called LIP and Obama has informed Florida that contrary to the ruling by SCOTUS, that he will be cutting them off.  That would force Florida to either fund LIP exclusively by themselves or end the program for millions who depend on it for their healthcare coverage.  The expansion of Medicaid in Florida comes at a steep price.  The leftwing Urban Institute in 2012 estimated that the expansion of Medicaid would cost Florida 82 billion dollars over the next 10 years, but Lip will only cost them 22 billion over the same period.  All this so shiftless bums can get free medical from the government.

Ohio Gov. Kasich on Medicaid Expansion: 'It's my money'.  Anytime Gov. Kasich opens his mouth to talk about Medicaid expansions, you can be sure either an absurd canard or an outright falsehood will spew forth.  Ohio's governor, who is positioning himself to run for president, brags incessantly about his history as a budget hawk during his time in Congress in the '90s, but apparently sees no contradiction between claiming to be a fiscal conservative and expanding Medicaid to hundreds of thousands of able-bodied working, childless adults.  Nevermind that he did so by circumventing the state legislature, adding to the federal debt and imperiling the benefits of the most vulnerable Ohioans — because it's his money.

Lawsuit: AIDS foundation scammed feds for millions.  The nation's largest supplier of HIV and AIDS medical care is accused of bilking Medicare and Medicaid in an elaborate $20 million scam that spanned 12 states, according to a lawsuit filed in South Florida federal court.

23 arrested in massive Medicare-Medicaid fraud scheme.  A 199-count indictment against 23 doctors, nurses, and medical supply companies was unsealed in Brooklyn, NY yesterday, revealing a massive scheme to defraud Medicare and Medicaid of millions of dollars.  Hundreds of poor people were recruited with the promise of new sneakers to visit a couple of clinics in the Bronx, where bogus tests and procedures were performed.  The criminals would then bill government insurance programs for millions.

AARP opposes Medicare bill which reduces its profits.  A major player in health insurance is resisting a bipartisan Medicare bill that would hurt the company's bottom line.  That's to be expected.  Here's the odd part:  The insurance giant is AARP.

Medicare Is Doomed — Save the Patients.  Medicare "as we know it" is doomed.  It never had a chance.  What was originally intended as a vital safety net for seniors has become a massive boondoggle that is collapsing under its own weight.  In 1965, Medicare started as a medical savings program for retirees.  The government would take a small amount out of your paycheck each month for forty years.  This would be placed in a virtual lockbox with your name on it, and would grow at some nominal but safe rate, say three percent.  At retirement, the average American would have well over $100,000 in today's dollars in a virtual individual Health Savings Account to cover old age medical costs.  Things did not work out that way at all.

Feds shelled out $125B in bogus payments last year.  The government paid out $124.7 billion in potentially bogus payments last year, the government's chief watchdog said Monday [3/16/2015], blaming a controversial tax credit for the poor as well as increased bad payments in Medicare and Medicaid.  One major problem is tracking when Americans die — the Social Security Administration admitted last week that its rolls are filled with names of more than 6 million folks who are listed as 112 years of age or older.

Lisa Crinel, former Zulu queen, charged in alleged $30 million Medicare fraud scheme.  Prominent New Orleans businesswoman Lisa Crinel, the 2004 Zulu Queen, faces federal charges in a scheme prosecutors say defrauded Medicaid for $30 million for bogus home health care fees, according to an indictment announced Thursday (March 12) by U.S. Attorney Kenneth Polite.  Crinel, 51, the owner of Abide Home Health Services, was one of 20 people named in the 26-count indictment alleging that from 2008 until charges were filed Thursday [3/12/2015], her company was the centerpiece of a scam that charged Medicaid program for services clients either didn't need or were never performed.

Report: Rural Hospitals Get Billions in Extra Medicare Funds.  A law that allows rural hospitals to bill Medicare for rehabilitation services for seniors at higher rates than nursing homes and other facilities has led to billions of dollars in extra government spending, federal investigators say.

Baker budget: Slash Medicaid to help close massive $1.8B gap.  The state is staring down a $1.8 billion budget gap entering next fiscal year, Gov. Charlie Baker will announce today [3/4/2015] when he unveils his first budget — a $38 billion proposal that includes deep cuts to the state's Medicaid program but keeps his vow not to raise taxes.  The deficit, which Baker is expected to detail at an afternoon press conference, is driven in part by nearly a $1 billion in new net spending at MassHealth and exceeds even the projections of the Massachusetts Taxpayers Foundation, which had pegged the total gap at $1.5 billion in recent weeks.

New York, Louisiana, Texas top Medicaid fraud recoveries in 2014 ranking.  Law enforcement nationwide recovered more than $2 billion through Medicaid fraud investigations in 2014, with New York state representing almost one-fifth of the money.  The Department of Health and Human Services inspector general released a state-by-state breakdown of money recovered by Medicaid Fraud Control Units, law enforcement tasked to act against individuals or entities taking advantage of Medicaid.  New York had the most success with more than 100 convictions.  It also recovered $378 million, one and a half times more than Louisiana, which compiled the second highest total of recoveries.

States find out why Medicaid expansion is bad idea.  I hate to say "I told you so," but in this case I actually did.  Back in August, I wrote a column for this paper calling on governors to say no to the massive boondoggle that is Obamacare's expansion of Medicaid.  It traps people in yet another government program and does nothing to help improve the health outcomes of the people it claims to serve.  But for some reason, governors in states like Illinois and Ohio jumped at the possibility of more "free" money from Washington.

Colorado hospitals to be penalized for Medicare readmissions.  More than half of Colorado hospitals that treat Medicare patients will be penalized for having high readmission rates under the federal health care law.

Medicaid is broken and expansion won't fix it.  Medicaid is administered jointly by the state and federal government, offering health coverage to Americans earning up to about $16,000 in the states participating in Obamacare's expansion of the program and up to roughly $12,000 in the states that do not.  Providing these benefits comes at a great cost to taxpayers.  In fiscal 2013 (even before the program expanded) federal and state governments spent nearly $460 billion combined on Medicaid.  Nearly a quarter of money spent by states went to finance the program in 2013, putting it ahead of elementary and secondary education as the biggest component of state budgets, according to the National Association of State Budget Officers.

Expanding Medicaid hinders growth costs jobs.  Expanding Medicaid through President Obama's healthcare law hinders economic growth and costs jobs, according to a study from the American Action Forum released on Thursday [12/11/2014].  The finding runs counter to the argument that the Medicaid expansion is an economic stimulus, one that many supporters of the law's expansion have been making to convince states to participate in it.  "[W]e find that Medicaid expansion, if adopted by all states, would result in a direct net loss of up to $174 billion in economic growth nationwide over ten years, and would result in the loss of over 206,000 full-year-equivalent jobs for the years 2014 to 2017," wrote economist Robert A. Book, the report's author.

Federal Spending by the Numbers, 2014 (Including 51 Examples of Government Waste).  Where Does All The Money Go?  Forty-nine percent, or almost half of all spending, paid for Social Security and health care entitlements (primarily Medicare and Medicaid).  In 2002, the entitlement share of the budget was 25 percent, about half of what it is today.  Without reform of these massive and growing programs, Washington will have to borrow increasing amounts of money, piling debt onto younger generations and putting the nation on a dangerous economic course.  Social Security is the largest federal spending program and has held this position since surpassing defense spending in 1993.  Medicare is one of the largest and fastest-growing programs in the entire federal budget.

Medicaid Is Destroying Public Education.  One of the truly unheralded disasters caused by Obamacare is the sharp reduction in spending on public education as Medicaid costs eat up an ever-larger share of state budgets.  When Obama took office, the proportion of state spending that went to Medicaid was smaller than that for public education (K-12).  In 2008, states spent 22.0 percent of their funds on education and only 20.5 percent on Medicaid.  But now the situation has reversed and health care has vaulted ahead of education spending in the states.  This year, only 20.0 percent of state funds will go to K-12 schools while almost a quarter — 24.5 percent — will go to Medicaid.

HHS still doing business with firm that twice defrauded Medicare.  A Tennessee home healthcare company was forced to pay $25 million to settle its second fraud case in two years.  CareAll, a collection of home nursing and rehabilitation companies, defrauded both Medicare and Medicaid by billing inflated and falsified costs to the federal programs for home healthcare services, the Department of Justice said.  From 2006 to 2013, CareAll exaggerated the severity of patient illnesses to pad its billings and sought reimbursements for medically unnecessary services that were administered to patients who weren't even homebound, according to the Justice Department.

Report: 42 percent of new Medicaid signups are immigrants, their children.  Immigrants and their U.S.-born children make up more than 40 percent of new Medicaid recipients at a cost of $4.6 billion, according to an analysis of government data.  The Center for Immigration Studies, a low-immigration advocacy group, released a report early Thursday [11/13/2014] that found both legal and illegal immigrants and their minor children made up 42 percent of Medicaid growth from 2011 to last year.

Study: 42 Percent of New Medicaid Recipients in the Last Two Years Were Immigrants.  Almost half of the low-income Americans who have enrolled in Medicaid in the past two years are immigrants to the United States, according to a new report, suggesting that Obamacare's large expansion in the program will disproportionately benefit immigrants as well.  "The data show that immigrants and their children accounted for 42 percent of the growth in Medicaid enrollment from 2011 to 2013," the CIS report says.  Because immigrants are more likely to have low incomes or lack insurance from their jobs, they're much more likely to be eligible for the existing Medicaid program — and Obamacare's expansion of it, which began this year.

Medicare Bought Meds For Dead People.  A report released Friday [10/31/2014] by the Health and Human Services Department's inspector general said the Medicare rule allows payment for prescriptions filled up to 32 days after a patient's death — at odds with the program's basic principles, not to mention common sense.

TLC — the Washington Version.  The Medicare Act was signed into Law by President Lyndon Johnson in January, 1965.  It was intended as a national Health Savings Account with individual accounts called lockboxes. [...] Sometime between 1965 and 1970 (I could not discover precisely when), Congress broke open all those tens of millions of lockboxes, confiscated tens of billions of dollars, and dumped them into the General Account, to spend on anything Congress wanted.  They replaced all the cash with government-issued IOUs.

The Secret Committee Behind Our Soaring Health Care Costs.  In 2012, national health care spending in the United States reached $2.8 trillion, or more than 17 percent of the country's gross domestic product — more than any other industrialized country. [...] Another explanation, debated by experts in health policy circles but less known to the public, lies with a secretive committee run by the American Medical Association (AMA) which, with the assent of the government, has enormous power to determine Medicare prices by assessing the relative value of the services that physicians perform.

Medicare Star Ratings Allow Nursing Homes to Game the System.  The lobby of Rosewood Post-Acute Rehab, a nursing home in this Sacramento suburb, bears all the touches of a luxury hotel, including high ceilings, leather club chairs and paintings of bucolic landscapes.  What really sets Rosewood apart, however, is its five-star rating from Medicare, which has been assigning hotel-style ratings to nearly every nursing home in the country for the last five years.

A Medicare scam that just kept rolling.  The government has paid billions to buy power wheelchairs.  It has no idea how many of the claims are bogus.

Medical Transportation Company Owner Pleads Guilty to Billing Medicaid for Dead People's Rides.  Unfortunately for Cynthia Keegan, dead men do tell tales.  Keegan, 51, owns a van company that provided nonemergency rides for wheelchair-bound MassHealth patients.  Some of the patients she billed MassHealth for, it turned out, had not used the service.  Because they were dead.  In September, Keegan was indicted on seven counts of larceny and seven counts of making false claims to Medicaid for billing MassHealth for nearly 10,000 rides that never happened, using the names of a dozen nursing home patients and 47 people who had previously ceased to be.  Those rides never actually happened because Keegan's Cross Roads Trolley is a wheelchair van company, not a hearse company.

The Obscure Drug With a Growing Medicare Tab.  An obscure injectable medication made from pigs' pituitary glands has surged up the list of drugs that cost Medicare the most money, taking a growing bite out of the program's resources.  Medicare's tab for the medication, H.P. Acthar Gel, jumped twentyfold from 2008 to 2012, reaching $141.5 million, according to Medicare prescribing data requested by ProPublica.  The bill for 2013 is likely to be even higher, exceeding $220 million.

Report shows $6.7 billion in improper Medicare payments.  Medicare paid out $6.7 billion in 2010 for health care visits that were improperly coded or lacked documentation, a report released Thursday [5/29/2014] found.  That's 21% of Medicare's total budget for diagnostic and assessment visits, according to the Department of Health and Human Services inspector general.  They found that 42% of diagnostic and assessment claims were improperly coded and 19% were improperly documented.  This comes after a 2010 report found that 1,669 physicians consistently billed for the two highest-paying codes.  In the new report, 56% of claims for those high-coding physicians physicians were incorrect, with 99% being up-coded in the provider's favor, and with 1% of the "errors" being down-coded.  Those providers cost $26 million in 2010 in incorrect coding.

