Update: Late Thursday, the administration said it would immediately stop paying what are known as cost-sharing reduction subsidies. The payments go to health insurers in the Affordable Care Act to help lower-income people with co-pays and other cost sharing. Without them, insurers have said they’ll dramatically raise premiums or pull out of the law’s state-based markets. According to Bloomberg, the White House said the Department of Justice and the Department of Health and Human Services both concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare. ‘The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system,’ the White House said in the statement. The payments will stop immediately, with no transition period, Acting HHS Secretary Eric Hargan and Centers for Medicare and Medicaid Services Administrator Seema Verma said in a statement. They next payments were due next week. ‘Congress has not appropriated money for CSRs, and we will discontinue these payments immediately,’ the department said.
This post was published at Zero Hedge on Oct 13, 2017.
As first previewed over the weekend, tomorrow at 11:15am, President Trump will sign an executive order aimed at taking action on health care, or as the White House put it, “to promote health care choice and competition”, after Congress’s failure to repeal ObamaCare. The order – which is expected to further weaken Obamacare – should, in theory, ease rules on small businesses banding together to buy health insurance, through what are known as association health plans, and lift Obama administration limits on short-term health insurance plans, according to a source on a call with administration officials Wednesday night. According to The Hill’s sources, the order will direct the Department of Labor to “modernize” rules to allow small employers to create association health plans. Small businesses will be able to band together if they are within the same state, in the same “line of business,” or are in the same trade association. Needless to say, this latest attempt to dismantle Obamacare did not make the likes of Andy Slavitt, who ran Medicare, Madicaid and Obamacare under Obama, happy, and he took to twitter to make it clear: BREAKING: Tomorrow 11:15 Eastern, Trump will sign his Executive Order on ACA. 1/ — Andy Slavitt (@ASlavitt) October 12, 2017
This post was published at Zero Hedge on Oct 11, 2017.
Recently, Senator Bernie Sanders unveiled a single-payer healthcare plan called ‘Medicare for All.’ Sanders titled his approach for nationalizing one-sixth of the American economy as ‘Medicare for All’ in order to offer a template for his vision of the U. S. healthcare system. Unfortunately, using Medicare as the template for the nation’s healthcare system is a little like using the production model for the Lada, the ‘people’s car’ of the former Soviet Union, as the blue-print for the U. S. auto industry. The ‘Medicare for All’ proposal would transition millions of Americans to a Medicare-style system over the course of four short years, all the while promising to expand benefits, eliminate deductibles, and cut costs. If that sounds too good to be true, it is. The assumption that Medicare can be a long-term, sustainable model capable of absorbing quadruple the number of current enrollees is flawed from the start. Medicare covers approximately 57 million Americans and is projected to cost nearly $700 billion this year. Revenue for the Medicare trust fund is generated via beneficiary premiums, which Sanders wants to eliminate, and general tax revenue, which he wants to increase. According to the 2016 Medicare Trustees Report, the Medicare trust fund faces a ‘substantial financial shortfall.’ In fact, the report forecasts that within 12 years the trust fund will be depleted unless further legislation is enacted. Sanders’s proposal would place a significant burden on an already financially shaky system.
Even Bernie Sanders has acknowledged that the federal government couldn’t afford to provide health care to all of its citizens. In a video clip from 1987 that was discovered by the Washington Free Beacon, then-Burlington Mayor Bernie Sanders (I., Vt.) admitted that ‘giving everybody a Medicaid card’ would ‘bankrupt the nation.’ ‘You want to guarantee that all people have access to health care as you do in Canada,” Sanders said. ‘But unless we change the funding and control systems to do that, for example, if we gave everybody a Medicaid card we would be spending such an astronomical sum of money that we would bankrupt the nation.’ Of course, as we reported two days ago, Sanders is pushing essentially the same system with his newly introduced ‘Medicare for All’ bill. The proposal would offer the same suite of medical benefits required for some insurance plans under the Affordable Care Act and eliminate most out-of-pocket costs. Mr. Sanders argues that although taxes would likely rise to support the new system, families would save money by no longer needing to purchase health coverage.
This post was published at Zero Hedge on Sep 16, 2017.
