[ColdNoMore]

Originally Posted by goodtimesintv

It's in here, but you don't want to see it.......

Originally Posted by goodtimesintv

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.....Impossible Burden For The Elderly And The Disabled

About half the cost of the ACA (Affordable Care Act) is paid for by cuts in Medicare spending and the only practical way those cuts can be made is by reduced fees to providers.

The Medicare actuaries have noted with alarm that Medicare fees to doctors will drop below Medicaid levels in the near future and the combined effect of lower Medicare and Medicaid hospital spending will drive one in seven hospitals from the market in the next five years.

Although the administration talks about making Medicare more efficient, three separate reports by the Congressional Budget Office (CBO) have concluded that the pilot programs and demonstration projects that are supposed to find these efficiencies are not working.

In fact, the only place in Medicare that shows any promise at all is in the Medicare Advantage (MA) program. But the administration is determined to proceed with cuts in MA subsides and appears to be paying no attention whatever to the efficiencies MA entrepreneurs are discovering.

Because no serious budget analyst believes the Medicare spending cuts can withstand the inevitable political backlash and because they don’t believe the pilot programs will work either, both the CBO and the Medicare Trustees are annually publishing “alternative forecasts” in an effort to predict how Congress will cave. But if Congress does cave and restores the previous Medicare spending path, that means that the ACA isn’t paid for; and that, in turn, means large unfunded liabilities stretching out indefinitely into the future and increasing federal debt......"

Six Problems With The ACA That Aren’t Going Away

Interestingly enough, if you look at the letters to your Opinion Article (written by someone who obviously wants to repeal ACA) you find this.......

6.) Impossible burden for the elderly and disabled: This section is purely speculative and the problems with Medicare financing are largely independent of the ACA.

The ACA does not cut coverage or provider reimbursement to Medicare. These budget pressures were coming with, or without the ACA.

I also don’t understand your argument for MA. First of all, this is essentially a national Medicare version of the state exchanges, which you seem vehemently against. The government was explicitly overpaying MA plans since its induction and the ACA eliminates this clause. If these plans are finding efficiencies as you claim, they should be able to cope with these cuts just fine. Also, one or two years of data on ACOs, which represent quite a radical change in the way organizations must think about health care financing (moving from fee-for-service, where billing more is encouraged, to a budgeted scheme where the goal is to control costs will take time and experience, trial and error), and we should not abandon them, but continue to monitor what is successful and make adjustments as we go.

I appreciate your commentary, but find it confusing and contradictory. If you are against everything the ACA stands for, stand up for yourself and call for its repeal. Outline your alternative that avoids these “problems” with the ACA yet still manages to extend health insurance to more people at a reasonable cost. I recognize and appreciate your budgetary concerns with health care in the US, but I don’t blame the ACA at all, nor do I think the ACA does anything to notably better or worsen the situation.

I see our staggering high number of uninsured as an even more critical failing, particularly among the developed world where our high rate of uninsurance is unique (and shameful).

Rather than address cost, the ACA is essentially a budget neutral policy that seeks to broaden insurance coverage in the US, and it does just that.