When the WORKING FOR WOMEN you tube video told us IPAB is bad---they were right. What they then said was this: Medicare costs per person is 3:1 cost overrun to what payroll deductions put into our Medicare HEALTH SAVINGS ACCOUNTS. That is WRONG. This is how we know WORKING FOR WOMEN is a far-right wing global 1% group-----not working for 99% of US OR GLOBAL WOMEN.
'In addition to billions in Medicare pillaging to fund Obamacare, President Obama has essentially circumvented the law and future presidential vetoes by using the Independent Payment Advisory Board (IPAB) to insure all cuts to Medicare "must become law by August 15th, 2014."'
US 99% and global journalism has placed the costs of US health care as a result of FRAUD AND PROFITEERING. We KNOW the costs these few decades are not the normal costs of heath care when it was a PUBLIC HEALTH INTEREST----we show this one current example------painkiller jumps to $2,979 from $138 these few years as Obama and Clinton neo-liberals pushed almost all of MEDICAID funding to PAINKILLERS AND MENTAL HEALTH PHARMA. So, Medicaid is not too costly----it is the global health corporation FRAUDS and PROFITEERING that is too costly. If we look at PER PERSON COSTS FOR HEALTH CARE adjusted to normal public interest rates there is not only a 1:3 ratio of payment-----one patient using only a third of those Medicare health savings----but there has built into the MEDICARE TRUST a perpetual funding for future generations just as with our US SOCIAL SECURITY TRUST.
IT IS TRUE THAT A RELATIVELY SMALL PERCENTAGE OF AMERICANS USE THE MAJORITY OF HEALTH CARE COSTS---BUT THAT IS THE NATURE OF DISEASE VECTORS AND GENETIC PRE-DISPOSITIONS.
So, the IPAB created by OBAMA and Clinton neo-liberals now MOVING FORWARD under TRUMP is composed of those very global health corporation executives having spent these few decades fleecing our US medical trusts and citizens' pockets.
'Painkiller that once cost $138 is now $2,979
by Matt Egan @MattEganCNN February 15, 2018: 4:16 PM ET '
Is that ratio really 3:1 WORKING WOMEN----or is it 1:3? We KNOW it is 1:3. Remember, there our US seniors are paying almost $100 a month just to access ordinary MEDICARE----then they are forced to pay a MEDIGAP insurance often $400 a month----none of which should be in place nor is it necessary. Every time COLA handed SS seniors a measly increase that MEDICARE monthly payment increased to take it all.
'#111 Great Power in the Hands of Few: The recently repealed IPAB
What is the Independent Payment Advisory Board (IPAB), how…
Obama Loots $716 Billion from Medicare
Posted by Justin Sykes on Tuesday, August 14th, 2012, 11:42 AM
Senior Obama adviser David Axelrod attacked Romney and Ryan this week with the accusation that a repeal of Obamacare would bankrupt Medicare. David Axelrod however is misinformed, as the real threat to Medicare is President Obama, who has taken billions of dollars from Medicare to fund Obamacare.
Medicare cost saving measures could be beneficial, however such measures should be used to make the Medicare guarantee stronger for tomorrows' seniors while preserving contemporary enrollee's plans. Instead, President Obama took Medicare dollars from today's seniors to fund Obamacare.
A report issued by the Congressional Budget Office (CBO) finds that the amount of money President Obama has taken from Medicare to fund Obamacare totals $716 Billion:
Obama's Cuts to Medicare:
Total Amount Cut by Service:
Hospital Services$260 Billion
Medicare Advantage (MA)$156 Billion
Home Health Services$66 Billion
Skilled Nursing Services$39 Billion
Hospice Services$17 Billion
Other Services$33 Billion
DSH Payments$56 Billion
Worst of all, President Obama has taken $56 Billion from Disproportionate Share Hospital (DSH) Payments. DSH payments go to Hospitals that primarily serve low-income patients.
In addition to billions in Medicare pillaging to fund Obamacare, President Obama has essentially circumvented the law and future presidential vetoes by using the Independent Payment Advisory Board (IPAB) to insure all cuts to Medicare "must become law by August 15th, 2014."
The profiteering these few decades was SO EGREGIOUS hundreds of billions of dollars each year------that what is needed to REALLY service PER PERSON MEDICARE is far less than what individuals pay into their MEDICARE SAVINGS ACCOUNTS.
Any discussion on costs per person in MEDICARE treatment must take into consideration this ROBBER BARON looting of our public trusts. This is why a IPAB is not only ILLEGAL ----but the opposite of what 99% US WE THE PEOPLE needed Obama and a super-majority of Clinton neo-liberals to do in FIXING US HEALTH CARE.
Trump will absolutely keep MOVING FORWARD----he could not possibly harm our US seniors more than OBAMA and Affordable Care Act meets $20 trillion national debt with trillion dollars gutting of MEDICARE.
So, any group trying to affix blame for cuts to MEDICARE on Trump and not including OBAMA and Clinton neo-liberals---are 5% far-right wing global banking 1% players and pols.
11:10 AM ET July 11th, 2013
U.S. health care’s dangerous profit fixation
By Russell J. Andrews, Special to CNN
Editor’s note: Russell J. Andrews is a neurosurgeon who has been a U.S. Army flight surgeon, a clinician and researcher in both academia and private practice and a medical device developer with NASA. He is the author of ‘Too Big to Succeed: Profiteering in American Medicine.’ The views expressed are his own.
Medicine is big business in America. Nearly one fifth of our GDP is spent on health care – 50 percent more than any other developed country. Yet by many measures we are not getting value for money. Even nearby Cuba, which spends less than one-tenth as much as the U.S. per capita on health care, has outcomes that are as good or better: life expectancy is just as long, and the infant mortality rate is actually lower. Health care in the U.S. is on an unsustainable course, and costs cannot continue to increase while outcomes continue to deteriorate.