After successfully leveraging promises for far-left policy reforms into a competitive challenge against frontrunner Hillary Clinton during the 2016 Democratic primary (forcing Debbie Wasserman Schultz to intervene on her longtime friend’s behalf), Senator Bernie Sanders has finally introduced a long-anticipated piece of legislation: His bill to create a single-payer health-care system, or, as his supporters know it best, ‘Medicare for all.’ As expected, the proposal would offer the same suite of medical benefits required for some insurance plans under the Affordable Care Act and eliminate most out-of-pocket costs. Mr. Sanders argues that although taxes would likely rise to support the new system, families would save money by no longer needing to purchase health coverage, according to the Wall Street Journal. *** Unsurprisingly given Sanders’s well-known views on government spending, the 96-page bill offers no mechanisms to pay for the plan, which is expected to cost the federal government hundreds of billions of dollars a year. A Bernie spokesman said his office plans to release a separate white paper focusing on payment strategies, but as of now, no such plan exists. While the bill’s chances of passing are infinitesimal (Republicans remain vehemently opposed), as the WSJ explains, the symbolism surrounding its introduction is actually quite potent.
This post was published at Zero Hedge on Sep 13, 2017.
Sadly, Congress has absolutely no controls on the willing to spend money and promise entitlements to borrowers. Spending is a runaway trend in Washington DC. Much of this spending is entitlement spending, such as Medicaid and Medicare.
Now that Obamacare repeal is dead for the foreseeable future thanks to John McCain, the full court press to expand on the existing system has begun with Bernie Sanders saying Sunday that he will ‘absolutely’ introduce legislation on single-payer healthcare. ‘Of course we are, we’re tweaking the final points of the bill and we’re figuring out how we can mount a national campaign to bring people together,’ Sanders said on CNN’s State of the Union. Sanders. who if it weren’t for the DNC’s collusion with Hillary Clinton would likely have been the Democratic party’s presidential candidate and perhaps current president of the US – a truth which the public must urgently forget and thus the daily barrage of “Russian collusion” headlines – promised to introduce a ‘Medicare for All’ proposal once the debate over repealing ObamaCare ended. He is one of several progressive lawmakers who back the healthcare model that has divided Democratic lawmakers.
This post was published at Zero Hedge on Jul 30, 2017.
Having warned “Republicans have a last chance to do the right thing on Repeal & Replace after years of talking & campaigning on it,” in a tweet this morning, building pressure on the GOP after threatening overnight that “if Republicans don’t Repeal and Replace the disastrous ObamaCare, the repercussions will be far greater than any of them understand!” President Trump will deliver a statement about healthcare, shortly after meeting with what he calls ‘victims of Obamacare.” The Senate will move forward with a vote this week on a Republican health-care bill, but, as MarketWatch.com reports, it’s not yet known whether the legislation will seek to replace Obamacare or simply repeal it, according to the Senate’s third-ranking Republican. The Associated Press reports Sen. John Thune of South Dakota said Senate Majority Leader Mitch McConnell of Kentucky will make a decision soon on which bill to bring up for a vote. At this stage, it’s unlikely that the senate will vote to begin debate, as the Trump administration has struggled to bridge the divide between moderates and conservatives, who have dramatically different expectations regarding the bill and its contents. In its latest draft, the Trump team included a revision that would allow insurance companies to sell cheap plans that provide little in the way of coverage as a sop to conservatives like Texas Sen. Ted Cruz. But it wasn’t enough to secure the support of conservatives, and moderates still balk at the proposed cuts to medicare.
This post was published at Zero Hedge on Jul 24, 2017.
…. fixing the government paid medical programs — Medicare and Medicaid. My plan does this. It not only puts a stop to the expansion of Medicare spending (and cuts it both immediately and over time without denying care to anyone in the program) it deletes Medicaid without denying care to one single person. Let me be clear — it does not evade all the Medicaid expense. But it does stop nearly 100% of the gaming of Medicaid and it drops the absolute expense amount dramatically. Between these two we will immediately and permanently close the entire federal budget deficit. No kidding, no nonsense, for real.
Here it is: “Notwithstanding any other provision in state or federal law, a person who presents themselves while uninsured to any provider of a medical good or service shall not be charged a price greater than that which Medicare pays for the same drug, device, service or combination thereof.” That’s it. One sentence. It ends the “Chargemaster” ripoff game. It ends the $150,000 snake bite or the $80,000 scorpion sting. It ends the $500,000 cancer treatment. It ends all of that, immediately and instantly.
