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View Diary: Paul Ryan must be planning the mother of all magic asterisks (73 comments)

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  •  Where in the report you have linked (1+ / 0-)
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    is any analysis re: lowering the age for Medicare recipients? Or analysis about negotiating drug prices within Part-D?

    "George RR Martin is not your bitch" ~~ Neil Gaiman

    by tardis10 on Thu Mar 07, 2013 at 09:48:39 AM PST

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    •  The Medicare Trustees Report sets out (2+ / 0-)
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      tardis10, VClib

      the enormity of the problem. It does not score potential changes.  If it's legislation, the CBO scores that.  In the absence of legislation, proponents and opponents do their own studies, which tend to be overly optimistic by proponents, and overly negative by opponents.  

      Proponents of negotiating drug prices for Part D have various estimates of the savings -- I've seen them from $10 billion a year to the most optimistic of about $20 billion a year.  That, of course, is not nearly enough to address the long-term problem, as even proponents recognize.

      I don't think that adding people to Medicare lowers the cost of Medicare -- or at least I haven't seen any studies that say that.  It simply transfers people from private insurance, with higher medical costs, to Medicare, with lower medical costs, as I understand it.  That may lower overall medical costs, but I've seen no studies that say that it lowers the cost of Medicare overall.  I'd be happy to take a look if you have any.  

      •  Here is a recent exchange between Rattner & Brill (1+ / 0-)
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        BRILL: Well, if you put Medicare in the context of the larger health care system, and this is something that everybody at this table is going to think that I should go to a mental hospital when I get finished saying this, the government and all of us would actually save money if you lowered — I said lowered the age for Medicare. If the Medicare age were 60 instead of 65, the economy and the taxpayers would actually save money. And George, please don’t look at me like that.

        RATTNER: You’re potentially right. And part of the argument — you’re taking people out of the Medicare age to 67 is you’re taking people out of the Medicare system.

        BRILL: Right. And what you would be doing, is you would be putting the most efficient player, which is Medicare — Medicare spends 80 or 90 cents to process a claim and the health insurance companies spend $18 or $20 or $25 to process a claim. Health insurance companies pay two, three, four times what Medicare pays for various services. So if you lowered the age, you would put more people into the bucket of much more efficient health care.

        I know I have read a few detailed reports on this. Maybe from Demos or CAP? When I find them,I will send them on to you. Collecting premiums from the younger and healthier,instead of govt. further subsidizing the for profit insurance corps., is indeed a kind of back door approach to saving taxpayer money. Can such be characterized as reducing Medicare costs? I'd say so but YMMV.
        As for negotiating drug prices,you are right.It isn't a single,silver bullet,just one arrow in a quiver. As is the IPAB.
        Of course,there are other ways to reduce healthcare spending that few limiting advertising & marketing by pharmaceutical companies.

        "George RR Martin is not your bitch" ~~ Neil Gaiman

        by tardis10 on Thu Mar 07, 2013 at 10:56:50 AM PST

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        •  That seems to support what I said (1+ / 0-)
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          that would lower the cost of health care generally, because Medicare (since its reimbursements are lower than private insurance companies pay for the same service) can deliver health care to the 62 year old cheaper than private insurance can deliver to the 62 year old.  

          That may mean a slight decrease in the percent of GDP that we pay for ALL health care (private insurance, uninsured, Medicare and Medicaid combined).  But I haven't seen any studies that it will decrease the cost of the Medicare program itself.  

          •  It isn't just the savings in (0+ / 0-)

            delivering healthcare,it is not having govt. subsidize the premiums to private insurers for the 60-65 folks.(as will be the case under the ACA) that adds to the savings. Further, if seniors spend their retirement nest eggs on insurance premiums from 60-65,then many may qualify for more govt. subsidies (medicaid,HEAP,SNAP) in their later years than would have.

            Pretty much off topic,have you ever seen this?
    Takes health tourism to a higher level.

            "George RR Martin is not your bitch" ~~ Neil Gaiman

            by tardis10 on Thu Mar 07, 2013 at 12:18:51 PM PST

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    •  And I think the Trustees Report sets out (0+ / 0-)

      that Medicare Part D in total is about $50 billion a year.  So, any savings by drug negotiations would be some fraction of that.  

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