This crisis has been blamed on greedy malpractice lawyers, drug companies, health care insurance companies and doctors who over treat patients by practicing defensive or wasteful medicine – unnecessary tests are ordered and unneeded operations are performed. And there is something to all of these. Doctors have failed to address this health care crisis, so other groups offer solutions – notably economists and political commentators. Not surprisingly these proposals represent the expected economic or political views, namely: “Which reform will rein in burgeoning health care costs?” and “Which reform will be politically acceptable?”
Medical students since ancient Greek times have sworn to uphold the Hippocratic Oath. Yet nowhere in the Hippocratic Oath is money, financing or making a profit mentioned. Medicine is a unique relationship between two people, one born of a person’s need for the skills of another person to live and be healthy. Even more than the teacher or the religious leader, the physician bears a responsibility that transcends financial gain. That responsibility to uphold the Hippocratic Oath has been lost in present-day American medicine.
Runaway costs and deteriorating patient outcomes are symptoms, not causes, of the present health care crisis. There are two primary factors at play: (1) the exchange of the unique long-term doctor-patient relationship (where the doctor assumes personal responsibility for the patient receiving the best care possible) for impersonal “corporate medicine;” (2) the morphing of American medicine from a function of humanitarian society into a revenue stream for health care professionals, drug and medical device companies, hospitals, and insurance companies. In essence, we have transformed health care in the U.S. into an industry whose goal is to be profitable, and the health of the patient is not really in the equation. Imagine if such a transformation from a societal good into a profit-making industry occurred in public safety (police and fire), clean air and water or basic education?
True, many incoming medical students have humanitarian motivations (an M.B.A. or a law degree is a quicker route to financial success than medicine). However, corporate America begins invading the physician’s professional “genome” early in training. Academic medical centers are as challenged as community hospitals in making financial ends meet: the faculty member who does not maintain the revenue stream is likely to be let go. The same is true for a physician in private practice – remaining economically viable is a full-time job (leaving less and less time for actual patient care) as for-profit insurance companies work ever harder to reduce their expenses.
The family doctor who follows you over time and place (“from womb to tomb,” and in both the office and the hospital) is being replaced by compartmentalized corporate medicine. In-hospital care is assumed by a team of hospital-based physicians (“hospitalists”). Hospitalized patients may see three or more different hospitalists in a 24-hour period – and still others if they remain hospitalized over a weekend. Indeed, one hospitalist group has impersonalized this to the point where the patient’s doctor is whoever happens to hold the “hospitalist pager” at the moment.
It is sobering how the for-profit “virus” has “infected” health care in the U.S. medical students learn that physicians must forego “the joy of healing those who seek their care” to survive in the profit-driven medical environment. Direct to consumer (patient) advertising – at present largely limited to prescription drugs, although ads for surgical procedures are appearing – clouds the physician’s ability to prescribe what is truly best for the patient. Physicians are forced to prescribe treatment plans that place the financial health of the system (including the doctor’s own “financial health”) ahead of the physical health of the patient.
Medical research and drug and device development also aren’t immune to the profit motive. Many examples exist of millions of dollars wasted in the development of drugs or devices that in the long run were doomed to fail. Competition in medical drug and device research is not like competition in the cellphone or automobile industries. Consumers quickly determine which cellphones are best for them. Health care consumers (i.e. patients) cannot determine if a novel (expensive) drug will be beneficial for them, nor can they predict if their artificial hip or lumbar spine fusion will provide many years of improved quality of life. There are “lemon laws” if your new car fails to perform – but there is no trade-in available for a “failed back.” And again, the profits are privatized up front (to the physicians, the hospitals and the drug and device manufacturers), while the losses are socialized later on (disability payments and the other societal costs of a person who cannot work).
Fortunately, there are signs of health care reform that put patient before profit. The PCMH (patient-centered medical home) places the physician-patient relationship at the forefront of a team providing full-service medical and social service care. The EPMA (European Association of Predictive, Preventive and Personalized Medicine) brings together medical societies, medical research institutes and university hospitals and medical corporations from around the world to address, comprehensively, medical challenges such as diabetes, cardiovascular disease and neurological disorders. Unlike the U.S., European countries provide basic universal health care for their citizens and are not controlled by for-profit insurers and hospitals.
Yet ultimately, the only way true health care reform will happen here is if the voting public in the U.S. rejects the unsustainable course of for-profit medicine. We must lobby our elected representatives in Congress and locally, demanding change. The public must exercise their democratic duty to make their views known – through emails, letters and the ballot box. We don’t just owe it to ourselves to do something – our lives depend on us doing so.
We begin this week's discussion on IPAB tied to not only MEDICARE PAYMENTS----but all US health care by making sure 99% US WE THE PEOPLE know the MEDICARE TRUST has plenty of money for all baby boomers and our children and grandchildren. Those appointed to today's IPAB are the global corporation executives behind all these few decades of massive frauds and profiteering-------
'Between 1982 and 2010, the U.S. spent $1.6 trillion more than Europeans on care for four leading cancers but had 729,000 more deaths, according to a new study. The figures are adjusted for population size. Photo of lung cancer tumor: James Heilman, Wikimedia Commons.On this blog, I’ve often dwelled on the disturbing fact that Americans pay far more for health care per capita than any other nation in the world and yet have a relatively low life expectancy. We spend more, and yet we’re less healthy'.
Taking ourselves for example as upper-middle class professionals having paid payroll taxes at a high rate over 30 years-----if we reach 65 years and have that incident of heart disease or cancer-----the costs of $25,000 inflated for our US medical staff wages and benefits-----would leave quite a bit of approximately $700,000 in payroll taxes with inflation paid into our MEDICARE HEALTH SAVINGS ACCOUNTS. We could have regular checkups and PHARMA and never reach that $700,000. We had a high percentage of middle-class Americans paying into that payroll trust who are mostly healthy going into MEDICARE years. Do we care if those less healthy use that extra? There is plenty of MEDICARE FUNDS to cover today's disease vectors and carry over to next generation.
'Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India.......U.S. patients will not indefinitely pay a 20-fold increase on the price of medicines that Indian consumers pay.
