Does ObamaCare Reduce Health Care Spending?

The short answer is no.


Yesterday, former Congressional Budget Office and Office of Management and Budget Director Peter Orszag had a piece in The New York Times claiming that the Patient Protection and Affordable Care Act of 2010 is an essential element to keeping future health care costs down. Worried that Republicans will make good on Election Night vows to repeal ObamaCare, Orszag's basic argument in summed up in his commentary's headline: "To Save Money, Save the Health Care Act."

He writes: "Sure, the health care law is not perfect, but it would cut the nation's long-term fiscal imbalance by a quarter and reduce the projected deficit within Medicare by three-quarters. That may seem fanciful, given how distorted the public discussion has become. But that's what the projections show, as long as Congress sticks to its guns and the Obama administration does a good job carrying out the provisions of the law."

However, Orszag's article amounts to little more than wishful thinking. Using Congressional Budget Office (CBO) data, the chart below shows that the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 have left the cost curve of federal healthcare spending virtually unchanged over the next 25 years.

The data for this chart comes from the June 2010 Long-Term Budget Outlook and the Cost Estimate for the Reconciliation of Act 2010. As we can see, the chart compares future projected federal spending on healthcare with and without the projected effects of the Affordable Care Act. In red, CBO's projected federal healthcare costs without the effects of the Affordable Care Act; in blue, CBO's projected federal healthcare costs with the healthcare legislation. The two lines closely follow one another, with currently legislated health care spending (which includes the effects of the health care legislation) dominating the baseline healthcare spending (absent the effects of the healthcare bill).

The CBO finds that the effect of the healthcare legislation has been to increase government spending by $3.8 trillion between 2010 and 2020. From 2020 to 2035, federal spending under the two projections are equal percentages of GDP. If Orszag is arguing that the real cost-containment provisions kick in around 2036, such futuristic projections are simply not worth taking seriously.

Assuming the very unlikely scenario that every cut in the Affordable Care Act is enacted, the law contains provisions that have conflicting effects on net federal spending. On the one hand, it increases spending by increasing the federal commitment to Medicaid and increasing federal subsidies for private insurance; on the other hand, federal payments to Medicare and private insurance are legislated to decrease.

(Article continues below the video, "3 Reasons Health Care Reform Won't Cut the Deficit by One Thin Dime.")

Indeed, the history of Medicare reimbursement rates demonstrates the fantasy at work in many official health care cost projections, including the CBO data seen above. It assumes that Medicare's sustainable growth rate mechanism, which would have reduced physician payments by 21 percent in 2010 alone, actually takes effect. Medicare reimbursement rates are legislated to decline over time but basically never do. Instead, Congress routinely enacts what's known as the "doc fix," or upward payment adjustments. As Politico reported in May, "In 2010 alone, Congress has already headed off three scheduled payment drops—in January, March and April." In fact, as the CBO notes, Congress has kicked the can down the road on payment reductions yet again, putting off the reduction in payment rates until at least December 2010.

ObamaCare doesn't reduce medical costs under even the rosiest of scenarios (that is, projections that take seriously all its creators' assumptions). What we can be certain of is that this legislation increases the amount of money taxpayers will be forced by law to pay for health insurance to the tune of $420 billion over the next 10 years. Claims about ObamaCare's deficit-reduction effects depend on new taxes growing even faster than new spending. Despite the persistent claims of Peter Orszag and other defenders of the president's health care legislation, ObamaCare has nothing to do with cutting costs.

Veronique de Rugy is a Reason columnist and an economist at the Mercatus Center.

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  1. How about the federales start appropriating less and less money for government healthcare programs every budget year? Won’t that guarantee lower spending on those budget line items?

    1. Veronique de Rugy, one of many Koch-suckers at Reason.

      1. Tommy Wiseau, one of the many parasitic trolls at Reason.

      2. Good job, Tommy. Your check is in the mail.

      3. Wow, ad hominen two comments in.

        Impressive liberal troll.

