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View Diary: Another False Frame from Fox: Trillions in Unfunded Liabilities (28 comments)

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  •  Affordable Care Act (ACA) (3+ / 0-)

    is addressing Medicare "structural problems":

    -- paying for outcomes, not tests performed;

    -- taking the wealthy (ACA surcharge) to pay for the health care of the poor;

    -- limits to profit margins, mark-up fees.


    Like Chris Hayes says, let's give that (ACA) a chance to work.  It's all about 'bending those cost curves' back down.

    SS is solvent to 2037 or 2039, I think.

    simply raising the FICA payroll Ceiling,

    would make it solvent indefinitely.

    Isn't it time to fix the Filibuster?
    -- Here's how.

    by jamess on Sat Dec 29, 2012 at 04:25:34 PM PST

    [ Parent ]

    •  taXing the wealthy (ACA surcharge) (2+ / 0-)
      Recommended by:
      phonegery, David PA

      it goes into effect this year, I think.

      Isn't it time to fix the Filibuster?
      -- Here's how.

      by jamess on Sat Dec 29, 2012 at 04:27:03 PM PST

      [ Parent ]

    •  Read the Trustees Report. That last link. (3+ / 0-)
      Recommended by:
      nextstep, Sparhawk, VClib

      That takes into account the ACA.  The numbers are still very very bad.  And if you assume that we won't cut provider reimbursements by 1/4 to 1/2, i.e., we won't do the "doc fix"  -- which Congress would never let happen, because few doctors would see Medicare patients -- the numbers could be dramatically worse.

      If you want to do it within the existing system, you have to fundamentally change the fee for service model, AND go to a system where you don't give 80 year olds very very expensive treatment that has a 25% chance of prolonging their lives for a year -- what Steven Rattner, in one of those links, calls "death panels."  You have to ration in some way.  You can't continue giving elderly patients every possible treatment that could have a chance of prolonging life.  That's the hard truth. Nobody wants to face that, because when it's your parent, or your spouse, you WANT them to have any and all treatments that could possibly prolong life.  

       READ THE TRUSTEES REPORT.  It puts forth some bleak numbers, and then says that the actual numbers could very well be much, much worse.  

      The ACA is not going to bend the cost curve enough, according to the Medicare Trustees.  I think they know a lot more about it than Chris Hayes, who is making a political statement.  

      I did not mention Social Security.  It would be  fine if you bring insured wages back up to 90% of all wages.  You can't lift the cap completely, because -- since retirement payouts are based on the amount of wages insured --- you'd be paying very very wealthy retirees hundreds of thousands of dollars in SS retirement benefits, a non-stater politically.   Remember, SS is not really a "tax."   It is wage insurance -- you insure a certain amount of wages (the amount you pay taxes on) in case you live longer than your ability to work.  Your payout, like any other insurance program, is based on the value of what you insure.  

      •  the main Conclusion of the Trustee Report (0+ / 0-)

        (on page 8)

        doesn't sound that bad:

        Kind of a drag, the report has settings, so that no one can copy their words.

        Isn't it time to fix the Filibuster?
        -- Here's how.

        by jamess on Sat Dec 29, 2012 at 04:54:05 PM PST

        [ Parent ]

        •  That says that Medicare costs will (2+ / 0-)
          Recommended by:
          Sparhawk, VClib

          double as a percent of GDP if Congress never does the doc fix.  If Congress does do the Doc fix, Medicare spending would grow to 10% of GDP.  That's not 10% of the federal budget, that's 10% of GDP, when the federal government, even during good years, collects total revenue of 18% of GDP (right now we're at about 15% of GDP).  

          That's just Medicare.  That's not counting Medicaid, which has spending about equal to Medicare.  That's over half of the total federal receipts going to Medicare alone, when now, Medicare and Medicaid together equal about 23% of the budget.  

        •  jamess - that's 10% of GDP (0+ / 0-)

          Not 10% of the total federal budget or 10% of the discretionary budget, but 10% of GDP. Historically the federal government has collected total revenues of less than 20% of GDP (it's currently 15%).

          "let's talk about that"

          by VClib on Sat Dec 29, 2012 at 09:35:59 PM PST

          [ Parent ]

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