Below we see what an OBAMA administration tells 99% of WE THE PEOPLE about goals and operations of IPAB ---meanwhile, costs of medical care and PHARMA have SOARED during OBAMA.
The Facts About the Independent Payment Advisory Board
April 20, 2011 at 5:46 PM ET by Nancy-Ann DeParle
Learn more about health care cost growth and the Independent Payment Advisory Board
Last week, the President outlined a framework for reducing our deficits and debt that is based on the values of shared responsibility and shared prosperity. We know we can’t reduce our deficit without reducing the growth of health care spending. But we also cannot bring down health care cost growth by simply raising costs for seniors and States and ending Medicare as we know it. That’s why the President opposes any plan that would simply place the burden of deficit reduction on seniors and undermine Medicare.
The President’s framework instead builds on the improvements made by the Affordable Care Act. It tackles Medicare fraud and excessive payments for prescription drugs, proposes a stronger Federal-State partnership in Medicaid, and includes a series of health care reforms that would save $340 billion by 2021, $480 billion by 2023 and at least an additional $1 trillion in the following decade.
Key to these savings is a proposal to strengthen the Independent Payment Advisory Board – IPAB, which was created by the Affordable Care Act. Here’s how IPAB works:
- 15 experts including doctors and patient advocates would be nominated by the President and confirmed by the Senate to serve on IPAB.
- IPAB would recommend policies to Congress to help Medicare provide better care at lower costs. This could include ideas on coordinating care, getting rid of waste in the system, incentivizing best practices, and prioritizing primary care.
- IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare.
- Congress then has the power to accept or reject these recommendations. If Congress rejects the recommendations, and Medicare spending exceeds specific targets, Congress must either enact policies that achieve equivalent savings or let the Secretary of Health and Human Services follow IPAB’s recommendations.
IPAB is a backstop – it would only take effect if Medicare costs grow too fast. We’re already implementing a series of reforms that will improve the quality of care and reduce costs. In fact, according to Congressional Budget Office projections, Medicare spending won’t hit the targets that would cause IPAB’s recommendations to take effect in the next decade. But independent experts agree that IPAB will offer constructive ideas and help keep Medicare cost growth per enrollee affordable in the long run:
- Experts including former Bush Administration Medicare Official Mark McClellan called for “[strengthening] and [clarifying] the authority and capacity of the Independent Payment Advisory Board (IPAB).”
- Former Congressional Budget Office Director Former CBO Director Robert Reischauer called IPAB a “big deal” that “could generate substantial savings.”
- Experts from the Commonwealth Fund wrote “the Affordable Care Act includes important provisions that will finally begin to control unchecked health care costs, such as…the creation of the Independent Payment Advisory Board. Building on and extending these provisions across the health system has the greatest promise of slowing the growth of government health care budget outlays, private insurance premiums, and underlying health care cost trends.”
- A coalition of economists including three Nobel laureates said “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending” including an Independent Payment Advisory Board.
Under the President’s framework, seniors will have their guaranteed Medicare benefits. People on Medicare won’t be saddled with thousands of dollars in additional health care costs. And Medicare beneficiaries will be able to choose the health care plan and doctor that work for them.
The same can’t be said for the Republican plan. Under their proposal, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 for health care, more than doubling what he or she would pay if the plan were not adopted. Guaranteed Medicare benefits would be eliminated. Big health insurance companies would decide which benefits and insurance plans are available and could limit seniors’ choice of doctor. And in some cases, seniors might not have any health care choices at all.
As with deficit reduction, there is a right way and a wrong way to strengthen Medicare. The wrong way is to simply slash benefits, leave seniors with higher premiums and hope for the best.
The right way is to identify and implement what works on an ongoing basis to lower costs and improve care, set spending goals, and have a way to ensure that they are met – which is what IPAB does. Reducing our deficit and debt is a goal we all share, and we can achieve that goal and ensure our seniors get the quality, affordable health care they need and deserve.
We want to be clear from the start----that these few decades of increasing MEDICARE fees and monthly insurance payments equate to seniors simply PAYING FOR A PRIVATE HEALTH CARE PLAN. We are not getting our MEDICARE ----we are paying insurance just as we pay throughout our lives.
Now that Social Security beneficiaries will receive a 2 percent cost-of-living adjustment in 2018, much or all of the gain may go toward Medicare Part B premiums. "Part B enrollees who were held harmless in 2016 and 2017 will see an increase in the monthly Part B premium from the roughly $109, on average, they paid in 2017," according to a statement from the Centers for Medicare and Medicaid Services.
Medicare Premiums for 2018:
Part A: (Hospital Insurance) Premium
Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of
The Part A premium is $232.00 per month for people having 30-39 quarters of Medicare-covered employment.
The Part A premium is $422.00 per month for people who are not otherwise eligible for premium-free hos-pital insurance and have less than 30 quarters of Medicare-covered employment.
Part B: (Medical Insurance) Premium
$134.00 per month*
*If your income is above $85,000 (single) or $170,000 (married couple), your Medicare Part B premium may
be higher than $134.00 per month.
Guaranteed Medigap Coverage
South Carolina has two guaranteed issue Medigap policies for persons under the age of 65 and on Medicare due to disability. The coverage is through the South Carolina Health Insurance Pool (SCHIP).
The plans and costs for all ages, effective January 1, 2018, are as follows:
Medicare Premiums Increase for Many Retirees in 2018
Most of the Social Security cost-of-living adjustment will be used to pay for higher Medicare Part B premiums.
By Emily Brandon, Staff Writer |Dec. 18, 2017, at 11:49 a.m.
The standard Medicare Part B monthly premium will be $134 in 2018, the same amount as in 2017. But many retirees who have been paying less than the standard rate for the past several years will see a jump in their premiums. Here's a look at how much you can expect to pay for Medicare Part B premiums in 2018.