  2. I’m no economic’s professor but it seems to me the only way to REALLY lower the amount spent on healthcare is to a)limit visits/procedures/meds that people utilize or b)pay doctors less. Whether the super-efficient government manages it or a privately held company doesn’t seem a huge potential cost savings.

    So are we going to use price fixing on MD’s? Or are we going to tell people that their insurance doesn’t cover a lot of the things they want?

    All of that seems intrusive or tinkering around the edges of the problem.

    Does anybody remember the old 80/20 plans? At least those made you think about whether you truly needed medical help. Why not just cover catastrophic 100% and non-catastrophic at some 80/20 level?

    Or better yet, allow insurance companies to offer cross-state policies and include within that policy whatever they want. Then allow each of us to choose what sort of medical insurance to have.

    1. President Obama:

      Let me be clear: I am open to any ideas anyone has about improving health care reform. I may summarily dismiss any and all of those ideas since it was me, after all, that won the election, but let’s hear them. Everyone here is very sharp. Where is Mike Flynn? Is he in the house? I want to give him a shout out.

    2. Your (b) is an illusion. Price fixing never works, and never will. You need to read a little Thomas Sowell: price is a signal of economic and social phenomena. You can no more change the phenomena by legislating the price than a dose of aspirin to cut the fever “cures” malaria.

      That leaves (a) get less medical care. Return to the medical care standards of the 1950s, which were relatively cheap to achieve.

      But you also left out (c) efficiency and technology. It is possible for those things to cut the cost, although it’s not as easy as cutting the cost of, say, electronic toys and cell phone service.

      What do you need to optimize the chances for that? How about the same situation that prevails in the gaming/tech/electronics/cell phone industry: less oversight, fewer regulations, fewer mandates, less intrusion, fewer top-down imposed solutions, a wide open free market filled with chiseling gimlet-eyed consumers and avaricious providers looking to make a killing underselling the Microsoft/AT&T equivalents, and racking their brains for novel methods of providing the same service for less dough?

      You’d think after watching this model succeed over and over and over again, throughout the last two centuries, that folks would learn the lesson: Want it cheaper? Stop fucking with the market. Let the best solutions bubble up from below, stop tryingto impose Clever Ideas from above. No CEO or Senator or President ever knows (or will know) more than the millions of people living with the decisions every day, so the fastest way to get the best possible outcome is to tie such people to chairs and gag them with their own underwear.

      But apparently the learning curve of humanity on this subject is pretty much flat.

    3. Fleeing Cali:

      You are right on point B: We can surely save on the amount we pay medical professionals. Our specialists in particular are highly overpaid vs their international peers.

      1. Chad|11.4.10 @ 6:56PM|#
        “Fleeing Cali:

        You are right on point B: We can surely save on the amount we pay medical professionals. Our specialists in particular are highly overpaid vs their international peers.”

        Chad once again demonstrates his abysmal econ ignorance.

        1. What is ignorant about pointing out how we pay our doctors too much?

          You certainly don’t believe that their incomes are set by a “free market”, do you?

          lol lol lol laugh lolAMACARTELlol lol lmao

          1. Chad|11.4.10 @ 10:06PM|#
            “lol lol lol laugh lolAMACARTELlol lol lmao”

            Why, Chad, that comment might make someone think you had a 3rd grade education! “LOL” is sooooo telling.
            There’s no doubt the AMA distorts the market in the US but somehow markets even more distorted yield other results. And you love those.
            Sorry, 2nd grade.

          2. It would be better if everyone made the same amount of money, without regard to their profession.

      2. Yes, yes, this makes much sense. Our actors here are highly overpaid vs their international peers. Let’s cut their pay. As well as our Chonys, they are highly overpaid vs international Chonys.

      3. This sort of garbage drives me crazy. I love when people determine who makes too much money for others.

        1. I agree.

    4. Definitely agree, although I don’t think it should ever hit 100%. Capping at out 98% for catastrophic care would force people to make sure doctors aren’t ripping them off (or at the very least have a personal stake in ex post facto action against ripoffs).