Medicare Ban on Sex Reassignment Surgery Lifted.  Medicare can no longer automatically deny coverage requests for sex reassignment surgeries, a federal board ruled Friday [5/30/2014] in a groundbreaking decision that recognizes the procedures are medically necessary for some people who don't identify with their biological sex.

Lung Cancer Screening Could Cost Medicare Billions.  Every person covered by Medicare would shell out an additional $3 a month if the government agreed to pay to screen certain current and former smokers for lung cancer, a new study estimates.

Medicaid paid $12 million for deceased people in Illinois, documents show.  The Illinois Medicaid program paid an estimated $12 million for medical services for people listed as deceased in other state records, according to an internal state government memo.

Feds Begin Fingerprinting 'High Risk' Medicare Providers and Suppliers.  Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks. [...] The provision is part of the Medicare, Medicaid, and CHIP Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad discretion in applying the background check requirements depending on the potential for abuse, fraud, and/or waste.

Americans on Medicaid Exceed Population of UK.  The number of Americans who were enrolled in Medicaid at any time during fiscal 2013 exceeded the entire population of the United Kingdom, according to new data published by the federal government's Medicaid and CHIP Payment Access Commission (MACPAC).  Were Medicaid a nation instead of a U.S. entitlement program it would be the 20th most populous country on earth.

Sliver of Medicare Doctors Get Big Share of Payouts.  A tiny fraction of the 880,000 doctors and other health care providers who take Medicare accounted for nearly a quarter of the roughly $77 billion paid out to them under the federal program, receiving millions of dollars each in some cases in a single year, according to the most detailed data ever released in Medicare's nearly 50-year history.

Data trove shows U.S. doctors reap millions from Medicare.  In 2012, an enterprising ophthalmologist in south Florida received $20.8 million in Medicare payments, the highest amount the government health plan for the elderly paid an individual provider that year, according to a preliminary analysis of federal data.

Data uncover nation's top Medicare billers.  The Medicare program is the source of a small fortune for many U.S. doctors, according to a trove of government records that reveal unprecedented details about physician billing practices nationwide.  The government insurance program for older people paid nearly 4,000 physicians in excess of $1 million each in 2012, according to the new data.  Those figures do not include what the doctors billed private insurance firms.

Obamacare's Medicaid Trap.  The technology behind a huge part of Obamacare's efforts to expand insurance coverage — the part aimed at low-income Americans — remains far from fixed, and the glitches are keeping some of the nation's most vulnerable patients from getting insured.  The administration launched a "tech surge" to improve the HealthCare.gov experience for those shopping for private insurance, but the website's process for enrolling in Medicaid remained mired in glitches.  And for President Obama's efforts to expand health coverage that's a major problem.

Political Ties of Top Billers for Medicare.  Two Florida doctors who received the nation's highest Medicare reimbursements in 2012 are both major contributors to Democratic Party causes, and they have turned to the political system in recent years to defend themselves against suspicions that they may have submitted fraudulent or excessive charges to the federal government.  The pattern of large Medicare payments and six-figure political donations shows up among several of the doctors whose payment records were released for the first time this week by the Department of Health and Human Services.

Healthcare cuts canceled after Dem complaints.  The Obama administration announced Monday [4/7/2014] that planned cuts to Medicare Advantage would not go through as anticipated amid election-year opposition from congressional Democrats.  The cuts would have reduced benefits that seniors receive from health plans in the program, which is intended as an alternative to Medicare.  Under cuts planned by the administration, insurers offering the plans were to see their federal payments reduced by 1.9 percent, which likely would have necessitated cuts for customers.  Instead, the administration said the federal payments to insurers will increase next year by .40 percent.

HHS updates Medicare enrollment rules for same-sex couples.  The Obama administration on Thursday [4/3/2014] announced that it was updating Medicare rules to allow partners in same-sex marriages to apply for benefits during special enrollment periods.  The Department of Health and Human Services said that the Social Security Administration would now be able to take applications for special enrollment periods for Medicare Part A and Part B and reduce late penalties for some eligible same-sex couples.  The move is the latest step taken by HHS after the Supreme Court in 2013 struck down a key part of the federal Defense of Marriage Act, which defined marriage as a union between one man and one woman.

So you want single payer? Medicare has 375,000 case appeals backlog.  And that sort of a backlog has Democrats worried. [...] This sort of a problem is also visible in another government run health care system.  VA currently has almost 400,000 disability claims pending.  It claims to be on track to erase that in 2015, but observers are skeptical of that claim.  While it claims to have shed 200,000 previously backloged claims, new claim backlog numbers continue to rise.

The Obama Administration's About-Face on Medicare.  The Obama administration seems determined not to rock the boat before the midterm congressional election this fall.  It's already delayed Obamacare mandates that could cause outrage.  Now it has stopped proposed Medicare changes that weren't even part of Obamacare — and with good reason.  The administration had proposed new rules for seniors' prescription drug plans in Medicare Part D.  This is significant because Part D is unusual for a government program:  People love it.

House subcommittee chairman: Obama administration policy would eliminate half of all existing Medicare Part D plans.  The Obama administration's new proposed rule for Medicare Part D would eliminate half of all Medicare Part D plans and raise prescription drug premiums for millions of seniors by up to 20 percent, according to a U.S. House subcommittee chairman.  "Today, the average senior has 35 different [Medicare Part D] plans to choose from this year.  This rule would reduce that choice to two plans.  50% of the plans offered today will be gone, and the health care that seniors like may go with it," House Energy and Commerce Health Subcommittee chairman Rep. Joe Pitts said in a statement at a Feb. 26 hearing attended by a top administration health official.

Update:
Administration drops controversial proposed Medicare changes.  The Obama administration says it's pulling the plug on proposed changes to the Medicare prescription program that ran into strong opposition on Capitol Hill.  Among other changes, the regulation proposed to remove three classes of drugs from a special protected list that guarantees seniors access to a wide selection of critical medications.

Drug rule is ditched by Obama.  Medicare chief Marilyn Tavenner alerted lawmakers Monday that her agency would not go forward with a proposal to give insurers more leeway to limit the number of drugs they cover for Medicare beneficiaries.  Critics argued that making the change, which was designed to save money, would have hampered seniors' access to necessary drugs.  Democrats worried the issue would hurt them in the midterm elections, and House Republicans had scheduled a vote this week on a bill blocking the regulation from going forward.

Obama's Not-So-Secret War On Private Medicare Plans.  To say that President Obama is not an enthusiastic backer of the two Medicare programs that offer seniors private insurance options would be something of an understatement.  Over the years, Obama has repeatedly derided Medicare Advantage — the program that lets seniors enroll in subsidized, private insurance.  He once called it "wasteful," and said it amounted to "giveaways that boost insurance company profits but don't make (seniors) any healthier."  Obama has been equally harsh when it comes to Medicare Part D — the drug benefit President Bush signed into law that relies on privately run plans.

Insurers: Medicare Advantage cuts cost seniors $900 per year.  The health insurance industry fighting proposed cuts to Medicare Advantage payments argued they will raise seniors' out-of-pocket costs next year.  America's Health Insurance Plans (AHIP), a trade group, blasted the reductions with a report Thursday finding that beneficiaries could pay as much as $900 more in 2015 if the cuts take effect.

Medicaid Fraud: Who's in on the Act and How They're Getting Away With It.  A single mom with five kids living in Brooklyn with no income on record and struggling to make ends meet sounds like an eligible candidate for government subsidy programs.  She signs up for the SNAP (Supplemental Nutrition Assistance Program) and Medicaid for herself and her children and gets government assistance to help cover her rent.  But in reality, she's married, her husband has an all-cash business, which allows her to rake in thousands of dollars a month via welfare programs and remain undetected by the government.

Feds to fine state over limit on Medicaid patients' ER visits.  Florida has been limiting Medicaid patients to six emergency room visits a year even though federal officials consider such a cap illegal.  As a result, the federal government intends to penalize the state by withholding a portion of Medicaid funding.  "We hope the state will realign their Medicaid program with federal standards to avoid this penalty," said Emma Sandoe, a spokeswoman for the Centers for Medicare and Medicaid Services.

The Editor says...
Mr. Obama apparently wants Medicaid "clients" to continue to use hospital emergency room physicians as their family doctors — without any limits.

Major flaw in Maryland health site may mean $30 million in unnecessary Medicaid payments.  The cost to taxpayers of flaws in Maryland's online health insurance exchange is coming into focus, with officials estimating at least $30.5 million in unnecessary Medicaid spending and conceding that they have no idea how much it will take to get a system that works.  The state has paid $65.4 million to the contractor hired to build the system and fired this week because of the protracted problems.  Costs are likely to keep rising as Maryland figures out how to fix or replace the system.

25 Charged in Largest Medicaid Fraud Bust in D.C. History.  Federal authorities say 25 people have been charged in a wide-ranging scheme to obtain millions of dollars in fraudulent Medicaid payments from the District of Columbia government.

Medicaid Overpays Millions for Diapers.  A lack of competitive bidding processes among state Medicaid agencies caused the program to overpay for diapers by about $62 million in 2012, according to a report released by federal auditors on Monday.  Only five state Medicaid agencies have implemented competitive bidding programs for "disposable incontinence supplies," according to the inspector general for the department of Health and Human Services.  Those states reported saving up to of 50 percent on those supplies, the IG report found.

ObamaCare death debt? States can seize assets to recoup Medicaid costs.  Though many may not realize it, states are allowed to recover the cost of health care after someone's death by seizing their assets.  It applies to Medicaid recipients who are between the ages of 55 and 64.  The law has been in place since 1993, when Congress realized states were going broke over rising Medicaid expenses.  But under ObamaCare, Medicaid eligibility has expanded dramatically along with the promise that the federal government will pick up the cost of the higher tab — at least for the first few years, after which states will be on the hook for a portion of the increase.  Millions more are entering the system, perhaps without knowing that their assets could be at risk.

How Obamacare will hurt doctors.  A study just published in the prestigious journal Science reveals that new Medicaid patients in Oregon were 40% more likely to use the emergency room than the uninsured were.  This finding is not a surprise to me or most physicians — we have known that truth for years.  But it does undermine one of the basic philosophical and practical underpinnings of Obamacare:  the notion that expanding insurance will invariably unclog ERs, improve primary and preventive care, prevent diseases and lower costs.

Single Payer: We've Been There, Done That.  Medicare is a single payer health care system for seniors, and it is Exhibit A in the case against government-run health care.  "Medicare-for-All" is what single payer advocates usually mean when they refer to universal health care.  Most of these people naïvely believe that such a system could be paid for with a few modest tax increases.

Surprise! Medicaid isn't free — it's a poorly advertised predatory loan.  It's called "estate recovery" and although it's been around for 20 years, most Americans have never heard of it.  Sadly, this arcane bit of Medicaid fine print is about to become much more familiar.  Basically, what it says is this:  If you're over 55 and are on Medicaid, when you die the state can seize your assets in an effort to repay the cost of your care.

Study: Expanding Medicaid doesn't reduce ER trips, it increases them.  As the health-care law expands Medicaid to cover millions more Americans, a new Harvard University study finds that enrollment in public program significantly increases enrollees' use of emergency departments.  The research, published Thursday in the journal Science, showed a 40 percent increase in emergency department visits among those low-income adults in Oregon who gained Medicaid coverage in 2008 through a state lottery.  This runs counter to some health-care law supporters' hope that Medicaid coverage would decrease this type of costly medical care, by making it easier for low income adults to see primary care providers.

Emergency Visits Seen Increasing With Health Law.  Supporters of President Obama's health care law had predicted that expanding insurance coverage for the poor would reduce costly emergency room visits because people would go to primary care doctors instead.  But a rigorous new experiment in Oregon has raised questions about that assumption, finding that newly insured people actually went to the emergency room a good deal more often.

Hospice firms draining billions from Medicare.  Hospice patients are expected to die:  The treatment focuses on providing comfort to the terminally ill, not finding a cure.  To enroll a patient, two doctors certify a life expectancy of six months or less.  But over the past decade, the number of "hospice survivors" in the United States has risen dramatically, in part because hospice companies earn more by recruiting patients who aren't actually dying, a Washington Post investigation has found.  Healthier patients are more profitable because they require fewer visits and stay enrolled longer.

Russian Diplomats' Medicaid Fraud Raises Questions About Foreign Officers Accessing Taxpayer Benefits.  According to the U.S. Attorney for the Southern District of New York, 25 current and former Russian diplomats and 24 of their spouses allegedly participated in a scheme to illegally obtain Medicaid benefits for prenatal care and related costs by underreporting their income or falsely claiming that their children were citizens of the United States, [Congressman Ed] Royce noted.  Over the course of nearly a decade, they milked the system of $1.5 million in benefits.