Medicare Part B payments are prevented by law from reducing Social Security payments by Social Security's "hold harmless" provision. Social Security recipients didn't get a cost-of-living adjustment in 2016 and only received a very low 0.3 percent cost-of-living adjustment in 2017, so they continued to pay premiums that were less than the standard rate charged to new enrollees and other people not protected by Social Security's "hold harmless" rule. Now that Social Security beneficiaries will receive a 2 percent cost-of-living adjustment in 2018, much or all of the gain may go toward Medicare Part B premiums. "Part B enrollees who were held harmless in 2016 and 2017 will see an increase in the monthly Part B premium from the roughly $109, on average, they paid in 2017," according to a statement from the Centers for Medicare and Medicaid Services.
The CMS estimates that 42 percent of Medicare Part B beneficiaries will see their Medicare premiums grow to $134 because the cost-of-living adjustment to their Social Security benefit will be greater than or equal to the amount that is necessary to increase their Medicare premium to the standard rate. "The majority of people who were protected by hold harmless will see a fairly significant increase in their premiums. That's because their Social Security cost-of-living adjustment is large enough to cover the Medicare increase," says Tricia Neuman, director of the Program on Medicare Policy at the Kaiser Family Foundation. "For some, it will take up the full income from their Social Security cost-of-living adjustment." However, CMS estimates that about 28 percent of Part B enrollees will continue to pay less than the full monthly premium of $134 because the increase in their Social Security benefit will not be large enough to cover the full Medicare Part B premium. "The hold harmless provision is designed to protect people so that the Part B premium doesn't result in a reduction in the Social Security check," Neuman says.
The standard rate.
Retirees who newly enroll in Medicare in 2017 or 2018 pay the standard monthly premium of $134 per month. Those who signed up for Medicare without claiming Social Security benefits or who are directly billed for their Medicare Part B premium also pay the standard rate. Low-income retirees who are eligible for both Medicare and Medicaid generally have their premiums paid by state Medicaid agencies. Medicaid pays the standard premium on behalf of the qualifying beneficiary.
Retirees with high incomes are required to pay more for Medicare Part B. Those with an income that exceeds $85,000 as an individual or $170,000 for married couples have $53.50 added to their monthly rate for a total premium of $187.50. Seniors with retirement income between $107,000 and $133,500 ($214,000 to $267,000 for couples) must pay $267.90 per month for Medicare Part B in 2018, and monthly premiums further increase to $348.30 per month for retirees bringing in between $133,500 and $160,000 ($267,000 to $320,000 for couples). Wealthy retirees with incomes above $160,000 ($320,000 for couples) must pay $428.60 per month for Medicare Part B.
You first become eligible to sign up for Medicare Part B during the months around your 65th birthday. If you sign up later, and you weren't covered by a group health insurance plan through your or a spouse's job while you delayed enrolling, you will be charged a 10 percent late enrollment penalty for each 12-month period you were eligible for Medicare Part B but delayed enrolling. For example, if your initial enrollment period ended on September 30, 2015, but you don't sign up for Medicare Part B until March 2018, your premiums will be 20 percent higher for the rest of your life due to two full years of delayed enrollment. In this case, the late enrollment penalty would increase the 2018 premium from $134 to $160.80 per month. "Some people miss their enrollment period, and unless they are covered by active employment, they will get a penalty," says Leslie Fried, senior director of the Center for Benefits Access at the National Council on Aging. "If you are five years late and you didn't have other insurance through active employment, then you could be hit with an additional 50 percent penalty."
Here is the AFFORDABLE CARE ACT with global state health systems being told to reduce MEDICARE costs to make up for the massive global health corporation FRAUDS AND PROFITEERING from our Medicare Trust. This is the trillion dollar gutting of MEDICARE during the OBAMA administration.
We already know our low-income seniors are being denied access to ordinary disease vector care---we already know our affluent citizens are paying tremendous amounts of their personal wealth simply to access ordinary care. The affluent are getting that care---but their family wealth is disappearing in order for them to receive what they PRE-PAID as HEALTH SAVINGS ACCOUNTS.
This SLOW-DOWN is called the ACCOUNTABILITY making spending on seniors AFFORDABLE. Health industry profits are soaring-------US seniors are seeing longevity declining in one generation.
Which US health corporations were made global corporations from all that fraud and profiteering? KAISER PERMANENTE AND GLOBAL HEDGE FUND IVY LEAGUE JOHNS HOPKINS are only two. Here is KAISER pretending to care about our seniors losing access to their own PRE-PAID HEALTH INSURANCE ACCOUNTS ---MEDICARE.
Below we see that trillion dollar cut to Medicare during OBAMA courtesy Clinton neo-liberals being phased in-----this is what national media are blaming on TRUMP.
'Medicare spending is expected to be $1,200 lower per beneficiary in 2014 than was projected in 2010, and $2,400 lower in 2019'
The Mystery of the Missing $1,200 Per Person: Can Medicare’s Spending Slowdown Continue?
Tricia Neuman and Juliette Cubanski
Published: Sep 29, 2014
This insight updates the original July 2014 version to reflect new budget projections released by the Congressional Budget Office.
The big story in the Medicare world these days is the slowdown in program spending. Based on our comparison of CBO’s August 2010 and August 2014 baselines, Medicare spending this year will be about $1,200 lower1 per person than was expected in 2010, soon after passage of the Affordable Care Act (ACA), which included reductions in Medicare payments to plans and providers and introduced delivery system reforms that aimed to improve efficiency and reduce costs. By 2019, Medicare spending per person is projected to be more than $2,400 lower per person than was expected following passage of the ACA. Medicare spending projections in CBO’s August 2010 and subsequent baselines take into account the anticipated effects of the ACA, along with other factors that are expected to affect future Medicare spending. So it seems that the ACA may be having a bigger than expected effect, but something else may be going on here too.
Medicare spending is expected to be $1,200 lower per beneficiary in 2014 than was projected in 2010, and $2,400 lower in 2019
The numbers are impressive, and the consecutive year-to-year reductions in projected Medicare spending are unprecedented. Looking back, total and per person Medicare spending have grown more slowly each year since 2010 than was expected based on CBO projections, and on a per person basis, Medicare spending actually declined between 2013 and 2014, according to our analysis of data from CBO.