    5. My syringe is loaded and ready when the Death Panel gives me orders.

  3. Portability across state lines will make the aromatherapy, chiropractic and homeopathic industries lobby DC for inclusion in mandatory health care insurance policies rather than each state capital as it is at present.

    1. That’s why I think that the only insurance that makes sense is INSURANCE.

      That means a high per-incident deductible, and 100% coverage above a certain threshold. Insurance is a way to prevent a genuine emergency from destroying you financially in case of, say, a fire, a car crash, or a serious disease or injury. Insurance is NOT a good way to manage the cost of routine health care — to say the least.

      As it stands now, I pay 20 bucks to go chat with a doc about a recurring pain in my leg (he bills $150 or so I think), but when our son was in the hospital for a few days, we owed $22,000 AFTER insurance had paid.

      That is exactly the opposite of any other kind of insurance, which ordinarily exists to cover very expensive unexpected emergencies, not routine, predictable expenses of everyday life.

      1. So obvious and well stated.

        My parents are on Medicare and it is 90% of their social life as they schedule 3-4 doc visits a week and show early to the waiting room to yack it up with the other elderly folk.

        Taxpayers under 50 should be in full revolt against this Tea Party Medicare crowd.

        I suggest a THC Party to overthrow the Tea Party Medicare “Keep yer Big Government hands off my Medicare” crowd.

      2. Well, to be honest, it has to be admitted that one of the reasons insurance often covers these little piddling costs is because they can be thrown in for very little overall cost, and lots of good PR.

        See? We cover your well baby checkup COMPLETELY! Isn’t this a GREAT plan?

        Of course, the true cost of the well baby checkup is $300 anyway, and your kid only gets 2 or 3 a year, which is peanuts compared to the $15,000 or more you’re forking out in insurance premiums. They can throw that in easily enough. Also a few chiropractic and acupuncture and aromatherapy visits! Why not? Aren’t we generous?!

        Where the rubber hits the road is, as you’ve observed, when you get something really expensive, like a hospital stay for a trauma or serious illness, where you may easily suck up $150,000 of care — and I mean you really do eat it up, because you cost hundreds of hours of specialist (MD, RN, pharmacist) time plus the services of some very expensive machinery. And it’s there that you’ll notice the insurance company starting to be cheap, chiseling corners, et cetera.

        You’re certainly right, that health “insurance” that actually works like insurance — e.g. the late Republican initiative of high-deductible “catastrophic” plans plus a tax-free Health Savings Account that earns interest and rolls over from year to year makes a lot more sense.

        But don’t fool yourself that in the end it would be a lot cheaper. It isn’t. It couldn’t be, really, otherwise people would be doing it. No one’s that stupid.

        It could still bring down costs over time, however, by two effects: (1) by making people aware of their general spending on health, so they would be more careful about hitting the ER for a CAT scan when suffering a nasty headache and 101 fever (OMG! I might have a BRAIN TUMOR!), and would shop around a little for relatively routine care (which provides a business opportunity for cheaper providers, clinics and such); not only that, they might start saving up for health care costs, the same way they save up to buy a new TV or vacation in Hawaii, which would be a Very Good Thing; and (2) by simplifying the entire financial side of the process, so that a lot fewer accountants and data-entry analysts and lawyers would need to be employed by insurance companies.

        I guess there’s also (3) by simplifying the plans sufficiently, it would make the relative value of health insurance options clearer. Who understands what the best buy in health insurance is today? It’s too damn opaque. By making things plainer, it would provide the opportunity for a lot more competition — because the “sticker price” would be more obvious.

        1. …the same way they save up to buy a new TV or vacation in Hawaii…

        2. they save up to buy a new TV or vacation in Hawaii

          What planet are you on?

        3. they save up to buy a new TV or vacation in Hawaii

          On which planet does this still occur?

        4. Not only is health insurance opaque, medical billing is so opaque that is borders on fraudulent and would likely violate many laws against anti-competitive practices (anti-trust, price-fixing, etc.). If an auto mechanic did what hospitals do, he’d be in jail. Seriously.