Surprise! Obamacare Includes A Medicaid Death Tax.  Before Obamacare there was a Medicaid provision allowing the state to recuperate funds spent on a Medicaid patient over 55 years old from his/her estate.  The end result of that policy, for those on Medicaid dying with assets, would see the government seizing the assets of an estate forcing family members to purchase back any items they'd want to keep.  It's called estate recovery, and it's not exactly advertised as one of the terms for Medicaid enrollment.  But pre-Obamacare there weren't many people who were a) on Medicaid and b) had many assets of value for seizing.

Expanded Medicaid's fine print holds surprise: payback' from estate after death.  As thousands of state residents enroll in Washington's expanded Medicaid program, many will be surprised at fine print:  After you're dead, your estate can be billed for ordinary health-care expenses.

Obamacare's expanded Medicaid asset seizure bonanza.  Basically, the problem is that the Democrats, in their infinite wisdom, decided to drastically expand the Medicaid rolls without considering the consequences — one of which being, state governments have been long in the habit of trying to get at the remnants of Medicaid recipients' estates in order to cut costs. [...] You see, in order to get a subsidy for an Obamacare plan people have to be making neither too much, nor too little.  People who make too little are expected to go onto Medicaid by the federal government; they certainly aren't going to get any kind of subsidy for their new health care plan.

ObamaCare created a Medicaid time bomb.  The good news, if you want to call it that, is that roughly 1.6 million Americans have enrolled in ObamaCare so far.  The not-so-good news is that 1.46 million of them actually signed up for Medicaid.  If that trend continues, it could bankrupt both federal and state governments.

Dozens of Russian diplomats have been ripping off Medicare for years.  Almost 50 Russian diplomats and members of their families have been charged in a massive health care fraud scheme, officials announced Thursday [12/5/2013].  Federal officials allege that 58 of the 63 births to Russian officials living in New York between 2004 and 2013 were fraudulently paid for by Medicare at a cost of roughly $1.5 million to US taxpayers.  The Russians were applying for these benefits while emptying their pockets at famed stores such as Bloomingdale's, Jimmy Choo's, Prada and Tiffany & Co, officials said.

Medicaid Fraud: Obamacare promise of free quality healthcare.  It may be the biggest Obamacare lie of all.  Not that you can keep your health care plan if you like your plan.  Not that you can keep your doctor if you like your doctor.  Not all of the phony cost estimates and supposed efficiencies.  The biggest lie of all is that 15-30 million additional people who will be enticed or shoved onto Medicaid will receive quality health care.  In reality, they will receive health care "insurance," but there will be few doctors willing to see them because the reimbursement rates are so low.

Obama Trashes America to Save ObamaCare.  The U.S. is hugely generous to those who can't afford to pay for health care.  Hospitals spend more than $40 billion a year doing so.  Doctors generously provide billions of dollars worth of free or discounted care to those who need help.  There are various philanthropies that raise billions each year for charity care.  And that's to say nothing of the existing government programs.  Taxpayers fork over $415 billion a year so Medicaid can provide health care for the poor, and another $500 billion for Medicare.  There's the VA for veterans and various state-run programs as well.  So, no, the health care system isn't now and never has been the cold, cruel, heartless disaster that the Obamas make it out to be.

ObamaCare Forced Mom Into Medicaid.  Countless individually insured Americans have received such letters; many are seeing more radical increases in premiums and deductibles.

White House attempts to shame Republican governors into Medicaid expansion.  The White House stepped up its effort Thursday night to shame more Republican governors into accepting an expansion of Medicaid rolls, calling on Florida and Louisiana to add more than 1 million uninsured residents under Obamacare.  "We should be about putting people over politics," said presidential adviser David Simas.  "It is reckless that some governors are so determined to see that the health care law not succeed, that they have even refused to expand Medicaid coverage for millions upon millions of working families."

Audit reveals half of people enrolled in IL Medicaid program not eligible.  [A] review of the Illinois Medicaid program confirms massive waste and fraud.  A review was ordered more than a year ago — because of concerns about waste and abuse.  So far, the state says reviewers have examined roughly 712-thousand people enrolled in Medicaid, and found that 357-thousand, or about half of them shouldn't have received benefits.  After further review, the state decided that the percentage of people who didn't qualify was actually about one out of four.

Watchdogs: Government Paid Millions in Medicare to Deceased, Illegal Immigrants.  The Department of Health and Human Services' Centers for Medicare and Medicaid Services paid out $23 million to beneficiaries after their deaths in 2011, according to one report from HHS' inspector general.  Another report tallied more than $28 million in payments from 2009 to 2011 to individuals who were in the country illegally.  In all, CMS paid Medicare benefits to 4,139 illegal immigrants and 17,403 deceased people, according to the two reports.

Medicare paid millions to dead patients, illegal immigrants, probe finds.  Medicare paid $23 million for dead patients in 2011 and $29 million for drug benefits for illegal immigrants from 2009 to 2011, according to a report Thursday [10/31/2013] from the Health and Human Services inspector general.  The investigators said Medicare has safeguards to try to stop payments to dead patients, but it still ended up sending out the $23 million anyway.  The Centers for Medicare and Medicaid Services (CMS) — the same agency that is struggling to fix the broken Obamacare website — acknowledged the problems and said it will try to take steps to fix them.

CMS Spent More Than $1 Trillion in Less Than 1 Year.  The Centers for Medicare and Medicaid Services (CMS), which runs the federal government's major health-care programs, and which was responsible for developing the Obamacare health-insurance exchange website, spent more than $1 trillion in just the first eleven months of fiscal 2013, according to the Treasury.  From October 2012 through August 2013, according to the Treasury, this one federal agency spent $1,036,561,000,000.

Medicaid Overview.  Medicaid covers pregnant women, individuals with disabilities, children of low-income households, some of the poorest elderly, and parents meeting specific income thresholds, generally those at or below the federal poverty level — $958 gross income per month for one person, or $1,963 gross income per month for a family of four.  (Children above the threshold for Medicaid can qualify for a separate program, the Children's Health Insurance Program; North Dakota's CHIP program covers children up to 160 percent of the poverty level, and New York's goes up to 400 percent of the poverty level.)

The Great Medicaid Swindle.  On Monday [10/21/2013], the same day President Obama gave a poorly received speech defending the glitchy Obamacare rollout, there was another unfortunate development in health-care reform:  Ohio expanded Medicaid.  In a controversial (and possibly illegal) move, Ohio's Controlling Board voted to expand Medicaid coverage in the state to adults that were not previously eligible by way of accepting billions in federal funds.  That means 25 states, plus the District of Columbia, have now signed on to take part in an aspect of the Affordable Care Act that is both optional and ill-considered.

Are they signing up for Obamacare, or for Medicaid?  How many people have tried to sign up for Obamacare?  How many have completed the process?  Those numbers are important, but let's keep something else in mind here — there's another important number that a lot of publications are failing to separate out.  That is, how many people are enrolling in the private insurance plans within the Obamacare exchanges — as opposed to those applying who report very low incomes and get steered into the Medicaid program?

Obamacaid.  Democrats do have one lament about [Obamacare's] implementation:  Some states are opting out of the Medicaid expansion.  Medicaid, the joint state-federal safety net intended for the poor, already covers more than one of five Americans and pays for two of five U.S. births.  And that's before ObamaCare dumps up to 20 million new dependents onto its rolls.

'Death doctor' accused of misdiagnosing cancer patients.  A Michigan oncologist charged with intentionally misdiagnosing patients with cancer as part of a major Medicare fraud operation will remain in prison until trial, with court officials scared he will flee to the Middle East.  Dr Farid Fata — who is accused of ordering unnecessary treatments for his patients, such as chemotherapy, to enrich himself through insurance programs — made an application in the federal court to have his bond reduced from $9 million to $500,000 so he could leave prison, where he has been held since August 6.

Almost Half of U.S. Births Covered by Medicaid.  According to researchers from the George Washington University (GWU) School of Public Health, in 2010, almost half of all births in the United States were paid for by Medicaid, and that rate is only going to go up.  Medicaid was responsible for 48% of the 3.8 million births in 2010, an increase of 90,000 births from 2008, which was an 8% increase during that period.

Detroit doctor charged in $35M Medicare scam gave fake diagnoses, feds say.  A Detroit-area doctor has been charged with bilking the government of tens of millions of dollars by deliberately misdiagnosing patients with cancer and illegally billing Medicare for the treatment.  Dr. Farid Fata [...] was arrested last week on charges he ripped off Medicare for millions of dollars by giving chemotherapy to patients who didn't need it and diagnosing cancer when the illness wasn't apparent, MyFoxDetroit.com reported.

Medicare by the Scary Numbers.  The trustees report's predicted expenditures are based on the assumption built into the law that next Jan. 1 there will be a 25 percent decrease in the fees that Medicare pays doctors.  The reason has nothing to do with ObamaCare.  In the Balanced Budget Act of 1997, Congress declared that Medicare physician fees could grow no faster than the economy as a whole.  Since then, though, Congress has postponed the cuts on 14 occasions, not allowing them to take place.  Why assume things will be different now?  A second problem does stem from ObamaCare.  In order to pay for the expansion of health insurance for the young, the new health law calls for steep cuts in the growth of health care spending on the elderly.

Obamacare's Insurance "Solution": Medicaid for All.  Even as the Left celebrates Obamacare's expansion of health coverage, a Reuters story highlighted what kind of "insurance" people will receive under the law.

This Thing Called ObamaCare.  It's instructive to witness the inability of politicians to accurately predict their own legislative outcomes.  In 1967, Congress predicted that Medicare spending would equal only $12 billion per year by 1990 — a paltry sum.  Actual spending for that year was $110 billion, so they were slightly off the mark.  But of course, by that point, Medicare was fully entrenched in the American political system, and the notion of even modestly reforming it was off the table (it evidently continues to be off the table today).  Thus stands the ossified character of American government, and thus will likely stand ObamaCare twenty-five years from now, too.

Feds let Medicare provider give away $20 grocery cards to lure patients.  The Department of Health and Human Services has given qualified approval for a Medicare provider to give away $20 grocery gift cards to induce seniors to get more taxpayer-funded health screenings, despite concerns the promotion could run afoul of federal anti-kickback laws.

FBI raids headquarters of The Scooter Store as part of $100 million Medicare fraud investigation.  More than 150 FBI agents and local cops have raided the Texas headquarters of The Scooter Store, the nation's largest supplier of mobility vehicles, after the company allegedly defrauded Medicare by $100 million.  The company is accused of harassing doctors with constant phone calls and surgery visits in order to wear them down to prescribe their vehicles to patients who do not need them.

Note:  Federal, state and local governments spent a total of $783.8 billion on health care in 2006.*

Report: $2 billion spent annually for Medicaid emergencies, largely for illegal immigrant baby deliveries.  Even though federal law largely bars illegal immigrants from obtaining Medicaid coverage, the program annually pays out more than $2 billion in free emergency coverage that mostly goes to illegal immigrants, according to Kaiser Health News.  The vast majority of the total emergency care reimbursements cover delivering babies, Kaiser reports.

Medicare improperly paid $120M to ineligibles.  Illegal immigrants and prison inmates received more than $120 million in Medicare services from 2009-2011 despite federal law that makes them ineligible for the program, according to two new reports from the HHS inspector general.  The issue, according to the reports, is timing.  When Medicare is alerted that someone is incarcerated or undocumented, its contractors help prevent payments from going out the door.  But often, Medicare's databases aren't up to date, and improper payments go out.

The Real Country-Killer in 2013.  Every week, the U.S. Treasury borrows money to keep operating, by holding auctions of "T-Bills."  Institutional investors, foreign and domestic, show up to bid on these government bonds (Treasury Bills).  What if investors decide that it just isn't worth risking any more of their money?  There won't be any money.  Even when the country still looks strong, investors could sit on the sidelines, worrying:  "Let someone else take the risk."  If the lending stops, can the country survive when the Ponzi scheme collapses?  What if there is no money to cut social security or Medicare checks, or operate the government?

Sheila Jackson Lee: Entitlements Off The Table, They Are "Earned".  Rep. Sheila Jackson Lee (D-TX):  "There is no way, Mr. Speaker, that we should raise the eligibility age for Medicare, that we should not think carefully about how we approach the reform of Medicaid.  And that we don't the American people that Social Security is solvent. [..."]

The Editor asks...
If you are entitled to receive something, it isn't necessary to earn it.

This Is Your Life under Obamacare.  We couldn't afford Medicare or Medicaid.  They're unfunded liabilities by trillions of dollars, when projected into the future.  And the solution is — what?  To impose a third government insurance program that we can't afford — ObamaCare?  That's like a working-class family not being able to afford their two cars, so their solution is to buy a third one.

Dems' Medicare lie.  Attention, New York's 3 million seniors:  Don't be fooled.  It's the Obama health law that destroyed Medicare, though the impact will not be felt for another year or more.