Health care observers are still scratching their heads trying to explain why Medicare spending is growing so slowly. A CBO analysis shows the Great Recession did not have the same effect on Medicare that it had on the slowdown in health care spending generally, which has been documented by our Kaiser colleagues. It is clear that the Medicare savings provisions in the ACA, such as reductions in provider payment updates and Medicare Advantage payments, have played a major role, and the changes included in the law may be having a bigger effect than was expected soon after the law passed. In addition, the Budget Control Act of 2011 also exerted downward pressure on Medicare spending through sequestration that reduced payments to providers and plans by 2 percent beginning in 2013. And yet even after incorporating these scheduled payment reductions in the baseline, CBO has continued to lower its projections of Medicare spending.
So what else might be going on here? In addition to scheduled reductions in Medicare’s more formulaic payment rates, providers may be tightening their belts and looking to deliver care more efficiently in response to financial incentives included in the ACA, and it is possible that these changes are having a bigger effect than expected. For example, CMS recently reported that hospital readmission rates dropped by 130,000 between January 2012 and August 2013. It is also possible that hospitals and other providers are using data and other analytic tools more successfully to track utilization and spending and to reduce excess costs. Another more straightforward factor is that several expensive and popular brand-name drugs have gone off patent in recent years, which has helped to keep Medicare drug spending in check.
Whatever the causes may be, the slowdown in spending is good news for Medicare, the federal budget and for beneficiaries—at least for now, and as long as it does not adversely affect access to or quality of care. Lower costs lead directly to lower Medicare premiums and cost sharing. Lower costs also help to improve the balance sheet for the Part A Trust Fund.
Even with this good news, it is unclear how long slow growth rates can be sustained. The Medicare actuaries expect Medicare spending to begin to rise more rapidly in the coming years due to a number of factors, including faster enrollment growth, an increase in service use, and faster growth in payment rates due to higher prices brought about by a healthier economy, which will not be fully offset by payment reductions included in the ACA. And Medicare continues to face long-term financing challenges brought about in part by an aging baby boom population.
These challenges will, no doubt, continue to be the subject of policymakers’ attention.
But for now, the slowdown in Medicare expenditures, as illustrated in the unexpected $1,200 per beneficiary reduction in spending this year, may ease short-term budgetary pressures on Medicare and could provide an opportunity for thoughtful consideration of ways to bolster the program for an aging population.
Between this IPAB installed by OBAMA and Clinton neo-liberals ----and these global banking 1% enriched from all the frauds and profiteering against our US Medicare and Medicaid Trusts------we are now told global 1% are going to get rid of AMERICAN TAPEWORM creating the huge cost to efficacy ratio in health care these few decades.
Now, if we had REAL left social progressives saying they were after the TAPEWORM----this would of course mean clawing back trillions of dollars stolen from our US health trusts. This would mean a global hedge fund IVY LEAGUE JOHNS HOPKINS would sell all of its global corporate campuses in every nation around the world---built mostly on the fleecing of our US health care. It would mean global UNITED HEALTH CARE would see its assets seized by BEZOS, BUFFET, AND JP MORGAN to RESTORE to our over-funded US MEDICARE TRUST that TAPEWORM of these few decades.
The IPAB was created and appointed but not yet operating because as we said------it was never a national IPAB----it is tied to TRANS PACIFIC TRADE PACT and BEZOS, BUFFET, AND JP MORGAN may indeed be those few global 1% on a GLOBAL IPAB.
Amazon, Berkshire Hathaway and JPMorgan Team Up to Try to Disrupt Health Care
By NICK WINGFIELD, KATIE THOMAS and REED ABELSONJAN. 30, 2018
SEATTLE — Three corporate behemoths — Amazon, Berkshire Hathaway and JPMorgan Chase — announced on Tuesday that they would form an independent health care company for their employees in the United States.
The alliance was a sign of just how frustrated American businesses are with the state of the nation’s health care system and the rapidly spiraling cost of medical treatment. It also caused further turmoil in an industry reeling from attempts by new players to attack a notoriously inefficient, intractable web of doctors, hospitals, insurers and pharmaceutical companies.
It was unclear how extensively the three partners would overhaul their employees’ existing health coverage — whether they would simply help workers find a local doctor, steer employees to online medical advice or use their muscle to negotiate lower prices for drugs and procedures. While the alliance will apply only to their employees, these corporations are so closely watched that whatever successes they have could become models for other businesses.
Major employers, from Walmart to Caterpillar, have tried for years to tackle the high costs and complexity of health care, and have grown increasingly frustrated as Congress has deadlocked over the issue, leaving many of the thorniest issues to private industry. About 151 million Americans get their health insurance from an employer.
But Tuesday’s announcement landed like a thunderclap — sending stocks for insurers and other major health companies tumbling. Shares of health care companies like UnitedHealth Group and Anthem plunged on Tuesday, dragging down the broader stock market.
That weakness reflects the strength of the new entrants. The partnership brings together Amazon, the online retail giant known for disrupting major industries; Berkshire Hathaway, the holding company led by the billionaire investor Warren E. Buffett; and JPMorgan Chase, the largest bank in the United States by assets.
They are moving into an industry where the lines between traditionally distinct areas, such as pharmacies, insurers and providers, are increasingly blurry. CVS Health’s deal last month to buy the health insurer Aetna for about $69 billion is just one example of the changes underway. Separately, Amazon’s potential entry into the pharmacy business continues to rattle major drug companies and distributors.
The companies said the initiative, which is in its early stages, would be “free from profit-making incentives and constraints,” but did not specify whether that meant they would create a nonprofit organization. The tax implications were also unclear because so few details were released.
Jamie Dimon, the chief executive of JPMorgan Chase, said in a statement that the effort could eventually be expanded to benefit all Americans.