        5. Carl, the HSA+high deductible plan you suggest is actually much more complicated than necessary, as it requires tracking all of your health care spending from the first dollar and keeping on your eye on a separate account that typically pays utter crap for interest.

          A much better way is how Japan or Singapore handles it, which is with high co-pays (20-30%, typically), and an income-based cap on total expenditures. Unless you hit the cap, you don’t have to track a thing, and you don’t have to keep a special pool of money in a special account earning nothing.

          And btw, there is nothing incompatible with either deductables or co-pays and universal coverage. Indeed, every nation I know of uses one or both to control costs.

          1. As a 30-year veteran of the health care business, I’m a huge supporter of HSA plans. Sure…it’s a different concept and will take a few months to get used to.

            Nationwide increased of utilization of HSAs along with a few extra small deposits from the govt. will be much more efficient than Obamacare.

          2. Chad,

            Ever been to a Japanese hospital?
            It’s cash up front prior to services rendered. And there’s no EMTALA.

            I’m all for it (and then some), but are you?

          3. Whoever said life could be lived on auto-pilot while you engage in work, sleep, eat and activities that will hasten your need for more healthcare?

            Frankly; a high-deductible, true insurance account and a HSA would be a good fix to the current crisis. It encourages personal responsibility and accountablility rather than drinking alcoholic beverages, eating fatty snacks and watching pro sports on the LCD TV that you bought on the high interest credit card.

            Try a little preventitive care of your body (easy to do); track what you spend on health maintenance (small effort); and, if you get a routine cold or flu, tough it out. You may build natural immunity against further illnesses.

            For the those who suffer from chronic and debilitating conditions, the activities of the healthy in accepting responsibility for themselves, could bring down the cost of comprehensive plans offered by the private sector by allowing insurance companies to be profitable. Offering tax advantages for writing such plans to those insurance companies would encourage them to establish a “risk pool” of insureds with medical conditions. Premiums would necessarily be higher, but resources could be focused on managing thier case for more effective treatmens.

          4. Chad-

            Why do you think “tracking all of your health care spending from the first dollar and keeping your eye on a separate account” is a bug, and not a feature?

            Half the reason we have such out of control costs is that the consumer isn’t watching what they consume.

            Look at all the product areas where people ARE conscious of their spending. It is in those industries where price sensitivity exists and there are pressures to reduce costs.

          5. Actually, one doesn’t need to track “…all of your health care spending…” My plan will track it for me, as long as I show my UHC card everytime I see the doctor / other providers. In fact, if I don’t I end up paying more since I will not get the UHC price.
            I guess I could try and negotiate a better price the UHC, but I am guessing it wouldn’t work.

        6. “But don’t fool yourself that in the end it would be a lot cheaper. It isn’t. It couldn’t be, really, otherwise people would be doing it. No one’s that stupid.”

          It changes the equation a lot when your employer is kicking in a lot for a full-featured insurance policy. Kill the tax loophole. Good for revenue, good for introducing some sanity into the insurance economy.

  4. Yes, yes, this may be true, but historically the government has done an amazing job at containing costs in government programs.

    Wait a second…. no,no…. let me try this again. But wait until we get all of those savings from cutting out waste,fraud, and abuse.

    Wait a second… one more time. But, but CBO doesn’t historically do a good job at projecting all of the savings from a bill. That’s it. That’s the one. It’s gonna be great.

  5. Somebody should ask Orszag is the government entitlement spending estimators today are any smarter than the ones estimating future Medicare spending in 1965 when the program started.

    The annual costs are about 10 times as much as they estimated they would be.

    1. I tried to warn Congress on Medicare Part D as well.

      1. You are talking about the Bush Medicare Welfare Fixed Price Pharma Plan, right?

        Bush – that bastion of GOP small government?

        That guy?

        1. Who argues that Bush was small-government, other than leftards who wouldn’t know small government if it gnawed off their tiny balls?