Record 70.4 Million Enrolled in Medicaid in 2011: 1 Out of Every 5 Americans.  A record 70.4 million people were enrolled in the Medicaid health care program for the poor in fiscal year 2011, according to government figures provided to CNSNews.com.  That figure equals about 22 percent of the population, which means there was one person on Medicaid for every five Americans in 2011.

Darryll Issa subpoenas documents on Medicare pilot program.  House Oversight and Government Reform Committee Chairman Darrell Issa subpoenaed the Obama administration Monday [10/22/2012] for documents he believes will expose Medicare malfeasance by Department of Health and Human Services officials.

Medicaid and Medicare Enrollees Now Outnumber Full-Time Private Sector Workers.  The combined number of people enrolled in Medicaid and Medicare — the government health-care programs for the poor, disabled and elderly — now exceeds the number of full-time private sector workers in the United States.  In 2011, according to the Centers for Medicare and Medicaid Services (CMS), there were 70.4 million people who enrolled in Medicaid for at least one month.

The First $1 Trillion Agency.  In 1965, when President Lyndon Johnson signed legislation creating Medicare and Medicaid, all federal outlays equaled $118.23 billion, according to OMB.  In fiscal 2012, according to the Monthly Treasury Statement for September, outlays for the Centers for Medicare and Medicaid (CMS) alone hit $1.05 trillion — the third straight year they exceeded $1 trillion.  No other federal agency has ever run annual outlays in excess of $1 trillion.  By comparison, total outlays for the Department of Defense in fiscal 2012 were $650.9 billion.

Sebelius stonewalling lawmakers about project that hides Obamacare cuts to Medicare.  Health and Human Services Secretary Kathleen Sebelius has ignored congressional inquiries about an expensive program, which the Government Accountability Office recommended she cancel, that hides Obamacare cuts to Medicare Advantage until after the presidential election.  HHS has spent $8.3 billion on a demonstration project that, in theory, "test[s] whether a tiered bonus structure would produce better results" by providing bonuses to insurance companies.

The funny think about reform & fear.  That segment of the population that has the least to fear from a reform of Medicare or Social Security is the most fearful — namely, those already receiving Medicare or Social Security benefits.  It is understandable that people heavily dependent on these programs would fear losing their benefits, especially after a lifetime of paying into these programs.  But nobody in his right mind has even proposed taking away the benefits of those who are already receiving them.

50 Examples of Government Waste.  Soaring government spending and trillion-dollar budget deficits have brought fiscal responsibility — and reducing government waste — back onto the national agenda.  President Obama recently identified 0.004 of 1 percent of the federal budget as wasteful and proposed eliminating this $140 million from his $3.6 trillion fiscal year 2010 budget request.  Aiming higher, the President recently proposed partially offsetting a costly new government health entitlement by reducing $622 billion in Medicare and Medicaid "waste and inefficiencies" over the next decade.  Taxpayers may wonder why reducing such waste is now merely a bargaining chip for new spending rather than an end in itself.

More Obamacare Fiction.  President Obama said during his weekly radio address today that he wanted to share "some actual facts" about "a lot of accusations and misinformation flying around" about Medicare.  Let's look at the "facts" that he highlights in his address:  ["]We've extended the life of Medicare by almost a decade.["]  He "extends the life of Medicare" by paying Medicare providers less and less every year to the point that 15 percent, and eventually 40 percent, of Medicare providers will either go bankrupt or stop seeing Medicare patients altogether, according to Medicare actuaries.

'They'll Just Lie'.  On Saturday [8/25/2012], the Obama campaign released [an] ad attacking the Romney Medicare proposal.  The ad doesn't walk some sort of narrow line between misleading and deceiving, it's just simply a pack of lies from top to bottom.  The ad's most significant claim is that "instead of a guarantee, seniors could pay $6,400 more a year" under the Romney plan — a claim attributed on the screen to the Center on Budget and Policy Priorities.

40 Reasons Not To Re-Elect Barack Obama.  [#1]  Obama took 700 billion dollars out of the Medicare program and put it into his wildly unpopular health care program.  This is despite the fact that even Obama has admitted, ["]Medicare in particular will run out of money, and we will not be able to sustain that program no matter how much taxes go up.["]  Mitt Romney and Paul Ryan will put that money back into the Medicare program where it belongs, while Obama won't.

Medicare Jujitsu.  Medicare has been a favorite issue of the left for decades.  As the program's spending has ballooned out of control, Democrats have used every Republican attempt to rein it in as an opportunity to paint the GOP as the enemy of the elderly — telling seniors that their benefits were threatened, and scaring Republicans away from reforms.  But Democrats have grown so comfortable with Medicare demagoguery that they have neglected to actually keep themselves on the safe side of the issue.

Krauthammer: Democrats Have "Stepped On A Land Mine With Medicare".  Charles Krauthammer:  ["]I think the Democrats are discovering that they stepped on a land mine with Medicare.  The fact is that Medicare was raided for Obamacare and here's why.  This isn't even a wee issue.  The Obama administration had to show — because it kept arguing that this is not going to cost anybody anything, this will be revenue neutral.  It's not going to add to the budget deficit.  Remember that was the mantra for a year and a half.  So they had to get half a [trillion] dollars from somewhere.["]

The Obama Bankruptcy.  The end of Medicare and Medicaid as we know them — through reform, the Ryan way, or bankruptcy, the Obama way.  The direction of the country — via the Romney-Ryan right track, or the Obama-Biden wrong track.  Those are the choices, made stark by the addition of Paul Ryan to the Republican ticket.

The Closer One Looks At Obamacare, The More It Looks Like Medicaid.  So far, President Obama is withholding the final set of regulations that describe just what health benefits the Obamacare plans will deliver.  He may be waiting until after the election.  But there's enough detail already in the law to make decent estimates.  The answer turns out to get a lot worse, the closer one looks.  There's good reason to believe that in short order, the health plans sold in Obamacare's heavily regulated, state-based insurance exchanges will degrade into something akin to today's Medicaid managed care plans.

The $6,400 Myth.  One of President Obama's regular attacks on Paul Ryan's Medicare reform is that it would force seniors to pay $6,400 a year more for health care.  But merely because he keeps repeating this doesn't mean it's in the same area code of accurate.  The claim is based on a now out-of-date Congressional Budget Office estimate of the gap between the cost of health care a decade from now, in 2022, and the size of the House budget's premium-support subsidy for a typical 65-year-old in 2022.

DNC Vice Chair: That $700 Billion Isn't 'Necessary or Essential' to Medicare.  Vice-chair of the DNC Hispanic Caucus, Andres Ramirez, discusses the $700 billion at issue in the Medicare debate with King of Nevada Political Coverage Jon Ralston, and declares that, "Both campaigns are consistent that that money, in and of itself, is not necessary or essential in the Medicare budget."

The Mediscare Boomerang.  President Obama all but called Paul Ryan's Medicare reform un-American in 2011, and Democrats have since spent 16 months running their familiar Mediscare campaign.  But all of a sudden liberals and their media bodyguards claim to be scandalized because Mitt Romney has the nerve to defend himself by describing Mr. Obama's own "Medicare cuts."  How dare he?  The double standard is predictable, but the furor is also instructive.  For the first time in memory, voters this year may have a choice between two very different philosophies about how Medicare ought to evolve.  The political class is spitting nails because, thanks largely to ObamaCare, a reform agenda might finally get a fair hearing.

The Obama Medicare Plan: Rob It and Let it Die.  Gov. Romney and Congressman Ryan have something President Obama does not:  A plan to save Medicare.  That's right, for all their scare tactics, President Obama and Democrats have no plan whatsoever to preserve Medicare for future generations — or protect it for today's seniors and those nearing retirement.

Ryan Plan Would Save Medicare; Obamacare Will Destroy It.  "Who is in charge:  the government or the patient?" Paul Ryan asked during a speech about health care last September at the Hoover Institution, Stanford University.  Obamacare's answer is the government -- to the detriment of today's seniors.  Ryan has come up with an alternative market-based plan that prevents Medicare from self-destructing because of out-of-control spending, without substituting government mandates and rationing for the choices that are better left to patients, including seniors, and their doctors.

The GOP's Medicare Advantage.  Predictably, Democrats went after Mitt Romney's new running mate immediately, describing Paul Ryan as a "certifiable right-wing ideologue" whose views are "extreme" and "radical."  They focused on Medicare, warning that Republicans "would end Medicare as we know it," making it "a voucher system" that costs seniors "thousands of dollars in health care costs."  Some Republican hand-wringers moaned.  They failed to consider that Democrats were going to level these charges no matter whom Mr. Romney picked as his running mate.  And they ignored the ammunition the party has to turn the issue against Democrats.

The Five Worst Ryan Myths.  [#1]  The Ryan budget "ends Medicare." [...] The oft-repeated claim is so blatantly false that the fact-checking website PolitiFact awarded it the dubious honor of "Lie of the Year 2011," having thoroughly debunked the charge in nine separate fact-checks rated either "False" or "Pants on Fire."  Ryan has proposed to restore solvency to Medicare by gradually transforming it from a fee-for-service government program into a "premium support" system. Americans aged 55 and above would not be affected.

The Return of Mediscare.  On CNN yesterday [8/12/2012], Obama strategist David Axelrod claimed that "most of the experts who have looked at this" have said that Paul Ryan's plan to reform Medicare would put the program "in a death spiral" and "would raise costs on seniors by thousands of dollars."  A day earlier — as Representative Ryan was preparing to accept Mitt Romney's offer to join his ticket — Obama campaign manager Jim Messina had said the plan involved "shifting thousands of dollars in health-care costs to seniors."  None of this is true.  Any expert who looks at Ryan's plan — any intelligent and fair-minded person, really — can tell you the actual worst-case scenario for how much more it could make beneficiaries pay:  $0.

For $460 Billion a Year, Medicaid [Should] Save Lives.  If saving lives is the goal, then politicians should instead find the lowest-cost way of doing so, because that enables the greatest number of lives to be saved with the available resources.

Southern governors secede from Medicaid.  House Republicans are lining up to repeal the Affordable Care Act on Wednesday [7/11/2012], but GOP governors in the South have a real plan to gut the law.  Govs. Rick Perry in Texas and Rick Scott in Florida have both said they won't expand Medicaid to more of the working poor in their states — rejecting a central part of the law designed to cover 15 million more Americans.

Obama admin to use $8.3 billion "slush fund" to fake out seniors?  How does Barack Obama keep from getting ousted by seniors who discover that their Medicare Advantage options for 2013 will be greatly reduced, if not eliminated altogether?  After all, ObamaCare's $500 billion in cuts to the highly successful private-public partnership begin in 2013, assuming that the Supreme Court keeps the law in place this summer.  Those cuts are necessary to fund the Medicaid expansion that comes in 2014 to provide funding for coverage of many — but not all — of the currently uninsured.

Sebelius Says GAO Report Is 'Just Not Accurate' Then Helps Confirm That It Is.  To the Cornhusker Kickback, the Louisiana Purchase, and Gator Aid, President Obama has now added the Senior Swindle — a ploy to spend $8.35 billion in taxpayer money to hide the effects of Obamacare's Medicare Advantage cuts until after the election. [...] The Obama administration is claiming that this expenditure of $8.35 billion is legal because this money is being spent, the administration claims, on a legitimate "demonstration project" to help improve the implementation of current law.

Medicare slush fund shows Obama's abuse of power.  President Obama regularly misuses executive power, often nakedly in the service of his political interests. [...] The administration's sleight of hand on Medicare Advantage fits a pattern of Obamacare provisions that were abandoned when they were shown to be unworkable.  What makes the Medicare gambit more distressing is that Obama is using taxpayer money for political purposes.

Is Obama Cooking the Medicare Books?  A new Obama administration report claims that health reform (ObamaCare) will save taxpayers $200 billion in the Medicare program through 2016.  To what do we owe this good fortune?  A good chunk of the savings, we are told, will be produced by lowering "excessive payments" to Medicare Advantage plans.

A bad day for the White House — and for taxpayers.  The White House did not have a good Monday [4/23/2012].  The day started with the Government Accountability Office calling for the cancellation of an $8.3 billion program that is supposed to reward high-quality Medicare plans, but is paying off average plans instead.  That was followed by the Medicare trustees, who reported that Medicare's trust fund will be out of money five years earlier than they predicted when the president's health reform law was enacted.

Obama's Latest Plan to Snooker Seniors.  For years, the President and his congressional accomplices have been telling us that the Medicare Advantage (MA) program is too costly. [...] This canard was the pretext for the massive slashes in MA funding he authorized when he signed Obamacare into law.