“The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” Jeff Bezos, Amazon’s founder and chief executive, said in a statement. “Hard as it might be, reducing health care’s burden on the economy while improving outcomes for employees and their families would be worth the effort.”
The announcement touched off a wave of speculation about what the new company might do, especially given Amazon’s extensive reach into the daily lives of Americans — from where they buy their paper towels to what they watch on television. It follows speculation that the company, which recently purchased the grocery chain Whole Foods, might use its stores as locations for pharmacies or clinics.
(We asked health care experts to imagine what the three corporations might do.)
“It could be big,” Ed Kaplan, who negotiates health coverage on behalf of large employers as the national health practice leader for the Segal Group, said of the announcement. “Those are three big players, and I think if they get into health care insurance or the health care coverage space, they are going to make a big impact.”
Taking On ‘the Hungry Tapeworm’
A look at the three companies that announced a joint health care initiative on Tuesday.
- Total employees: 1.2 million
Berkshire Hathaway: 367,000
JPMorgan Chase: 252,000.
- Individual strengths
Amazon: logistics and technology
Berkshire Hathaway: insurance
JPMorgan Chase: finance.
- Jeff Bezos of Amazon:
“The healthcare system is complex, and we enter into this challenge open-eyed about the degree of difficulty.”
- Warren E. Buffett of Berkshire Hathaway:
“The ballooning costs of healthcare act as a hungry tapeworm on the American economy. Our group does not come to this problem with answers. But we also do not accept it as inevitable."
- Jamie Dimon of JPMorgan Chase:
“The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans."
But others were less sure, noting that the three companies — which, combined, employ more than one million people — might still hold little sway over the largest insurers and pharmacy benefit managers, who oversee the benefits of tens of millions of Americans.
“This is not news in terms of jumbo employers being frustrated with what they can get through the traditional system,” said Sam Glick of the management consulting firm Oliver Wyman in San Francisco. He played down the notion that the three partners would have more success getting lower prices from hospitals and doctors. “The idea that they could have any sort of negotiation leverage with unit cost is a pretty far stretch.”
Even the three companies don’t seem to be sure of how to shake up health care. People briefed on the plan, who asked for anonymity because the discussions were private, said the executives decided to announce the initiative while still a concept in part so they can begin hiring staff for the new company.
Three people familiar with the partnership said it took shape as Mr. Bezos, Mr. Buffett, and Mr. Dimon, who are friends, discussed the challenges of providing insurance to their employees. They decided their combined access to data about how consumers make choices, along with an understanding of the intricacies of health insurance, would inevitably lead to some kind of new efficiency — whatever it might turn out to be.
“The ballooning costs of health care act as a hungry tapeworm on the American economy,” Mr. Buffett said in the statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”
Over the past several months, the three had met formally — along with Todd Combs, an investment officer at Berkshire Hathaway who is also on JPMorgan’s board — to discuss the idea, according to a person familiar with Mr. Buffett’s thinking.
The three chief executives saw one another at the Alfalfa Club dinner in Washington on Saturday, but by then each had already had dozens of conversations with the small in-house teams they had assembled. The plan was set.
Mr. Buffett’s motivation stems in part from conversations he has had with two people close to him who have been diagnosed with multiple sclerosis, according to the person. Mr. Buffett, the person said, believes the condition of the country’s health care system is a root cause of economic inequality, with wealthier people enjoying better, longer lives because they can afford good coverage As Mr. Buffett himself has aged — he is 87 — the contrast between his moneyed friends and others has grown starker, the person said.
The companies said they would initially focus on using technology to simplify care, but did not elaborate on how they intended to do that or bring down costs. One of the people briefed on the alliance said the new company wouldn’t replace existing health insurers or hospitals.
Planning for the new company is being led by Marvelle Sullivan Berchtold, a JPMorgan managing director who was previously head of the Swiss drugmaker Novartis’s mergers and acquisitions strategy; Mr. Combs; and Beth Galetti, a senior vice president at Amazon.
One potential avenue for the partnership might be an online health care dashboard that connects employees with the closest and best doctor specializing in whatever ailment they select from a drop-down menu. Perhaps the companies would strike deals to offer employee discounts with service providers like medical testing facilities.
“Each of those companies has extensive experience using transformative technology in their own businesses,” said John Sculley, the former chief executive of Apple who is now chairman of a health care start-up, RxAdvance. “I think it’s a great counterweight to what government leadership hasn’t done, which is to focus on how do we make this health care system sustainable.”
TOTAL DEREGULATION OF US HEALTH CARE-------ABSOLUTELY NO ABILITY TO STOP CRONYISM BETWEEN GLOBAL CORPORATIONS ---
Erik Gordon, a professor at the University of Michigan’s Ross School of Business, predicted that the companies would attempt to modernize the cumbersome process of doctor appointments by making it more like booking a restaurant reservation on OpenTable, while eliminating the need to regularly fill out paper forms on clipboards.
“I think they will bring the customer-facing, patient-facing thing into your smartphone,” he said.
Amazon has long been mentioned by health care analysts and industry executives as a potential new player in the sector. While the company has remained quiet about its plans, some analysts noted that companies often use their own employees as a testing ground for future initiatives.
The entry of Amazon and its partners adds to the upheaval in an industry where much is changing, from government programs after the overhaul of the tax law to the uncertain future of the Affordable Care Act. All the while, medical costs have persistently been on the rise.
Nationwide, average premiums for family coverage for employees rose to $18,764 last year, an increase of 19 percent since 2012, according to the Kaiser Family Foundation. Workers are increasingly paying a greater share of those costs — they now pay 30 percent of the premium, in addition to high deductibles and growing co-payments.
“Our members’ balance sheets speak for themselves — health care is a growing cost at a time when other costs are either not rising or falling,” said Robert Andrews, chief executive of the Healthcare Transformation Alliance, a group of 46 companies, including Coca-Cola and American Express, that have banded together to lower health care costs.