  6. There are no lower limits on spending.
    There are no upper limits on spending.

  7. Now we turn to Medicare’s 2010 report. It shows enormous improvement in the program’s long-term costs as a result of the Affordable Health Care Act. Starting with Part A, we see that Medicare’s actuaries are projecting no long-term deficit whatsoever. Last year’s projected deficit of $36 trillion has literally fallen to zero (p. 85). Part B’s finances also show significant improvement, with the long-term deficit falling from $37 trillion to just $12.9 trillion or 1.5 percent of GDP. Medicare Part D’s finances are unchanged. The long-term deficit is estimated to be $15.8 trillion or 1.1 percent of GDP.


  8. Another opinion —

    Now we turn to Medicare’s 2010 report. It shows enormous improvement in the program’s long-term costs as a result of the Affordable Health Care Act. Starting with Part A, we see that Medicare’s actuaries are projecting no long-term deficit whatsoever. Last year’s projected deficit of $36 trillion has literally fallen to zero (p. 85). Part B’s finances also show significant improvement, with the long-term deficit falling from $37 trillion to just $12.9 trillion or 1.5 percent of GDP. Medicare Part D’s finances are unchanged. The long-term deficit is estimated to be $15.8 trillion or 1.1 percent of GDP.


  9. Under egalitarian single-payer ObamaCare, who goes to the front of the organ-transplant recipient line: Barack’s Sasha, Barbara Boxer’s husband, Sarah Palin’s youngest child, a famous baseball player, a corporate CEO or a roofless drug addict? Would Barack be allowed to buy his from a Chinese organ mill?

    1. You should look up the liver transplant stories from the LA Times where Asian mobsters were cornering the market on livers with big private donations.

      Why Asian mob leaders needed a disparate number of livers? I have forgotten.

      1. Because Chinese Baijiu is strong as hell. Mostly in the 50-65% alcohol range.

  10. Why is it that advanced countries with state-run health care spend less per capita on health care and have better outcome than the U.S. does? Is it the large underclass that skews the numbers?

    1. Can’t answer that, but that Miami medical-specialist trip was very nice.

      1. Simply loved the whores in Amsterdam.

        1. I loved those doctors in Madrid.

          1. I guess I will have to check out Madrid someday.

    2. I don’t think you’re trying to blame the underclass — but the immigrants from the south get an enormously better outcome than they ever would at home.

    3. Because we have the worst of both worlds – big government rules and regulations combined with a non-market based purchasing system. During WWII, government wage controls were enacted, so employers paid for health insurance as a perk. Now, we have a system in which medical procedures are created based on what an employer will pay for instead of what the end consumer will. Laborers and the unemployed get screwed because they can’t afford to buy health insurance, and the middle class gets screwed with lower take-home pay. Regulations that prevent insurers from selling across state lines hurt consumers and drive up prices even further.

    4. They don’t. This is a common (1) lie or (2) bit of self-deception, depending on whether the person in question knows better or not.

      The best health care outcomes, meaning what happens to you after you get sick, occur in the United States. That’s why the wealthiest people, who can afford to go anywhere, come here when they get sick. Duh.

      The only way your opening statement is correct is if you pick some other random health-related statistic and call it “health care outcomes.”

      For example, life expectancy at birth. Obviously this has mostly to do with the genetic mix of your population, with how obese they are and what their diet is like, whether they have a high teen- and twentysomething death rate from car accidents and gang violence, levels of air pollution, prevalence of AIDS or malaria, and so forth. But if you’re an idiot (or a nasty liar) you might think (or pretend to think) it must, somehow, be dominated instead by how good a nation’s cancer or diabetes care might be.

      1. You are wrong.

        Annual health care costs are $7700 here and $3800 in Western Europe (per person) while outcomes are roughly the same.

        France has mobile care units that drastically cuts hospital stays by treating emergency care calls at home where we have hospitals who favor high-cost admissions.

        1. shrike|11.4.10 @ 6:14PM|#
          “You are wrong.
          Annual health care costs are $7700 here and $3800 in Western Europe (per person) while outcomes are roughly the same.”