Texas Doctor Charged With $375-Million Healthcare Fraud.  A Texas doctor was arrested Tuesday for allegedly "selling his signature" to process nearly $375 million in fraudulent Medicare and Medicaid claims in a scheme that was carried on for half a decade; $350 million was improperly billed for Medicare and $24 million for Medicaid.  In what is being characterized as one of the largest healthcare scams organized by a single doctor, critics are suggesting that the development only solidifies the fact that the government's Medicare and Medicaid fraud detection system is gravely flawed.

Undercover Grandma Catches Medicare Fraud on Tape.  A hidden camera recorded the undercover grandmother's visit to a doctor in McAllen, Texas, where she told the doctor and nurses she exercised regularly and, other than some hypertension and arthritis, was in excellent health. ... Yet the official certification sent to Medicare for home health care services indicate she was homebound and suffered from two internal infections, incontinence and needs "assistance in all activities, unable to safely leave home, severe sob," an abbreviation for shortness of breath.

7 accused of $375M Medicare, Medicaid fraud.  Years after Jacques Roy started filing paperwork that would have made his practice the busiest Medicare provider in the U.S., authorities say they've found most of his work was a lie.

Riverside Hospital employee charged in $100 million Medicare case.  An executive of Riverside General Hospital was arrested and charged Wednesday [2/8/2012] in a $116 million Medicare scheme involving kickbacks to patient recruiters and the owners of homes for the elderly and disabled in exchange for steering residents to Riverside's mental health clinics.

Medicare Reforms:  Medicare is the third-largest federal program after Social Security and defense, and it will cost taxpayers about $430 billion in fiscal year 2010.  Medicare is one of the fastest-growing programs in the federal budget, with spending likely to double over the next decade and to surpass Social Security spending by 2028.  Numerous studies suggest that about one-third of Medicare spending is wasted.

NAACP Plantation Masters Play Race Card Again.  The more states expand their Medicaid programs, the more federal funds they get.  So they have a perverse incentive to keep growing these programs.  It is unfortunately analogous to drug pushers who get richer with each new addict.  If indeed Santorum did single out blacks, it's not unreasonable because they are disproportionately on Medicaid.  Blacks comprise 12 percent of the population but they constitute 30 percent of those on Medicaid.  Medicaid is government monopolized socialized medicine for the nation's poor.  Not surprisingly, its spending is out of control while delivering increasingly shoddy care.

3 arrested in $90 million Medicare fraud scheme.  The owners of a Houston mental health program were arrested Wednesday [12/14/2011], charged with trying to bilk Medicare out of $90 million for treatments that amounted to little more than patients "watching movies, playing bingo or engaging in other activities," federal authorities contend.  Mansour Sanjar, 78, and Cyrus Sajadi, 64, both physician owners of Spectrum Care in West Houston were charged in the alleged phony treatment scheme, which involved kickbacks to the owner of an assisted living facility in exchange for finding and funneling patients to the clinic.

New billing system for Medicaid in trouble.  Managers of one of the state's largest service contracts came in for a barrage of criticism Tuesday after legislators were provided a copy of an audit detailing why the project is hundreds of millions of dollars over budget and nearly two years behind schedule.

Entitlement Programs: A Plan to End Them.  America's financial situation is precarious.  Over the past eight years our national debt has doubled to $14.5 trillion, and our total unfunded liabilities now exceed an astonishing $114 trillion.  That's $1,115,000 per federal income taxpayer.  Even the most unrepentant spendthrift understands that these debts and liabilities are unsupportable, nor can they be solved by immorally targeting the rich.  Instead, we must enact immediate, across-the-board spending cuts, with special emphasis on the biggest components of our financial wreck:  Social Security, Medicare and Medicaid.  These entitlement programs constitute the majority of our unfunded liabilities, because despite being labeled "trusts" they're not actually savings plans.

All Entitlements Are Not Created Equal.  Medicare was signed into law in 1965.  It was advertised to be the same as Social Security but was another Ponzi scheme, even less sustainable than Social Security. ... Estimates vary but best "guesstimates" suggest that the average person who works 40 years pays $115,000 in to Medicare, and will take out at least $375,000 in medical expenses.  Anyone who has ever balanced a checkbook knows you cannot spend more than you have, unless of course you are the federal government.

West U doctor gets 11 years for Medicare fraud.  A West University anesthesiologist was sentenced Friday [10/28/2011] to at least 11 years in prison for her role in a $45 million Medicare fraud scheme involving a bogus physical therapy clinic.

Tuckerton man's resolve helps uncover multimillion-dollar health care fraud.  It started when Richard West went for some dental work and was told his Medicaid benefits had somehow maxed out. ... After checking his own medical records, West, 63, discovered the company providing him with nursing care appeared to have overbilled Medicaid for hundreds of hours for people who were never there.  He called various government hotlines but got no help, he said — so he found his own lawyer.

New O'Keefe Sting Exposes Medicaid Corruption.  Conservative activist James O'Keefe traded in his pimp hat for a Russian accent during his latest undercover sting operation, in which he pretends to be an affluent European drug dealer attempting to obtain Medicaid benefits from an Ohio government office.  Once again, the con apparently worked.  Government employees are shown on video assisting O'Keefe in applying for medical assistance, after he tells them that he sells drugs, pimps out his underage sister and recently purchased an $800,000 car.

Pelosi Prediction Backfires? Glitches Arise in Health Law.  Back in March 2010, then-House Speaker Nancy Pelosi, D-Calif, uttered the now-famous words, "We have to pass the bill so that you can find out what is in it, away from the fog of the controversy."  Pelosi was talking about the health care law, and it appears she was right about the fact that it was full of unknowns.  It turns out that, due to a glitch in the law, roughly three million middle-income Americans could wind up on Medicaid — which was designed to assist the country's poorest citizens.

Repeal IPAB.  The best way for congressional Republicans to make the case for the Paul Ryan budget is to contrast it with the Democrats' plan.  To the extent the Democrats have one, it centers on empowering the so-called Independent Payment Advisory Board (IPAB), a panel of 15 bureaucrats, to make cuts to Medicare.  This is a constitutionally suspect scheme that will make Medicare worse for seniors while leaving in place all the program's perverse incentives, which distort the rest of the health-care market.

Obamacare wrecks Medicare by design, but why?  "We don't want to take away people's health insurance," Health and Human Services Secretary Kathleen Sebelius so graciously declared earlier this year.  But then she quickly qualified that with these ominous words:  "before they have some realistic other choices."

Medicare is Bad Medicine for Young America.  [Scroll down]  Some in the media will confirm that when changes to Medicare are debated, the response from the audience is more abrupt than almost any other topic.  Angry Americans call or write in afraid that they'll lose their health benefits; the most common response?  "I'm only getting back what I paid in."  This "getting back what I paid in" mentality has long been fostered by our paternalistic government and is difficult to argue with unless you know that it is absolutely false.

End Medicare.  Medicare was a scam from the start.  It had to be a scam because its ostensible purpose — providing health insurance for the elderly — was never the objective of its proponents.  Instead, Medicare was a stepping stone to a utopia its champions dared not acknowledge:  A compulsory universal-health-care system administered by government experts.  FDR's Committee on Economic Security initially intended to issue a health-care plan in conjunction with its universal, compulsory Social Security proposal in 1934.

Reid: 'Not in Favor of Changing Medicare' Despite Its $24.6 Trillion Shortfall.  Senate Majority Leader Harry Reid (D-Nev.) said he was not willing to change Medicare despite the fact that the program has an estimated $24.6 trillion in unfunded liabilities — the amount of money the government is obligated to pay, above what it gets in tax revenue, to honor future benefits under the Medicare program.

Mediscare: The Surprising Truth.  The Obama administration has repeatedly claimed that the health-reform bill it passed last year improved Medicare's finances.  Although you'd never know it from the current state of the Medicare debate — with the Republicans being portrayed as the Medicare Grinches — the laim is true only because ObamaCare explicitly commits to cutting health-care spending for the elderly and the disabled in future years.

Obama, Ryan and You.  Both parties are being disingenuous about Medicare reform.  So let me be the first to open Pandora's box and reveal three unpleasant truths.  First, health care spending is growing at twice the rate of growth of our income — clearly an unsustainable and undesirable spending path.

Medicare and Medicaid Made $70 Billion in 'Improper Payments' Last Year.  The Center for Medicare and Medicaid Services — the federal health-care agency that is a key bureaucracy in implementing Obamacare — made at least $70.5 billion in "improper payments" last year.  These improper federal health-care payments amounted to more than the combined total of $68.3 billion spent by the entire Homeland Security and the State departments last year, which spent $44.5 billion and $23.8 billion respectively according to the White House Office of Management and Budget.

Obama plays the Medi-scare card against Republicans.  Medi-scare is back.  This week President Obama marched out Health and Human Services Secretary Kathleen Sebelius to start a new Democratic campaign aimed at frightening senior citizens.  Her message:  They will be left with unfilled prescriptions, canceled rehab sessions and a thousand other pains because of spending cuts being sought by the terrible, hard-hearted Republicans in Congress.

GAO: Almost A Tenth of Medicare Spending was Improper.  An estimated $48 billion went to improper Medicare payments last year, out of the $509 billion spent on health care for elderly and disabled patients, an audit shows.  Medicare's susceptibility to fraud, coupled with its size and complexity, has helped keep it on the GAO's high-risk list since 1990.  The GAO has repeatedly requested that Medicare make a number of changes, and while some progress has been made, the agency has significant challenges to overcome.  "Medicare remains on a path that is fiscally unsustainable," warned Kathleen King, health care director at GAO.

Texas doctors leaving Medicare hits record high.  Texas doctors fed up with Medicare's declining reimbursements dropped out of the government-funded program for the elderly in record numbers in 2010, according to new data.  One hundred and seventy-two doctors formally ended involvement with Medicare last year, the most yet in a surge of "opt-outs" that has claimed more than 450 Texas doctors since 2008.  Before 2007, the number averaged a handful a year.

This is an original compilation, Copyright © 2013 by Andrew K. Dart

Medicaid:  States' $24 billion black hole.  Governors and state lawmakers are anxiously waiting to see whether Congress will send them another $24 billion to help cover their ever-expanding Medicaid rolls.

Who rules America? AARP.  The great question haunting Washington's budget debate is whether our elected politicians will take back government from AARP, the 40 million-member organization that represents retirees and near-retirees.  For all the partisan bluster surrounding last week's release of President Obama's proposed 2012 budget, it reflects a long-standing bipartisan consensus not to threaten seniors.  Programs for the elderly, mainly Social Security and Medicare, are left untouched.

Mugged by Medicare.  The Obama administration is trying to shove Medicare coverage down the throats of senior citizens who don't want it, but it's efforts are falling flat. Five plaintiffs are suing, arguing that no statute or regulation allows government to implement this requirement.

Running the government on 8¢:  Today, the United States spends roughly 76 cents of every federal tax dollar on just four things:  Medicare, Medicaid, Social Security and interest on the $14 trillion debt.  That leaves 24 cents of revenue to pay for everything else the federal government does.

Doctors, Nurses, Therapists Arrested For Medicare Fraud.  Federal agents raided health care facilities in nine states this morning [2/17/2011], arresting dozens of suspects believed to be defrauding Medicare of tens of millions of dollars, ABC News has learned.  Federal authorities say this is one of the largest — if not the largest — take down of Medicare fraud suspects ever conducted.

ObamaCare and the General Welfare Clause.  [Scroll down]  Congress could simply provide any state that chooses to withdraw from Medicaid a federal block grant equal to the amount that state's taxpayers would otherwise receive for Medicaid.  That would make its choice to remain in or opt out of Medicaid truly voluntary and ensure that the Medicaid program serves the general welfare.  A cynic might respond, Congress would never offer such a block grant because then lots of states might withdraw.  Exactly right.

15 states get bonuses for adding uninsured children to Medicaid rolls.  Even states can get performance bonuses, at least when it comes to moving kids from the "uninsured" to the "insured" list.  Health and Human Services Secretary Kathleen Sebelius announced that 15 states will be getting a little something extra in their end-of-the-year stockings for their effectiveness at providing health insurance to kids through Medicaid.

The Editor says...
In other words, the federal government is bribing the states to get more people dependent on welfare.

Here's a tool that could untrack the third rail.  Neither the Democratic Party nor the Republican Party has ever shown much desire to address the problem of ever-increasing government, in part because they would pay a political penalty if they did.  Certain big-ticket programs still retain considerable support from people who have no idea of their costs.  That's especially true of those out-of-control "entitlement" programs, Social Security and Medicare.  The challenge now is to help the American people understand that their future — and that of their children and grandchildren — depends upon their willingness to rein in these beloved programs which the nation simply cannot afford.

Obama's 'Big Lies' Get Bigger.  How many "Big Lies" has Obama told?  Frankly, it's becoming difficult to keep track of them.  Most recently, the top actuary at the Centers for Medicare and Medicaid — a pair of programs that shouldn't even exist in the first place — revealed that millions of American seniors will have to pay increased out-of-pocket health care costs next year for "less generous benefit packages" as a direct result of Obamacare.