Earlier today the Centers for Medicare and Medicaid Services (CMS) released the first projected county-by-county map of Obamacare coverage for the 2018 plan year which depicts at least 47 counties, with 35,000 active Obamacare exchange participants, that will have no health insurance options next year. Meanwhile, another 2.4 million people are expected to have only 1 option for coverage. Per CMS: The Centers for Medicare & Medicaid Services (CMS) is releasing a county-level map of 2018 projected Health Insurance Exchanges participation based on the known issuer participation public announcements through June 9, 2017. This map shows that insurance options on the Exchanges continue to disappear. Plan options are down from last year and, in some areas, Americans will have no coverage options on the Exchanges, based on the current data. The CMS map displays point in time data and is expected to fluctuate as issuers continue to make announcements on exiting or entering specific states and counties. It currently shows that nationwide 47 counties are projected to have no insurers, meaning that Americans in these counties could be without coverage on the Exchanges for 2018. It’s also projected that as many as 1,200 counties – nearly 40% of counties nationwide – could have only one issuer in 2018. Currently, for 2018 at least 35,000 active Exchange participants live in the counties projected to be without coverage in 2018, and roughly 2.4 million Exchange participants are projected to have one issuer. It’s expected that the number of consumers with no coverage choices will rise.
This post was published at Zero Hedge on Jun 13, 2017.
Medicare paid about $729 million in improper payments as part of a program to reimburse doctors for investing in electronic health records (EHRs), according to a government audit. During a three-year period starting in 2011, the Centers for Medicare and Medicaid Services (CMS) paid out more than $6 billion as part of a program to incentivize hospitals and physician practices to adopt electronic medical records, but many of the payments audited did not have sufficient justification. CMS conducted ‘minimal documentation reviews’ on doctors claiming payments as part of the program, ‘leaving the EHR program vulnerable to abuse and misuse of Federal funds,’ the Office of the Inspector General wrote in its report. To be eligible for EHR incentive payments, doctors must prove they are making ‘meaningful use’ of electronic records systems, which means taking advantage of dozens of features designed to make health care more efficient.
He knows folks. He knows its coming, and yet he’s going to take it out of your ass, and he has the entire GOP with him in doing it too. What’s “it”? The medical cost explosion, which has run about 9% compounded for the last 30 years or so and which shows exactly no sign of slowing down, as I’ve noted repeatedly. In fact Obamacare only got one year of flat spending in Medicare and Medicaid. One. After which it went right back to where it was. As I have repeatedly shown by the numbers just taking one condition (Type II diabetes) and changing how we deal with it — turning it from a drug pusher mentality into one that is managed through changes in what one eats, a change in approach that works for virtually everyone with the condition to a material degree and has a good probability of returning blood sugar to normal without the use of any drugs at all would virtually eliminate the Federal deficit.
Obamacare probably doesn’t affect you directly. Most Americans get their health insurance from either their employer or Medicare. If you are a healthcare provider, your job likely existed before Obamacare and will still be there long after. If your income is below $200,000 a year, the healthcare surtax doesn’t add to your tax bill. However… Saying Obamacare doesn’t affect you directly is not the same as saying it doesn’t affect you at all. It certainly does. You and I are part of the economy, and so is healthcare. We are all roped together. That’s actually a good thing because we’re going to need each other next year when Obamacare changes into something else. It’s not going to die… but it won’t be quite alive either. It will be somewhere between alive and dead. That’s right. In 2018, Obamacare may become Zombiecare.
On Wednesday, the General Accountability Office (GAO), the bipartisan congressional watchdog, released an in-depth report on the U. S. government’s challenging fiscal outlook. Despite its surprising revelations, the study received little to no coverage by major media outlets. While most Americans have been led by political rhetoric to believe that government programs like Medicare and Medicaid are the biggest threats to the future U. S. fiscal picture, the GAO study found the following: ‘While health care spending is a key programmatic and policy driver of the long-term outlook on the spending side of the budget, eventually, spending on net interest becomes the largest category of spending in both the 2016 Financial Report’s long-term fiscal projections and GAO’s simulations.’ The GAO cited a simulation that showed net interest payments on U. S. debt increasing ‘from $248 billion in fiscal year 2016 to $1.4 trillion in fiscal year 2045 in 2016 dollars.’
Note the nostrum here…. One of Donald Trump’s few universally welcomed campaign promises was to do something about the prices of pharmaceutical drugs. Most Americans recognize that prices are too high, and are bothered by the rise of pharmaceutical price gouging….. The key power is found in the ‘import relief’ law – an important yet unused provision of the Medicare Modernization Act of 2003 that empowers the Food and Drug Administration to allow drug imports whenever they are deemed safe and capable of saving Americans money. The savings in the price-gouging cases would be significant. Daraprim, the antiparasitic drug whose price was raised by Mr. Shkreli to nearly $750 per pill, sells for a little more than $2 overseas. The cancer drug Cosmegen is priced at $1,400 or more per injection here, as opposed to about $20 to $30 overseas. The remedy is simple: The government can create a means for pharmacies to get supplies from trusted nations overseas at much lower prices. In other words Trump has the ability to administratively put a stop to the drug-price rape. But let me point out that while this article is informative and points out a means by which Trump can irrespective of Congressional interference put a stop to the scam in one area of the medical system it ignores — intentionally — a much-larger and more-powerful hammer that every President has had available to them for the last 30 years and yet has refused to use.