          I’m tire of listening to this bullshit. Your comment is both irrelevant and a half-truth.
          Americans choose to spend more than other for many things, especially if they find them attractive. The fact that some choose to spend a lot of money on health care /= that health care costs a lot of money.
          Secondly, please control you cost/outcome data data for:
          1) Provider incomes
          2) Insurance costs
          3) “Defensive” medical treatments
          4) High-end medical tourism
          5) Homicide rates
          5) Bogus stats (what is “infant mortality” in, oh, France)
          There’s more, but do that first and get back to us.

          1. Why should 1, 2, or 3 matter? Especially 1, if our market is distorded to increase doctor pay, how is that plus? If “defensive” treatments lower over-all costs, isn’t a market that encourages them more efficient?

            4,5,6 – sure, especially 4, but I don’t see that more than doubling the cost of healthcare overall.
            The price we pay here in the states for medicine is absurd. The problem is that the market does a worse job with needs than with wants. I will spend every penny that I have if it means not dying. With no regulation, the market will ensure that I do.

            1. You are certainly not logical in your reply.
              If someone is getting a “defensive treatment” it means that it probably wasn’t needed. If so, and if there are a lot of them, then there are people going under the knife for NO REASON. More people going under the knife means there are more people who are likely to have a negative outcome to the surgery. That raises the cost of care.
              If only 100% of those who needed surgery, for example, are operated on, that is the ideal scenario. I realize it probably isn’t possible, but defensive medicine makes it worse, not better.

    5. Can you say fat?

    6. Don’t forget, a lot of “state-run” health systems DO NOT have the state of the art equipment Americans can have access to. On a per capita basis Canada’s bumber of CT Scans, MRI’s etc. is mong the lowest in the OECD.

      I’d tread carefully with those numbers.

      Also, America’s system is so different from all others the crtieria used will usually clip the U.S. figures. Besides, Canada is not that far off health care costs to the USA and it’s rising and continuously under duress.

      It’s a fact.

  11. The health care disaster will only drive up prices and drive down quality like any other centrally planned system. Look at the military, a gallon of diesel in Afghanistan is priced at 3.20 here in Ohio is over $100.

    The only way to bring down prices and increase quality is to let the free market do it. That means getting the Feds out of health care period. Of course this is not going to happen as Obama and his buds now have a lot more power than any US government previously to hand out favors in the health care sector.

    But don’t worry, preventive care and contraception will be free. Well not for me, because I am a man but for women. And that by law can not raise the price of health insurance. See it is magic insurance.

    1. While I agree with your general point, that has got to be the dumbest example I have ever seen.

      The price premium of getting gas in the middle of a mountainous, landlocked, third-world war zone is not primarily due to government inefficiency.

  12. Veronique: Your title is misleading, probably deliberately so.

    It should read

    “Does ObamaCare Reduce Federal Health Care Spending?

    The short answer is no”

    You then proceed to conflate federal and total spending throughout the article. Reason is really going downhill nowadays.

    1. Even Tim Cavanaugh, who has written many fine articles, just opined in H&R that Bush’s TARP has “allowed Obama to spend trillions”.

      Sloppy as hell.

      1. Gee, shrike, that must hurt.

      2. I guess he shoulda said “MADE Obama spend”.

        1. It’s “Bush’s Fault” ™

          1. I thought Bush made or saved Obama from spending?

    2. Yeah, wtf Veronique, misleading. But hey, if you like your health care article, you can keep it! 😉

      Chad, tell these fine folks where they can go to get some good solid information about health care reform.

    3. Yeah, Veronique, so misleading. But hey, if you like the health care article you have, you can keep it. 😉

      Chad tell these smart, fine folks where they can go to get the skinny on my benevolent (the right thing to do) health care reform.

  13. So is the long answer!

  14. “Does ObamaCare Reduce Health Care Spending?’

  15. Is everybody in the comment section owns small business or something? I’m all in for the health care plan and I do believe if they all(reps & dems) work together to refine the plan, it will make a difference as predicated.