How To End The Doctor Dance.  If you want to know why Washington can't control entitlement spending, there's no better example than the regular ritual surrounding Medicare payments to physicians.  It has been going on for more than a decade, and it follows a consistent script.

Barack Obama: Welfare King.  ObamaCare is supposed to help about 32 million uninsured Americans get health coverage.  Half of those will get it through Medicaid, a means-tested entitlement program.  Folks, Medicaid is welfare.  Democrats want to put 16 million more Americans on the welfare rolls through Medicaid — and they think that's a good thing!

Every Awful Thing You Need to Know About Obamacare.  Medicare and Medicaid are already famous for the billions in fraud in these two programs.  Obamacare sharply expands Medicaid.  The Congressional Budget Office reports the Act will increase federal spending by almost $1 trillion over the first ten years.  With full implementation, starting in 2014, it will increase spending by $2.4 trillion, making it the most expensive legislation ever approved by Congress and signed by a president.

Dozens charged with largest Medicare scam ever.  A vast network of Armenian gangsters and their associates used phantom health care clinics and other means to try to cheat Medicare out of $163 million, the largest fraud by one criminal enterprise in the program's history, U.S. authorities said Wednesday [10/13/2010].

Obamacare's stealth ambush of senior citizens.  Even Obamacare's biggest cheerleaders won't be able to ignore Medicare chief actuary Richard Foster forever.  Based on current law, Foster says, seniors who rely on Medicare will replace Medicaid recipients at the bottom of the health care ladder as early as 2019, five years after the individual mandate kicks in.  That's when the fees Medicare pays to providers will be slashed below Medicaid rates, which are already well below market prices.

Obama to Seniors:  'Drop Dead'.  According to surveys, no group of Americans is more skeptical of Obamacare than senior citizens — and with good reason.  While bits and pieces of the massive law are designed to appeal to seniors — more taxpayer subsidies for the Medicare drug benefit, for example — much of the financing over the initial ten years is siphoned off from an estimated $575 billion in projected savings to the Medicare program.  Unless Medicare savings are captured and plowed right back into the Medicare program, however, the solvency of the Medicare program will continue to weaken.  The law does not provide for that.

Refusing the Entitlement Lollipop.  Two months after passing a law that supporters claimed would reduce federal deficits, largely through Medicare cuts, the House is moving toward a temporary "doctor fix" that would add tens of billions in Medicare costs.  Even more expensive fixes are likely in the future.  Congressional leaders knew this spending would be necessary when they passed health reform in March.  Yet they didn't include this liability in the law, in order to hide the overall cost of the entitlement.  In a failing corporation, this would be a scandal, investigated by Congress.  In Congress, this is known as legislative strategy.

Obama Names Rationing Czar to Run Medicare.  Dr. Donald Berwick of the Harvard Medical School does not like free enterprise, but he does like rationing.  Two years ago, in England, he delivered a talk celebrating the 60th birthday of Great Britain's National Health Service, the bureaucracy that runs that nation's socialized medical system.  He apparently entertained some fear that day that the Brits might turn back to free enterprise.  So ... he offered British socialists some words of advice.

O's radical pick for Medicare.   Controversy is mounting over Dr. Donald Berwick, President Obama's nominee to run Medicare and Medicaid — and for good reason.  Berwick's writings reveal that he would make radical changes — seniors beware. ... A fervent ideologue, Berwick puts social engineering ahead of the individual patient's needs.  In contrast, most doctors understand that their duty is to heal each patient who comes to them.

Re: Berwick.  President Obama will bypass the Senate's advice and consent and use a recess appointment to install Harvard's Donald Berwick — a self-avowed admirer of Britain's National Health Service — as head of the Centers for Medicare & Medicaid Services.

Berwick Blues.  As one who generally believes that administrations should receive deference in their personnel selections, I found the recess appointment of Dr. Donald Berwick to be the administrator of the Centers for Medicare and Medicaid Services (CMS) disturbing.

Obama names a health czar who favors rationing.  Donald Berwick is no household name, but President Obama just handed him immense power to shape what kind of health care will be available to every American man, woman and child.  Berwick is the president's newly appointed administrator of the Centers for Medicare and Medicaid Services, the federal agency that is ground zero for Obamacare's politicization of American medicine.

Obama Names Rationing Czar to Run Medicare.  Dr. Donald Berwick of the Harvard Medical School does not like free enterprise, but he does like rationing.  Two years ago, in England, he delivered a talk celebrating the 60th birthday of Great Britain's National Health Service, the bureaucracy that runs that nation's socialized medical system. He apparently entertained some fear that day that the Brits might turn back to free enterprise.

Spending on Medicaid can be brought under control.  [Scroll down to page 13]  Next to education, Medicaid is the largest single expense in most state budgets.  Costs are rising at double-digit rates in many states, while fraud and abuse take an alarming share of every dollar spent.

The 'Unintended Consequences' of Liberalism:  [Scroll down]  According to the Houston Chronicle, doctors in that state are "opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable."  Again, only liberals believe doctors would be willing to lose money in order to make government health care workable.  That they won't is another one of those "unintended consequences" that apparently mystify those who consider themselves intellectually superior to the hapless dullards known as ordinary Americans.

A house divided, again.  Now we enter our history's second stage in the struggle against the abomination of socialism.  Just as slavery had been contained in the South, so entitlement socialism has, until this week, been more or less contained in service to only the poor and the elderly.  And even those programs — Medicare and Social Security — rested on the principle of beneficiaries paying monthly premiums for the benefits they will get later.  Only the poor under Medicaid received benefit without premium payment.

A Nation of Dependents.  The more we expect government to provide our basic needs, the more we become a nation dependent on government largesse, rather than independent individuals personally empowered to earn the values we seek. ... It has already happened in medical insurance for the elderly.  Medicare, a wealth redistribution program misnamed "insurance," pays for the health care of our nation's elderly and has reduced the private insurance industry for this market segment to only 1% of seniors.  None can compete with Medicare's mandatory contributions or the IRS as its collection agency.

Welcome to the Long Run.  [Almost] no one is pushing real Medicare reform or any entitlement reform at all.  If anything, politicians simply want to add more stuff to them.  Let's be clear.  The real causes were not those listed by [Joel] Achenbach.  The real causes were the great "accomplishments" of the New Deal and the Great Society:  Social Security and Medicare.  They were Ponzi schemes, budget time bombs.  The short run is over and I hope you all had a good time, because the long run is here and now.

Let It Burn.  If Republicans take control of the House and Senate, and if they repeal the health care bill, then they will not be able (or likely even try) to reform Medicare or Social Security.  These programs alone will bankrupt our nation.  Yet they are untouchable because a large number of Americans have come to depend upon these benefits.  They have become unknowingly hooked.

Entitlement Rip-Off.  Bernie Madoff took money from people who thought he'd invested it, gave some to others who thought it was a partial return on their earlier investments and kept much for himself.  That's called a Ponzi scheme, and his $50 billion fraud was called the biggest ever.  But it wasn't the biggest.  Social Security and Medicare are much bigger ones.  These are trillion-dollar scams.  Medicare has a $36 trillion unfunded liability.  Social Security's is $8 trillion.  There's no money to keep those promises.  But Congress isn't investigating this scam.  Congress runs it.

ObamaCare and American Power:  The United States currently spends roughly as much on defense ($661 billion in fiscal year 2009) as the rest of the world combined.  But that's a pittance compared to what we spend on three major entitlement programs — Social Security, Medicare and Medicaid.

Federal Spending:  With the entitlement programs Medicaid, Social Security, Medicare and Medicaid and discretionary spending levels set to consume increasing shares of national income, a challenge of unprecedented proportions looms large for Congress and the president.  Federal revenues are expected to consume 19 percent of gross domestic product (GDP) in 2009, which constitutes a high by historical standards.

5 Ugly Truths Americans Will Have to Face.  [#1]  Entitlements must be cut.  By 2030, the Congressional Budget Office is estimating that Social Security, Medicare and Medicaid will make up 75% of our budget spending.  In other words, unless we get a handle on entitlement spending, it will be impossible to get our deficits under control.

Accelerating the Speed of Lies:  Even Republicans know that Medicare is in need of some changes to improve the program.  Tort reform and the ability to purchase health insurance across state lines are but two improvements that make perfectly good sense to most people.  However, the reform being proffered by the White House is nothing more than a socialist expansion of a government that is already too large and too unwieldy to serve the interests of Americans.  It would, as is often pointed out, destroy the best health system in the world and put one sixth of the nation's economy under the control of government.

The Land of Entitlements.  [Scroll down]  To put this in context, one must realize that there are no Medicare recipients alive today who have firsthand knowledge of being without Medicare while elderly.  Some may remember their parents or grandparents surviving well into old age without Medicare, but not themselves.  Very few alive today remember a time without Social Security. Within the space of a human lifespan, our society has become a culture conditioned to accept (and expect) entitlements as the norm without questioning the consequences.  It has been a very effective strategy to enlarge government.

Clueless in Washington.  [Scroll down]  In the medium term there are only two ways to bring the deficit back to a sustainable level — which means no more than 3% of GDP.  Either taxes will have to rise, or a serious attempt must be made to rein in the entitlements — legally mandated programmes such as Medicare, Medicaid and Social Security — that constitute the great bulk of spending.

States Warn Congress of Possible Lawsuit Over Nebraska's 'Cornhusker Kickback'.  Thirteen state attorneys general have sent a letter to Congress threatening legal action against health care reform unless a provision in the Senate bill given to Nebraska is removed.  The provision is known as the "Cornhusker Kickback," because it gives Nebraska a permanent exemption from paying for Medicaid expenses that would be required of all the other states.  This means that taxpayers in other states would be paying for an increase in Nebraska's Medicaid population.  Medicaid is a federal-state health care program for the poor.

Mayo Vs. Medicare.  President Obama suggested last summer that the Mayo Clinic was the model for government medical care.  On Monday [1/4/2010], the Mayo Clinic in Arizona stopped taking Medicare patients.  Now what?

The mother of all unfunded mandates.  Now that the Medicare expansion has been stripped from the Democrats' health care legislation, we would do well to focus on the Medicaid expansion.  The legislation would expand eligibility for Medicaid to those whose income equals 133 percent or less of the poverty level.  According to Mississippi Governor Haley Barbour, this would add roughly 15 million people to the program. ... Where will the money for the expansion come from?  Not from the federal government.

Study shows how Medicare rewards MDs for overuse.  Medicare's move in 2005 to pay doctors to do bladder cancer surgery in their offices rather than in hospitals dramatically raised the number of procedures and overall health costs, U.S. researchers said on Monday.

Remember December 3.  58 Democrats voted to slash half a trillion from Medicare.  And those who are up for re-election next year will hear about it over and over again.

Annual Medicare Fraud:  $60 Billion; Annual Profits of Top Ten Insurance Companies:  $8 billion.  As 60 Minutes reported last week, Medicare fraud is rampant and has now replaced the cocaine (ahem) business as the major criminal activity in South Florida.  Both 60 Minutes and the Washington Post report that Medicare fraud now costs American taxpayers roughly $60 billion a year.

Court clears suit to affirm voluntary Medicare, Social Security.  A federal judge has cleared the way for consideration of a class-action lawsuit in which plaintiffs — including former House Majority Leader Dick Armey — are asking for a ruling upholding an existing law that declares participation in Medicare and Social Security to be voluntary, not compulsory.

The 'kill granny' bill.  As the health-reform bills move through Congress, the prognosis for Medicare patients gets worse and worse.  The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus) robs the elderly to cover the uninsured — like snatching purses from little old ladies.  The House bills already cut future funding for Medicare by $500 billion over the next decade.

Making the World Safe for Medicaid Fraud.  Americans expect to show a photo ID when they board a plane, enter many office buildings, cash a check or even rent a video — but rarely in voting or applying for government benefits such as Medicaid.  Many Democrats seem to view asking citizens for proof of identity as an invasion of privacy — though what's really being protected is the right to commit identity fraud.  Exhibit A is Tuesday's 13 to 10 party-line vote in the Senate Finance Committee rejecting a proposal to require that immigrants prove their identity when signing up for federal health care programs.

Medicare Is No Model for Health Reform.  [Scroll down]  Medicare is going bankrupt.  The Medicare Trustees estimate that the program will run short of money starting in 2017.  Medicare will drown in a sea of red ink, with spending over the next 75 years outpacing dedicated revenues by nearly $38 trillion.

Washington's Lies:  At its start, in 1966, Medicare cost $3 billion.  The House Ways and Means Committee, along with President Johnson, estimated that Medicare would cost an inflation-adjusted $12 billion by 1990.  In 1990, Medicare topped $107 billion.  That's nine times Congress' prediction.  Today's Medicare tab comes to $420 billion with no signs of leveling off.  How much confidence can we have in any cost estimates by the White House or Congress?

