National Review – The Corner
August 25, 2012
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.
“And I’ve proposed reforms that will save Medicare money by getting rid of wasteful spending in the health care system and reining in insurance companies — reforms that won’t touch your guaranteed Medicare benefits. Not by a single dime.”
The Affordable Care Act assumes deep reductions in payments to doctors, hospitals, nursing homes, and Medicare Advantage program, totaling $716 billion over ten years. By paying providers less, the trust fund may last a bit longer, but it means seniors will have a harder and harder time finding a doctor to see them as they drop out of the program or stop taking new Medicare patients. The law may not explicitly cut benefits, but it certainly will impact access to care. What good is a Medicare card if you can’t find a doctor? That is precisely the problem that patients on Medicaid — the program for lower-income Americans — face today, forcing them to go to hospital emergency rooms for even routine care. Do seniors want that?
And they certainly don’t want the Independent Payment Advisory Board, the unelected, unaccountable board of 15 bureaucrats charged with keeping Medicare spending down. The main tool the IPAB will have is an ax to cut Medicare payments even further, which will reduce access to care even more.
Worse, the president’s health-care law harms tomorrow’s taxpayers by spending that $716 billion in alleged Medicare savings twice! It uses the money again to create a vast new entitlement program to provide generous taxpayer subsidies for health insurance through the new exchanges.
If the president wants to use the Medicare-savings provisions to extend the life of the Medicare trust fund– and not to fund the new entitlements created by the law — the CBO estimates the fiscal impact would be a “net increase in federal deficits of $260 billion” through 2019.
Medicare actuary Richard Foster has written that the Medicare provisions in the law “cannot be simultaneously used to finance other Federal outlays (such as the coverage expansions under the PPACA) and to extend the [Medicare] trust fund, despite the appearance of this result from the respective accounting conventions.” Even President Obama himself admitted this irrefutable logic in a 2010 interview, when he admitted that “you can’t say that you are saving on Medicare and then spending the money twice.”
And just to drive the point home: The CBO said that the Medicare reductions in Obamacare “will not enhance the ability of the government to pay for future Medicare benefits,” because those savings will be used to fund the new exchange entitlements.
The president also asserted:
“As part of the Affordable Care Act, we gave seniors deeper discounts on prescription drugs, and made sure preventive care like mammograms are free without a co-pay.”
Does he believe that seniors aren’t going to understand that $4 billion worth of drugs and free mammograms can’t begin to equate with the $716 billion that will be taken out of the program to fund ObamaCare over the next 10 years?
Then the president misrepresented the Republican plan:
“Republicans in Congress have put forward a very different plan. They want to turn Medicare into a voucher program. That means that instead of being guaranteed Medicare, seniors would get a voucher to buy insurance, but it wouldn’t keep up with costs. As a result, one plan would force seniors to pay an extra $6,400 a year for the same benefits they get now. And it would effectively end Medicare as we know it.”
Premium support is not a voucher but a promise that the government will fund the health plan of seniors’ choice and that the payment will be enough to cover the cost of traditional Medicare enrollment or the second least expensive competing private plan. It is a guarantee of coverage, and the new program wouldn’t start until 2022. The “one plan” he cites that would cost an extra $6,400 has long since been put on the shelf.
A study released August 24 by the liberal Center for American Progress Action Fund claims that seniors will pay “increased costs during retirement under the Romney-Ryan Medicare Plan.” The analysis assumes that the $716 billion in Medicare cuts remain in place and will be enforced by the dreaded IPAB rationing board. Seniors would face the “increased costs” they would pay in copayments, etc. by paying doctors at today’s rates, enough to encourage most of them to keep seeing Medicare patients.
David Hogberg has a detailed analysis of the problems with access to physicians under Medicare here at the national Center for Public Policy Research.
“The Next Exodus: Primary-Care Physicians and Medicare”
The Manhattan Institute’s Avik Roy has an analysis of the impact of the $716 billion here.
“How Obamacare’s $716 Billion in Cuts Will Drive Doctors Out of Medicare”
And the president’s concluding statement was very rich:
“Here in America, we believe in keeping our promises . . .”
Maybe we could start with a few of the promises that were made to the American people to pass ObamaCare, promises the president made such as:
Health insurance: “If you like your health insurance, you will be able to keep your health insurance” — when at least 20 million people are likely to lose their job-based health insurance, according to the CBO, and as many as 80 million people could be forced to switch plans to comply with Obamacare, according to McKinsey.
The deficit: “We will not add one dime to the deficit.” If the president wants to use the Medicare-savings provisions to extend the life of the Medicare trust fund and not to fund the new entitlements created by the law CBO estimates the fiscal impact would be “a net increase in federal deficits of $260 billion” through 2019.
Health-care costs: Mr. Obama promised during the 2008 campaign that, under his health reform plan, health-insurance premiums would go down by $2,500 a year for every family by the end of his first term. But they actually have gone up by nearly as much — from $12,680 in 2008 to $15,073 in 2011. Senator Jim DeMint released a report from the Republicans’ Joint Economic Committee quantifying the cost of President Obama’s broken promise to reduce premiums. The report finds the cumulative cost (through 2012) of Obama’s broken promise on premiums is $805 billion. During the past four years, the average family has spent a total of $12,230 more on private health insurance, while the average individual has spent $4,163 more.