  16. As already pointed out, this piece is very confusing and only considers government spending and not total spending.

    I also note that with reform we will be spending the same with everybody insured as we would have payed with millions of uninsured.

    I suppose Medicare is a sizable part of this spending and in particular the prescription drug extension.
    Would be interesting to have an estimate of just that and to know how much drug consumption increased since the extension was adopted.
    It would also certainly help if Medicare & Medicaid could negotiate prices as does any other costumer.

    1. I wasn’t confused at all.

    2. Hey, you just gave me a great idea! Let’s just give all of our money to the government to spend, because just like you said: “I also note that with reform we will be spending the same with everybody insured as we would have payed with millions of uninsured.”

  17. The data for this chart comes…


  18. If “Obamacare” was dependent on the cuts to be “deficit reducing,”
    could negating the cuts betray the electorate?

    “The Centers for Medicare and Medicaid Services
    has released the 2011 Medicare Physician Fee Schedule Final Rule,
    which includes a 23 percent cut to Medicare physician fees…

    …Congress delayed a scheduled pay cut of around 20 percent in June.

    Rachel Fields
    Beckers Hosptial Review, November 04, 2010
    Did the delay of the June pay cut alter the “affordability”
    of the Patient Protection and Affordable Care Act (PPACA),
    and if so, who voted for both the initial legislation
    and also voted to reverse the cuts making the law “affordable”?
    “…The report from Medicare’s Office of the Actuary
    …acknowledged that some of the cost-control measures in the [PPACA] bill
    Medicare cuts, a tax on high-cost insurance
    …could help reduce the rate of cost increases beyond 2020.

    …the longer-term viability of the Medicare . . . reductions is doubtful.”
    wrote Richard Foster, Medicare’s chief actuary”

    Associated Press
    Have the American people been lied to,
    if the government passed a law that said X,
    and those who voted for it did Y,
    that made the “affordability” non-viable?
    “…Neither the [the Patient Protection and Affordable Care Act (PPACA)] bill
    …nor the accompanying reconciliation…
    …addresses the flawed formula that dictates physician payments under Medicare

    …a bill passed by the House in November would scrap the SGR altogether,
    replacing it with a formula designed to ensure that doctors’ Medicare payments
    reflect the true cost of delivering care.

    Pricetag: $210 billion.

    …it was that cost that caused Democrats,
    who’d vowed both to keep their reform package below $1 trillion and to offset the entire tab
    to strip the doc fix from the larger reform bills.”

    The issue has left Democrats in a pickle:
    …with voters already weary of deficit spending,
    [and/or borrowing] another $210 billion to fund a permanent fix.”

    Mike Lillis
    Washington Independent
    If Medicare Cuts
    are what makes the recently passed Healthcare Legislation “deficit reducing”
    and the 23% cut is not enacted in December,
    how could those who voted for the legislation be considered
    not guilty of misleeding the electorate?
    From an email from some supporting the elimination of the cut:

    “Is the new healthcare law accounting dependent on the 23% payment reduction?

    If the can is kicked down the road,
    does the math in the healthcare legislation become not operable?”

    George Hartzman

    The answer:

    “That is how the administration officials explained it to us…

    …Their numbers are based on the law as it stands,
    and it currently stands that the cuts will occur.

    I think you know the answer to your last question.”

    Lee Beadling
    Managing Editor, Orthopedics Today

  19. I recently read a blog that said the healthcare law could lead to Nullification. That would be an awesome and appropriate step…and the irony would be magnificent. One can only dream!


  20. “Obamacare” is a disaster. While we certainly need to do something to bring healthcare costs under control (esp. with the over 50 age group becoming dominant), Obama and the Democrat party are going to destroy what good remains with our current health care system.

    – David

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  21. The demo link doesn’t work.

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  23. I never liked Obama “health care” program. One group hardworking people must pay for lazy people…


  24. this bill is going to raise health care costs simply because of the prescription rx lobby that got a sweet heart deal during the passing.

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