Other major employers have also sought more direct control over their employees’ health care. Walmart contracted with groups like the Cleveland Clinic, Mayo and Geisinger, among others, to take care of employees who need organ transplants and heart and spine care. Caterpillar, the construction equipment manufacturer, sets its own rules for drug coverage, which it has said saves it millions of dollars per year, even though it still uses a pharmacy benefit manager to process its claims.
Suzanne Delbanco, the executive director for the Catalyst for Payment Reform, a nonprofit group that mainly represents employers, said controlling rising prices is especially hard in markets where a local hospital or medical group dominates. While some have tried to tackle the issue in different ways, like sending employees with heart conditions to a specific group, “it’s piecemeal,” she said.
She added, “There are so many opportunities to do this better.”
The issue is not solely a 21st-century concern: In 1915, Henry Ford became increasingly worried about the quality of health care available to his growing work force in Detroit, so he opened the Henry Ford Hospital. It is still in existence today.
Here is our FAKE ALT RIGHT ALT LEFT 5% global banking player ROBERT REICH------out there selling the demise of MEDICARE is all about TRUMP AND REPUBLICANS-----the trillion dollar corporate and wealth tax cut by Trump mirrors the same TRILLION DOLLAR TAX CUT in 2010 when OBAMA and Clinton neo-liberals extended Bush-era tax cuts for super-sized tax give-away. Yes, it is bad of Trump to give these corporate and wealth tax breaks.
What Robert Reich NEVER discusses -----these few decades of MASSIVE HEALTH INDUSTRY FRAUD AND PROFITEERING started from CLINTON-ERA deregulation and privatization of MEDICARE AND MEDICAID TRUSTS. Clinton dismantled oversight and accountability and outsourced local public health to corporations and Bush era let that fraud go wild. Obama era super-sized global health industry subsidy and allowed open fraud. All this coming from our Federal health spending.
Obama MOVED FORWARD US health care as TELEMEDICINE for the 99% of US WE THE PEOPLE-----all of this was GOODBYE MEDICARE AND MEDICAID access to ordinary hospital and doctor care.
REICH HAS NEVER MENTIONED ALL THIS----HE PROMOTES UNITED NATIONS UNIVERSAL SINGLE PAYER WHICH IS TELEMEDICINE PREVENTATIVE CARE FOR ALL-----
Medicare will disappear if 99% WE THE PEOPLE do not reverse AFFORDABLE CARE ACT----the deregulation and global health system privatization of MEDICARE AND MEDICAID with the goals of taking US health care to third world preventative care only.
Yale/Stanford Johnson & Johnson Global Health Scholars Program
Thank you for your interest in the Yale/Stanford Johnson & Johnson Global Health Scholars Program. Our established program rotations sites for 2018-19 are in South Africa, Uganda, Rwanda and Colombia. We are not selecting Scholars to go to our site in Liberia, and we are ironing out supervisory and visa issues in ...
Next New Deal: The Blog of the Roosevelt Institute
Incredible Shrinking Public Option: Robert Reich takes Harry Reid to task
By Roosevelt Institute | 11.26.09
Building these global health corporations these few decades is to where our US MEDICARE AND MEDICAID funding went through fraud and profiteering.
Robert Reich: Hello Trump Tax Cuts, Goodbye Medicare, Medicaid, Social Security
. . . .By Robert Reich On 11/2/17 at 10:04 AM
The goal of Trump and the Republican leaders is to pull off a giant redistribution of over $1 trillion from the middle class, working class, and poor to the rich, who are already richer than ever.
They’re selling this to the public with a false claim that the middle class will benefit from their tax cut plan. It’s a gigantic Trojan horse.
For most Americans, the proposed tax cuts are tiny and temporary. That’s right – temporary. They will shrink in just a few years. And some middle class Americans will actually get a tax increase.
Meanwhile, the top 1 percent will get a gigantic tax cut. The Tax Policy Center estimates that the current plan will save the bottom 80 percent between $50 and $450 in taxes per year, but that it saves each person in the top 1 percent an average of $129,000 a year. For people at the very top, like Trump himself, the tax cuts are humongous. And the corporations they own will also get a massive tax cut.
Republicans say economic “growth” will pay for the tax cuts, so there’s no need to cut social programs like Medicare and Medicaid.
But Republicans have just passed a budget that would cut nearly $1.5 trillion from Medicare and Medicaid to pay for these tax cuts. Pell Grants, housing assistance, and even cancer research are also on the chopping block.
Now, they say we shouldn’t take their budget resolution seriously. It was just a device to get the tax bill through the Senate with 51 votes.
But once these tax cuts are passed, the budget deficit will explode. The Tax Policy Center predicts that it will cut federal revenue by $2.4 trillion over the next 10 years.
When that happens, the only way out of the crisis will be something dramatic – exactly the cuts in Medicare and Medicaid, and maybe even Social Security – that Republicans have wanted for years.
By this time, any talk of raising taxes on the rich will be dismissed.
Using the promise of middle-class tax cuts as a Trojan horse for a tax windfall for the rich and deep spending cuts is a tactic dating back to the Reagan administration.
But the version they’re aiming for now is “YUGE.”
We must see the strategy for what it is. And it must be stopped.
Leon Washington is helped by volunteer Rebecca Cox as he signs up for the new Medicare drug prescription program during a Medicare enrollment event December 19, 2005 in Pleasanton, California. Justin Sullivan/Getty
Robert Reich is the chancellor’s professor of public policy at the University of California, Berkeley, and a senior fellow at the Blum Center for Developing Economies. He served as secretary of labor in the Clinton administration, and Time magazine named him one of the 10 most effective Cabinet secretaries of the 20th century. He has written 14 books, including the best-sellers Aftershock, The Work of Nations and Beyond Outrage and, most recently, Saving Capitalism. He is also a founding editor of The American Prospect magazine, chairman of Common Cause, a member of the American Academy of Arts and Sciences and co-creator of the award-winning documentary Inequality for All.