Clinging to magical-thinking fixes that change nothing on the fundamental level hastens collapse. Here we stand on the precipice, and all we have in our kit is a collection of delusional magical thinking that we label “solutions.” We are not just morally and financially bankrupt, we’re intellectually bankrupt as well. Here are three examples of magical thinking that pass for intellectually sound ideas: 1. Mainstream neo-classical/ Keynesian economics. As economist Manfred Max-Neef notes in this interview, neo-classical/ Keynesian economics is no longer a discipline or a science–it is a religion. It demands a peculiar faith in nonsense: for example, the environment–Nature– is merely a subset of the economy. When we’ve stripped the seas of wild fish (and totally destroyed the ecology of the oceans), no problem–we’ll substitute farmed fish, which are in economic terms, entirely equal to wild fish.
Let’s talk about the implementation of my model bill that I recently posted to reform health care on a permanent basis. It’s fairly easy to envision timelines based on complexity. Simply put, most of this isn’t complex because providers have price lists now — you just can’t see them. So with that said, let’s look at an example and assume The Bill was passed and signed somewhere around 30 September — or the close of the fiscal year. What’s next? The following timeline appears to be reasonable. Beginning immediately on signature with implementation required on or before 1/1/2018: CMS (Centers for Medicare and Medicaid Services; the existing federal agency) would be required to spin up the interface for Treasury to verify whether someone who presents credentials as a US citizen or lawful permanent resident is, in fact, a citizen or lawful permanent resident. Treasury already has this via the Social Security Administration, since they have the records of all issued Social Security numbers and addresses from tax filings. In fact you can get at this right now (for yourself) via CMS also already has an electronic interface system for all medical providers who are registered in order to submit Medicare or Medicaid billing; ergo, the infrastructure is already in place along with access credentials. Medical providers who wish to avail themselves of the ability to bill Treasury for indigent patients would have to register, but the number of providers currently not registered is a tiny minority of the whole.
Last week the American political establishment was shaken to its foundation when the Republican Party leadership withdrew the American Health Care Act (AHCA) just before the vote was to be taken on the floor of the House of Representatives. Besides being a most unusual procedure, it exposed a fundamental split in the country, reflected not merely in Congress but within the Republican Party. GOP purists, represented by the House Freedom Caucus, demanded more significant roll backs in socialized medicine that were contained in the Ryan plan. Their refusal to back the plan, after years of promising complete repeal, doomed the bill. Given the political and popular landscape, the legislative fiasco should cast serious doubt that Washington will ever be able to take any meaningful steps to roll back government involvement in health care. Although widely considered a failure of design and execution, Obamacare seems to have succeeded in one important mission: It has created an even greater dependency on government in the health care marketplace. Getting government out is now much more difficult than it was just eight years ago. This may have been the democrats’ plan from the start. As a result, the choice conservatives now face is to embrace an increasingly complex, cumbersome, and inefficient public/private hybrid system, or to acknowledge the political reality and make the most palatable lemonade they can from the lemons that are available. Believe it or not, that may argue for a deeper embrace of socialized medicine. Contrary to the current rhetoric, Obamacare was not in fact America’s first foray into socialized medicine and it did not represent the kind of crossed Rubicon that Republicans like to accuse it of being. The door had first been opened in the Second World War when government imposed wage controls that gave incentives to employers to bundle health insurance into compensation packages.(1) When the government then made employer-provided insurance tax deductible, such plans became the norm. But the government really charged into the market in 1965 with the creation of Medicare and Medicaid. For many years, Republicans have had to twist themselves into logical pretzels in order to argue that Obamacare is socialism while Medicare is not.
This post was published at Euro Pac on Thursday, March 30, 2017.
Like it or not, Obamacare lives. The question is, for how long? President Trump is right when he says the Affordable Care Act will collapse on its own. Its condition is terminal, and Congress declined treatment last week. Maybe that’s no big deal to you. Maybe you’re on Medicare, or get group health coverage from your employer, or are independently wealthy, or you’re in good health and confident you will remain so. Unfortunately, millions of Americans who don’t fall into any of those categories may soon find themselves in a tough spot. I don’t want that to be you, so today I’m sounding the alarm. You may enter 2018 with no access to health insurance, which means you will be at risk both medically and financially. Now is the time to prepare. Money for Nothing The first step to solving a problem is admitting you have one. Some of us are in denial, so here’s a hard fact: We Americans spend far more money on healthcare than any other developed nation, but we’re no healthier. We’re even less healthy overall.