Monday, November 16, 2009

Don't blame the actuary

Has your local hospital recently shuttered services that where the patients are predominantly on Medicare or Medicaid? There could be a very logical reason.

The Department of Health and Human Services is the home the Centers for Medicare and Medicaid Services. Its Office of Actuary recently issued a report on the financial effects of the House healthcare bill.

The Washington Post reports,
A plan to slash more than $500 billion from future Medicare spending -- one of the biggest sources of funding for President Obama's proposed overhaul of the nation's health-care system -- would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others, according to a government evaluation released Saturday.

The report, requested by House Republicans, found that Medicare cuts contained in the health package approved by the House on Nov. 7 are likely to prove so costly to hospitals and nursing homes that they could stop taking Medicare altogether.

Congress could intervene to avoid such an outcome, but "so doing would likely result in significantly smaller actual savings" than is currently projected, according to the analysis by the chief actuary for the agency that administers Medicare and Medicaid. That would wipe out a big chunk of the financing for the health-care reform package, which is projected to cost $1.05 trillion over the next decade.
...
In the face of greatly increased demand for services, providers are likely to charge higher fees or take patients with better-paying private insurance over Medicaid recipients, "exacerbating existing access problems" in that program, according to the report from Richard S. Foster of the Centers for Medicare and Medicaid Services.

Though the report does not attempt to quantify that impact, Foster writes: "It is reasonable to expect that a significant portion of the increased demand for Medicaid would not be realized."
The excellent economics expositor Greg Mankiw puts it this way:
If a government policy increases the demand for a service, the price of that service tends to rise. If the government prevents prices from rising, shortages develop. The quantity provided is then determined by supply and not demand. In the presence of such excess demand, the result could be a two-tier market structure. Consumers who can somehow pay more than the government-mandated price will be able to purchase the service, while those paying the controlled price may be unable to find a willing supplier.
The laws of economics are like the laws of physics. You can't suspend them.

How do our elected representatives want to deal with the ethical issue they have created? Do they want to face the very real likelihood that the bills being considered what hurt the very people they seek to help? Do they want to be honest that the bills do not pay for themselves?

1 comment:

RLEE said...

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Ron Moomaw