Pelosi pushed AFFORDABLE CARE ACT----pushed the gutting of MEDICARE as the answer to addressing deficit created by these few decades of massive frauds against all our Federal agencies and trusts ----especially MEDICARE AND MEDICAID. Pelosi is that Baltimore politician -----it is her CA district tied to KAISER PERMANENTE and roots to GLOBAL IVY LEAGUE STANFORD AND JOHNS HOPKINS-----all of which heavily fleeced our US health trusts and people's pockets. We could claw back the hundreds of millions Pelosi managed to offshore these few decades to pay for CA 99% of citizens hit again by another Silicon Valley industry's frauds.
PELOSI WAS ONBOARD FOR ALL OF OBAMA'S STANDINGS ON BUDGET CUTS, RESTRUCTURING OF MEDICARE, IGNORING TRILLIONS OF DOLLARS IN MEDICARE AND MEDICAID TRUST LOSES FROM FRAUD.
Pelosi is a far-right wing global banking pol------she would not be working for REAL LEFT SOCIAL PROGRESSIVE health issues like MEDICARE.
Pelosi is HILLARY CLINTON and her health reform from 1990s-----she is behind IPAB.........
Revisiting the cost of the Bush tax cuts
By Glenn Kessler May 10, 2011 Washington Post......
'Tax cuts are estimated to have totaled $2.8 trillion, which we guess would count as “trillions,” as the president put it. Strictly speaking, the two big tax cuts during the Bush years are estimated to total about $1.5 trillion, But many continued into the early years of the Obama presidency, and in December he cut a deal with Republicans to extend them even more, which brings us to $2.8 trillion.
Pelosi cautious on Medicare, Social Security cuts
Politics Oct 27, 2011
By ANDREW TAYLOR and DAVID ESPO
WASHINGTON (AP) - The top Democrat in the House declined Thursday to endorse cuts to Medicare and Social Security benefits proposed by Senate Democrats earlier this week. Minority Leader Nancy Pelosi also said a counter-offer from Republicans on the deficit "supercommittee" - it totals about $2.2 trillion - isn't bold or balanced enough because it lacks tax revenues.
"If it's going to be bold, that doesn't do it," Pelosi told reporters.
She also said she's "not making any judgment" about a plan proposed earlier this week by Sen. Max Baucus, which totals about $3 trillion in deficit cuts, including $400 billion in Medicare savings over a decade and Medicaid cuts of another $75 billion. The Baucus plan also would use a new inflation measure that would slow the annual cost-of-living increases in future Social Security benefits.
Pelosi says any plan has to be "big, bold and balanced" and that any willingness by her and other Democrats to change federal retirement programs depends on requiring the wealthy to pay higher taxes.
"It's not fair to say to a senior `you're going to pay more for Social Security and we're not going to touch a hair on the head of the wealthiest people in our country,"' Pelosi said.
The California Democrat made her comments after Republicans and Democrats on a deficit "supercommittee" swapped initial offers that left the two sides far apart despite weeks of secret talks.
The Republican offer would cut deficits by about $2.2 trillion over a decade, according to officials in both parties. About one-third of that would come from increases in items such as Medicare premiums, the sale of public lands and airport fees - measures that increase government revenue without raising taxes. The GOP plan also assumes that tax reform would generate economic growth that would also lift revenues.
The GOP plan would cut about $500 billion from Medicare over a decade and another $185 billion from Medicaid, these officials said.
By contrast, Democrats want $1.3 trillion in higher tax revenue, a similar amount in spending cuts and enough other savings elsewhere in the budget to reduce deficits by more than $3 trillion over the coming decade while financing a $450 billion jobs bill along the lines that President Barack Obama is recommending.
The officials who described the rival approaches did so on condition of anonymity, saying they were not authorized to provide details of the committee's confidential discussions. In private, each side also disparaged the other, providing yet another indication that the panel's deliberations have not shown significant progress.
More importantly, the two sides are at a fundamental impasse over taxes. Republicans insist that the panel won't increase revenues; Democrats say they can't agree to cuts to critical benefit programs like Medicare unless Republicans agree to new taxes.
The panel of six Republicans and six Democrats has until Nov. 23 to recommend deficit savings of $1.2 trillion. But in fact, most if not all of the decisions must be made by early next month to give the nonpartisan Congressional Budget Office time to render precise estimates on their costs on future deficits.
Whatever the committee recommends must be approved by both houses of Congress in December if lawmakers want to avoid automatic spending cuts of about $1 trillion across a range of federal programs.
There were signs of Democratic dissension one day after Baucus, D-Mont., outlined a proposal on behalf of his party's negotiators that included changes in large government benefit programs.
According to several officials, he called for $1.3 trillion in increased tax revenue over a decade, and $1.3 trillion in spending cuts. Another $1 trillion in savings would come from the presumed reduction of Pentagon costs in Iraq and Afghanistan and $500 billion more from a reduction in interest costs resulting from declining deficits.
Those savings would be on top of cuts that Congress approved earlier in the year of nearly $1 trillion.
For Democrats on the committee, it appeared that the most contentious of the items would slow the growth of monthly checks to recipients of Social Security and other benefit programs, curtail Medicare spending by $400 billion over a decade and Medicaid by another $75 billion.
Several Democrats said during the day that the presentation had the support of a majority of the six Democrats on the panel, leaving the impression that at least one, and possibly two, of the party's lawmakers had not signed on. They also stressed that Obama has previously endorsed each of the proposals they made, including the one to adjust the government's calculation for inflation in a way that curtails the growth of benefit programs.
Others suggested that Rep. James Clyburn, D-S.C., a member of the party's leadership, and Rep. Xavier Becerra, D-Calif., had not agreed to support the recommendations.
Aides to the two men would not confirm the accounts.
In contrast, Republicans appeared to avoid any ideological pitfalls in their counter-offer, pulling well back from a position that House Speaker John Boehner, R-Ohio, took earlier in the year in private talks with Obama.
In those discussions, Boehner and the president discussed legislation to enact tax reform that was assumed to result in economic expansion and increases in tax revenue of $800 billion over a decade.