Obama's ambitious agenda:  The Social Security trustees announced this month that the program will begin running out of money in just seven years, and the Medicare trustees said Medicare's Part A hospital fund will be insolvent one year later.  Saving these programs from financial collapse would be a major task in and of itself.  Mr. Obama, however, wants to do it all — including bail out the economy; create a government health care system; pour billions more into education, including a new college-tuition program; and end the nation's reliance on fossil fuels.  And that's just for starters.

A 'Dear Congresswoman' Letter Protesting ObamaCare.  [Scroll down]  I would be pleased if you would consider the following observations and suggestions regarding this effort as I believe that they may better inform your considerations of legislation as it may develop over the months ahead.  First and, I believe, foremost, is the financial condition of Medicare.  Without reiterating the facts that are well known and confirmed by all of the analysts and budget watchers, this program, by itself, is broken and will bankrupt our nation within the next generation or two.

Debt crisis must not be 'wasted'.  Trust me, I do know about the payroll tax, having been paying it for these past 30-some years... but that's not what I was referring to when I said, "we don't have to pay for" Social Security, Medicare and Medicaid.  Instead I was talking about the fact that Congress has authorized these benefits without being able to point to a sufficient revenue source to actually fund them.  Oh yes, the politicians talk and blather and obfuscate and promise that they will never default on their commitment to the American voters who have paid into the system for many years.  But convicted-felon financier Bernie Madoff told his clients that their money was safe, too.

Social Security and Medicare Projections: 2009.  The 2009 Social Security and Medicare Trustees Reports show the combined unfunded liability of these two programs has reached nearly $107 trillion in today's dollars!  That is about seven times the size of the U.S. economy and 10 times the size of the outstanding national debt.

Manufactured Healthcare Crisis.  Medicaid is funded roughly 50/50 by federal and state governments.  As an essentially free benefit to the poor, Medicaid has no tax associated with it, so it is covered by state and federal income tax revenues — that's you and me...   In 2006, Medicaid spending alone totaled $314 billion.  For perspective, this is roughly equivalent to the baseline defense budget (i.e. excluding war spending like for Iraq/Afghanistan).  State Medicaid programs are the largest single recipient of all federal grants, comprising 43 percent of the total.  In 2008, federal Medicaid and Medicare spending totaled $676 billion.  Comprising only 2 percent of the federal budget in 1967, these two programs today consume 23 percent of total federal spending.  This is the largest component of the federal budget, even exceeding total wartime outlays for national defense.

Liberal Fantasyland.  From 1900 to 1965, life expectancy for men in the US rose from 46 to 67 years.  In 1965, health spending in the US was 5.9% of GDP.  That was the year LBJ gave us Medicare.  Life expectancy continued to go up after that, but more slowly.  Today it is about 75 years for men.  And by 2007, health spending took 16.2% of GDP.  Medicare is now about to go completely broke.  It paid out more than it took in for the first time in 2008.  The Medicare "fund" is expected to be depleted by 2017.

$1 billion a day for stimulus.  The federal government has made available more than $75 billion for stimulus projects in the 10 weeks since President Obama signed the $787 billion recovery package into law.  Not all of that money has hit the streets, however.  So far, $14.5 billion has been spent, nearly all of it to help states cope with rising Medicaid costs.

Obama's LBJ Syndrome:  As Americans listen to the smooth assurances from President Obama that his health care plan would cost $634 billion over 10 years, a look back at how liberal assurances like these actually work out in practice is in order.  Specifically, let's take a look at the smooth assurances in 1965 from LBJ as to the costs he saw for Medicare.  Medicare, of course, was the liberal health care panacea for seniors enacted into law by LBJ and a Democrat Congress in July of 1965 and is a fixture of today's America.  So how much was Medicare supposed to cost the American people?  Promised a solemn LBJ:  $500 million a year.

Social Security and Medicare Are Unsustainable.  In 2011, the first group of baby boomers in the United States will reach the age of 65.  When the last of that generation retires in 2032, 77 million of them will have ceased working and paying taxes and will have at least begun receiving taxpayer-funded health care and pension benefits.  A similar trend is occurring throughout the developed world.  In Japan, Europe, and North America, the number of retirees will double over the next 25 years while the number of taxpayers will grow only 10 percent.  The economic consequences of these changes are dire:  higher taxes, slower growth, and lower living standards.

Tax Hikes Could Pay for $36 Trillion in Medicare Costs, Dems Say.  Sens. Jay Rockefeller (D-W.Va.) and Barbara Boxer (D-Calif.) told Cybercast News Service on Tuesday [7/8/2008] that they would support raising taxes to pay the $36.3 trillion needed to pay for promised Medicare benefits over the next 75 years.

We Can't Tax Our Way Out of the Entitlement Crisis.  The spending shortfalls in Social Security and Medicare are large.  According to the Congressional Budget Office, Social Security and Medicare spending left unchecked would, after a generation, consume about 10 percentage points more of GDP than it does today.

Congress Must Pull the Trigger to Contain Medicare Spending.  For years, official Washington has studiously ignored the warnings of prominent liberal and conservative analysts, as well as the Government Accountability Office, about the entitlement crisis, particularly the exploding costs of the Medicare program.  As a result, the crisis has deepened, piling up future debt and threatening huge tax increases on younger workers. … Medicare already has unfunded costs of $34 trillion over the next 75 years (in net present value terms).

Rethinking Social Insurance:  The single greatest threat to the fiscal health of the United States is the runaway growth of the nation's major retirement and health care entitlement programs.  Social Security and Medicare are projected to grow from 7.5 percent of GDP today to almost 13 percent of GDP by 2030.  Already, the two programs consume over a third of the federal budget.

The Entitlement Mess.  Congress is spending us into a hole.  We hear about the cost of earmarks and the Iraq war.  But what about "entitlements"?  That's the government's ironic term for programs that transfer money from people who earned it to people who didn't.  Entitlement?  How can you be entitled to someone else's money?  To finance "entitlement" programs, the government threatens force against the taxpayers who provide the money.

New warnings about entitlements shortfall.  Trustees for the government's two biggest benefit programs warned Tuesday [3/25/2008] that Social Security and Medicare are facing "enormous challenges," with the threat to Medicare's solvency far more severe.  The trustees, issuing a once-a-year analysis, said the resources in the Social Security trust fund will be depleted by 2041.  The reserves in the Medicare trust fund that pays hospital benefits were projected to be wiped out by 2019.

Looming Entitlement Tsunami Threatens America's Health Care Freedom.  A quarter of health spending in the United States, about $420 billion this year, is by the Medicare program established by the government in 1965 to ensure people 65 years old and older have access to health care.  Medicare is an entitlement covering 44 million older Americans (or 14 percent of all Americans) and pays hospitals, doctors, suppliers, drug plans, and a variety of other providers.  Medicare is financed by a mix of premium payments by beneficiaries, payments directly from federal revenues, and a payroll tax on workers and employers.

Liberal Pyromaniacs:  Liberals behave like a pyromaniac who sets fire to his own house, then is angered because the rest of the family try to salvage their possessions and escape from the blaze.  Like the pyromaniac, liberals feed the destructive flames of inflation with deficit spending on new welfare programs and the mandated monsters, Social Security and Medicare.  Then they become indignant when rational investors take steps to hedge against liberal-created inflation.

Adding Passengers to the Titanic.  According to the 2006 report of the Medicare Trustees, the unfunded liability in Medicare over the next 75 years is $11 trillion.  This is the gap between the promises that the system makes to future beneficiaries and the taxes that will be collected under current law to pay for those benefits.  Medicare is the fiscal equivalent of the Titanic, and its unfunded liability is the iceberg that lies ahead.  Proposals to increase government's role in funding health care amount to adding passengers to the Titanic.

Medicare:  The Monster at Our Door.  Unless you're a news junkie, you probably missed Mark McClellan's announcement that he'll resign in early October, after two grueling years as head of CMS.  What's CMS?  Well, it's the Centers for Medicare and Medicaid Services, which spent $515 billion in 2005 — 21 percent of the federal budget and about $21 billion more than all defense spending.

The Medicare Mess is Guaranteed to Grow.  The real problem is that this [Medicare drug] program eventually will replace existing public and private spending for drugs with new taxpayer financing — at a time when entitlement costs already are growing much more rapidly than the tax receipts that are supposed pay for them.

Take Our Money, Please!  Medicare's prescription-drug benefit — with its huge costs and labyrinthine complexities — is already a notorious entitlement program, and it just began operating a couple of weeks ago, on Jan. 1.  Little wonder, then, that its sponsor and "partners" — the federal government, insurance companies, drug retailers — have launched a slick ad campaign on its behalf.

Letting Medicare "Negotiate" Drug Prices:  Myths vs. Reality.  In 2003, Congress and President Bush enacted the "Medicare Prescription Drug, Improvement and Modernization Act," which established a prescription drug program for Medicare.  That legislation expressly prohibited Medicare from negotiating drug prices with pharmaceutical companies.  Rather, any negotiation that takes place is to be between pharmaceutical companies and the insurance companies that administer the Medicare prescription drug program.

The Entitlement Panic.  Will America have to declare Chapter 11 because of $80 trillion in unfunded entitlement promises of Medicare, Medicaid and Social Security?  Economist Laurence Kotlikoff believes the answer is perhaps yes unless we reform our fiscal institutions.

For Some, Medicare Drug Plan Pays Off.  When Lacey P. Green went to his neighborhood pharmacy to pick up five prescriptions, he thought he heard the pharmacist say he owed $250, but he was wrong.  The cost, with his new Medicare prescription drug card, was just $50.

Bush Opposes Delay in Medicare Drug Benefit.  The administration's rejection of one of the chief ideas from fiscal conservatives for covering the tab for Katrina marked another example of how difficult it will be to spend billions of dollars for hurricane relief without increasing the federal deficit.

Nigerian indicted in $42 million health care fraud.  A Nigeria native who lives in Houston was indicted Friday [7/24/2009] on charges he sought $42 million in false Medicare and Medicaid claims by paying folks $100 each to sign blank health care forms he would later submit for reimbursement.  Umawa Oke Imo, 54, a permanent resident alien in the United States and native of the Federal Republic of Nigeria, was indicted this week but first charged and detained in June.

Politicians on Drugs:  When [Illinois Congressman Rahm] Emanuel and [Gov. Rod] Blagojevich first proposed I-SaveRx in 2003, the Food and Drug Administration warned such a program would be an illegal violation of the national ban on importing prescription drugs. … The ban on importing prescription drugs wasn't something Republicans dreamed up to punish the poor and senior citizens.  It has been the law since 1987.  That law was enforced for eight years by none other than Bill Clinton, Rahm Emanuel's former boss.

Getting rid of reckless spending.  We are less than one generation away from Congress being unable to pay for anything other than Medicare, Medicaid, Social Security, and interest on the federal debt — leaving not so much as a penny for defense or homeland security.

Let's get real about Social Security and Medicare.  The Social Security and Medicare trustees have just issued their annual report on the state of these programs, and the picture is not pretty.  The combined unfunded liability, the shortfall of projected funds available to meet projected obligations, of the two programs is around $75 trillion.  For perspective, the Gross National Product is $10 trillion.

Changing values:  The displacement of traditional values with the "do your own thing" agenda puts perspective on the problems with which we're now wrestling on Social Security and Medicare.  The conventional explanation for today's Social Security and Medicare problems is demographics.  Our population is "graying" as a result of longer lifespan and fewer babies.

How Big Is the Government's Debt?  As of 2001, the accumulated entitlement obligations owed to all people (including all current workers) who have earned Social Security and Medicare benefits is $12.9 trillion for Social Security and $16.9 trillion for Medicare.  When these obligations are combined with the debt held by the public, the total burden equals $33.1 trillion, or 10 times the official debt measure.  This "total debt" is more than three times the size of the nation's total output in 2001, and amounts to $116,381 for every man, woman and child in America.

How Will We Pay for Social Security and Medicare?.  Social Security and Medicare are making future promises much greater than the taxes that will be collected at current rates.  Unfortunately, some policymakers seem to be intent on making the problem worse, not better.  Reforms are needed that create more saving today for retirement and increase the nation's capital stock.

Reforming Medicare:  In a few years, as medical costs escalate and baby boomers retire, Medicare and Social Security will place significant burdens on the federal budget. By 2030, about the midpoint of the baby boomer retirement years, deficits in Social Security and Medicare will require 37 percent of federal income taxes.  This means that within three decades the federal government will either have to eliminate more than one-third of all the income-tax-funded services it currently provides or increase the income tax burden by more than one-third.

