The Amazing ObamaCARES News Buried Inside A 283-Page Medicare Report.


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The amazing news buried inside a 283-page Medicare report

 

From VOX.com  By 

 

This is arguably the most unexpected piece of news in the new Medicare Trustees report: the government’s hospital insurance program might be spending less money to cover more beneficiaries than it did a year ago.

 

Tele-consultation between the neurology department in Besancon hospital, France and A&E in Dole hospital, France. Dole hospital doesn't have a neurology department which makes detecting a CVA a difficult task. Telemedicine allows A&E doctors at Dole

 

Medicare’s hospital insurance program — known to wonks as Medicare Part A — spent $266.8 billion covering 50.3 million people in 2012. In 2013, the the same program spent $266.2 billion to cover 51.9 million people. These figures come from Table II B.1 in the 2012 and 2013 reports.

 

Medicare’s hospital insurance program is gigantic; it spends more money in a given year than the entire state of Wisconsin. In that context, $600 million is not much more than a rounding error. And some senior administration officials I spoke with cautioned against reading too much into these particular figures; receipts for services rendered in 2013, for example, might trickle after the year has ended.

 

But what’s definitely clear — and what’s driving this trend — is that Medicare is spending significantly less per person than they did two years ago. And this report expects that trend to continue for another two years going forward.

 

medicare_per_person

 

By 2015, the Medicare Trustees’ Report projects that the program will spend less per person on hospital care than it did in 2008. This doesn’t happen much in health care: not just slower growth, but the actual dollar amount spent on a given type of care dropping.

 

These figures only represent the hospital insurance part of Medicare (this is Medicare Part A). The government insurance program has separate programs for doctor visits (Medicare Part B) and prescription drug coverage (Medicare Part D).

 

But even when you look at the overall picture, it generally looks pretty good: per-person Medicare spending has grown by an average of 0.8 percent since 2009. That’s a lot slower than the rest of the economy, which has grown at an average 3.1 percent rate. Between 2012 and 2013, it was even slower: Medicare’s per person costs stayed exactly the same.

 

As Health and Human Services Secretary Sylvia Mathews Burwell put it at a press briefing today, “that is a growth rate of 0 percent.”

 

As to why this is happening, that’s the big question. There has been an overall slowdown in health care spending, some of which is likely due to the recession: when people have less money to spend, they don’t buy as many medical services.

 

But Medicare beneficiaries should be somewhat insulated from the economy. They don’t lose insurance coverage during economic downturns, for example, as many who lose their jobs do. Many live on a more fixed income, too.

 

Its certainly possible that the overall economic climate might have impacted seniors’ decisions about health care. And its possible the health care law, and its changes to the Medicare system (this report estimates there are 165 of them) have had an impact as well.

 

The Affordable Care Act, for example, penalizes preventable readmissions — times when seniors turn up at the hospital a second time after something goes wrong during their first visit. Readmissions have been falling pretty steadily for the last few years, and those reductions could be showing up in the lower per-person spending.

 

readmission_rates

 

 

Last, the downward shift in hospital spending could just reflect larger trends in how doctors deliver medicine. As new innovations happen, procedures that used to be more invasive — and require a hospital stay — improve, become easier and shift into an inpatient setting, or can be treated with prescription drugs. You see that change below, with hospital care, since the early 1980s, becoming a slightly smaller portion of the country’s overall medical bill.

 

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(California Healthcare Foundation)

 

Overall, this report suggests a pretty positive trend for Medicare spending — it just doesn’t totally explain the forces that are driving it.

 

CARD 6 OF 15 LAUNCH CARDS

How much of health-care spending is wasteful?

A lot: about one-third of all health-care spending — $785 billion — goes to things that aren’t making us any healthier, according to a massive Institute of Medicine study published in 2012.

 

Most of the waste comes from the way the United States delivers medical care, with a fragmented system that delivers a lot of care that isn’t needed. The IOM estimates that we spend about $210 billion on unnecessary care, with doctors delivering care that isn’t recommended by medical guidelines. Unnecessary care can be harmful to patients, too, especially when it involves surgical procedures that didn’t need to happen.

 

Administrative costs are another huge driver of wasteful spending in the United States. Every doctor typically takes in payments from numerous health insurers, and need to employ lots of billing staff to handle the deluge of paperwork. The average doctor in the United States spends $82,975 dealing with insurers each year.

 

Last but not least, the American health-care system tends to have much higher prices than other countries. Most developed countries have some form of government rate-setting in health care, where bureaucrats set a specific price for any given medical treatment. The United States doesn’t have that — and also has thousands of health insurance plans, each negotiating their own price with doctors and hospitals. This helps explain why an appendectomy costs $8,156, on average, here — and $4,498 in the Netherlands.

 

 

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5 Responses

  1. How some people must hate this information. Costs going down, care improving. Sucks to be them.

    Another nicely done piece. Thank you

    Like

  2. ObamaCare is working! Healthcare costs are coming down. I’ve read that in a couple different magazines. ;)

    Like

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