Government Spending on the Elderly: Social Security and Medicare.  When today's 18-year-olds reach retirement age, Social Security spending will equal 21.7 percent of payroll — more than twice the current burden.  When Medicare and other elderly health programs are included, spending in 2050 will equal 54.4 percent of taxable payroll.  If this projection proves true, we have already pledged more than half the incomes of future workers just to cover benefits for the elderly already included under current law.  This burden will be even greater if Congress tacks on a new Medicare prescription drug benefit or a long-term care benefit.

Are Medicare and Social Security really worth it?  The 2004 Medicare and Social Security Trustees Reports show that programs for the elderly are on an unsustainable course. The expenditures exceed the revenues to be collected, and the funding gap is projected to grow through time. Obligations to the elderly are more than six times the size of the economy and 18 times the size of the outstanding federal debt.

Thwart Hillarycare 2006.  [Lately] there has been unrelenting negative press about the Medicare drug benefit.  The persistent whine of hysteria (to quote Joan Didion) goes something like this:  People are too confused, too scared, too ignorant to make the right choice among a "bewildering" array of plans.  And if you think making Medicare choices on your own is scary, just try using health-savings accounts.  In other words, there is agreement among mostly liberal policymakers, journalists and advocacy types that people are too stupid to make complex health-care decisions.  (Except abortion.)

Howard Dean's Abortion Contortions:  A 1994-1995 AGI survey of abortion patients found that in states where Medicaid pays for abortions, women covered by Medicaid have an abortion rate 3.9 times that of women who are not covered, while in states that do not permit Medicaid funding for abortions, Medicaid recipients are only 1.6 times as likely as nonrecipients to have abortions.  A more recent study by Dr. Michael New of the University of Alabama found:  "State laws restricting the use of Medicaid funds in paying for abortions reduced the abortion rate by 29.66" abortions per 1,000 women of childbearing age.

Another commission?  The second reason why Bush's call for an entitlement commission is laughable is because he is largely responsible for the growing crisis of entitlement spending.  That is because he rammed a vast expansion of Medicare through a Republican Congress in 2003 that increased the unfunded liability of that program by almost 40 percent.  According to Medicare's trustees, the unfunded liability of Medicare is $68.1 trillion.  Of that, $18.2 trillion is accounted for just by the new drug benefit.

Anatomy of the Coming Collapse, and Solutions:  The Treasury Department takes a snapshot of Social Security and Medicare.

Medicare-for-all Plan Headed for Congress:  This is much more than an expansion of Medicare.  It's a Socialist manifesto.  It's also a sure-fire recipe for disaster.  It encourages unlimited demand for health care services while severely limiting the ability of physicians to provide them.

Medicaid:  Waste, Fraud and Abuse.  A 2001 GAO report on Medicaid stated, "The magnitude of improper payments throughout Medicaid is unknown. … An even more difficult portion of improper payments to identify are those attributable to intentional fraud. … There are no reliable estimates of the extent of improper payments throughout the Medicaid program."

Medicare's muddled meddling.  What if Medicare threw a really lavish party and nobody showed up?  Last week, as Medicare cheerleaders valiantly attempted to persuade, bribe or threaten seniors to sign-up for one of dozens of different prescription drug plans, there were numerous reports of people being so totally befuddled they might just take a pass.

Fraud and Waste Infect New York Medicaid.  The extent of Medicaid fraud in New York State was highlighted in July by extensive news coverage in The New York Times and other publications.  A dentist operating out of a small Brooklyn storefront billed Medicaid for 991 procedures in one day in 2003.  Similarly, in a single day a school in Buffalo received funds for referring 4,434 students to speech therapy — without actually talking to them or reviewing their records.  Over a period of about three years, a physician prescribed $11.5 million worth of a synthetic hormone popular with bodybuilders.

Medicaid-paid births on the rise.  Nearly half of all births in Wisconsin were paid for by the state's Medicaid program in 2005, rising 26% since 2000.  In 2005, the most recent year for which figures are available, five of the top 10 hospitals that delivered babies paid for by Medicaid were in Milwaukee.

Feeding the 800-Pound Gorilla:  Medicaid — the nation's program to reimburse hospitals and physicians for health care provided to the poor — has become an 800-pound gorilla sitting on the back of state budgets.  In 2004 it consumed nearly a quarter of states' budgets, and its cost is expected to rise 12 percent this year.  State legislators are scrambling to find a way to slow the program's cost spiral.  Reform measures include cutting benefits and managing the use of expensive prescription drugs.  While these options deserve attention, they do not address the loophole in eligibility rules that is really draining money out of the system.

Medicare Prescription Drug Benefit:  What Difference Would It Make?.  That seniors lack access to prescription drugs is offered as a rationale for supporting a new Medicare prescription drug benefit.  If many of them do in fact lack access, spending $400 billion in general tax revenues during the next 10 years for the benefit would increase seniors' use of drugs.  The questions then are:  What fraction of the Medicare population lacks prescription drug coverage, and how much more would they spend if they had coverage?

The Bankruptcy of Medicare:  At the end of last year George W. Bush signed the Medicare Modernization Act of 2003 into law in the name of "honoring the commitments of Medicare to all our seniors."  The bulk of the law provided prescription drug subsidies for the elderly, at an estimated cost of between $400 billion and more than $1 trillion over the next decade.  Less than four months later, the Medicare's Board of Trustees issued a report citing Bush's subsidy as a major reason that the program would go bankrupt by 2019, seven years earlier than the board predicted last year.

White House Raises Prescription Drug Cost Estimate — Again.  The Bush administration on February 8 [2005] estimated that a new federal program to provide prescription drug coverage to Medicare recipients would cost $724 billion over the next 10 years.

Explaining the Growth of Medicare:  Utilization of medical care has risen dramatically since Medicare began in 1965.  That year, health expenditures accounted for 5.7 percent of the nation's output.  By 2000, the size of the health care sector had risen to 13.2 percent.  This dramatic rise has been hastened by Medicare's growth.  In 1970, Medicare accounted for 11 percent of all health care expenditures in the United States; but by 2000, its share stood at 17 percent.  As health care spending has grown faster than the economy as a whole, so Medicare expenditures have grown even faster than health care expenditures in general.

Prescription Drugs for Seniors:  Despite its political popularity, Medicare violates almost all principles of sound insurance.  It pays too many small bills the elderly could easily afford themselves, while leaving them exposed to thousands of dollars of potential out-of-pocket expenses, including their drug costs.  For instance, each year about 750,000 Medicare beneficiaries spend more than $5,000 out-of-pocket.

We should not covet Canada's prescription drugs.  The primary value that we obtain from the higher prices we pay for our prescription drugs is research and the development of new prescription drugs, which benefit not only us but also people throughout the World.  If it were not for the United States, we simply would not have new prescription drugs and vaccines to combat diseases such as cancer, AIDS, and diabetes.

Greedy or ignorant?  Myth:  Skyrocketing prescription drugs are driving health-care spending up.  Fact:  According to the Bureau of Labor Statistics, as a whole, Americans spend about 1 percent of their income on drugs.  Seniors spend about 3 percent on drugs, less than the amount they spend on entertainment.  Spending on drugs, as a percent of total health-care spending, was 10 percent in 1960.  It's roughly the same today.

Compromising Quality:  The High Cost of Government Drug Purchasing.  Recently revised estimates of the projected cost of the new Medicare prescription drug benefit have re-ignited congressional debate about the merits and design of the recently enacted Medicare legislation.  One particular argument that has received renewed attention, both in and out of Congress, is the contention that the new drug benefit will be unnecessarily costly because the legislation does not allow the government to use the "enormous market clout" of 41 million Medicare beneficiaries to drive down the cost of drugs.

The FEHBP as a Model for Medicare Reform:  In deciding the future of Medicare, Congress must choose between consumer choice or legislative and bureaucratic control of benefit design, prices, and operational decisions.  A successful example of the consumer choice model already exists:  The Federal Employees Health Benefits Program meets the health care needs of 9 million federal employees, retirees, and family members, and should be the model for Medicare reform.

Congress Approves Huge Expansion of Medicare:  Congress approved [06/27/2003] the biggest expansion of Medicare since its creation nearly four decades ago.  Seen as a political victory for President Bush and breaking six years of political gridlock, the Senate and House passed competing legislation to provide prescription drug benefits to elders and give private health plans a much larger role in the program.

Uh oh, Ted Kennedy loves the Medicare bill.  Republicans in Congress seem to have convinced themselves that they have to have a drug subsidy bill to keep control.  And the Bush administration has irresponsibly signaled that it will sign any bill, no matter how bad.

Taxpayer Group Seeks to Save Feds $12.6 Million:  The National Taxpayers Union requests that the Bush administration immediately terminate the planned $12.6 million ad campaign on behalf of the forthcoming Medicare prescription drug benefit.

Short-Term Candy:  The new Medicare legislation does include a step toward greater freedom by allowing people to set aside money in tax-free medical savings accounts.  Good idea.  But it also communizes the entire prescription drug industry for seniors.  Since we tend to get sick the most when we are older, the law pretty much communizes the whole prescription drug industry.  The cost will eventually be trillions.

Blimp is Right.  The bureaucrats probably didn't realize what they were doing when they shelled out $600,000 this year to send a Medicare blimp touring around the country.  I don't mean just the money.  The blimp money is just part of the $30 million that Medicare spends annually to let Medicare recipients know they're on Medicare.

Medicare fraud:  Reforming our way to bankruptcy.  The essence of the Medicare bill is a reckless expansion of a program that was bound for bankruptcy even before the Republicans decided to steal an issue from the Democrats by pushing a huge new prescription drug entitlement.  The official price tag for the law is $400 billion over 10 years, but it will ultimately cost far more.

Compassionate tyranny:  No thought is given to the American taxpayer, who is looked upon as a magic purse that never runs out of gold.  House Republicans have been working through all-night sessions to burden the federal taxpayer with $350 billion to subsidize prescription medicines for the elderly.  These open-ended commitments make no sense financially or in terms of health care.

The Real Cost of the Medicare Modernization Act:  There is more than a $100 billion discrepancy in estimates for the cost of the new prescription drug benefit.

Socialized Medicine at the Back Door:  For patients, single-payer means less care, and lower-quality care.  After being assigned to a physician (no, you can't choose), getting in to see that physician may not be easy — just ask patients enrolled in Medicare or Medicaid.

Drugs and politics:  In the midst of a bipartisan stampede toward "prescription drug benefits for the elderly," someone needs to ask the question:  Why should seniors be singled out to be subsidized by the taxpayers, except that their votes are being sought by both parties?

Washington spending going wild:  [President Bush] supported the prescription-drug plan — even if it was quite a bit richer than he proposed.  And he has pretty much set the agenda for Congress' spending — since the Democrat majority has not seen fit to formulate an actual budget.  It's just been runaway, ad hoc spending — something for everyone.

Counting the Cost of Prescription Drug Price Controls:  Many politicians are calling for government price controls as a way to keep prescription drugs affordable for senior citizens.  But price controls in Canada and other countries where they have been tried have only resulted in rationing and higher prices for life-saving drugs.  A better solution is to expand the use of tax-free Medical Savings Accounts so more seniors can pay for the drugs they need.

Reforming Medicaid:  Medicaid is enormously expensive.  For the second year in a row, spending on Medicaid (for the poor) will exceed spending on Medicare (for the elderly).  At $280 billion this year, Medicaid costs almost $1,000 for every man, woman and child in the country — or $4,000 for a family of four.  Indeed, it is likely that many taxpayers are paying more in taxes to fund health insurance for the poor than they pay for private health insurance for themselves and their own families.

Medicare Reform and Prescription Drugs:  Ten Principles.  In an election-year rush to satisfy impatient voters, politicians of both parties are endorsing ill-considered schemes to add a prescription drug benefit to Medicare.  While the problems with the program are bad, most of the proposed solutions are worse.  Medicare deserves thoughtful reform — reform that can greatly reduce seniors' exposure to catastrophic prescription drug costs, improve overall health care quality and control taxpayer costs.

Medicaid in critical shape:  Across the nation, state governments spend nearly as much money on health insurance for the poor as they do on public schools — more than on welfare, prisons and roads combined.  And the tab keeps rising, fast.

Health Care is Not a Right.  Our only rights … are the rights to life, liberty, property, and the pursuit of happiness.  That's all.  According to the Founding Fathers, we are not born with a right to a trip to Disneyland, or a meal at Mcdonald's, or a kidney dialysis (nor with the 18th-century equivalent of these things).  We have certain specific rights — and only these.  Why only these?  Observe that all legitimate rights have one thing in common:  they are rights to action, not to rewards from other people.  The American rights impose no obligations on other people, merely the negative obligation to leave you alone.

Medicaid Is Not A Bottomless Well.  One of the "benefits" of the way we finance Medicare (and Social Security), at least, is that the law requires offically appointed actuaries to report annually on the fiscal status of the program, via the Medicare Trustees Report.  Each year, the horror of Medicare's unfunded liability grows starker and closer.



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Updated May 14, 2017.

©2017 by Andrew K. Dart