I'm making up the 10 years part, as I don't know that exactly. It will probably happen sooner than that.

The conventional number on this is the year 2024 -- that's when the system goes bankrupt, based on CBO projections. But as we learned with ObamaCare, the CBO is required by law to assume patently unrealistic scenarios in their projections... making CBO projections chiefly a strong prediction of what won't happen because it can't happen.

When you dump such silly assumptions, Medicare goes bankrupt well early of 2024. Says who?

Says the Board of Trustees of Medicare.

In past reports, and again this year, the Board of Trustees has emphasized the strong likelihood that actual Part B expenditures will exceed the projections under current law due to further legislative action to avoid substantial reductions in the Medicare physician fee schedule. While the Part B projections in this report are reasonable in their portrayal of future costs under current law, they are not reasonable as an indication of actual future costs. Current law would require a physician fee reduction of an estimated 29.4 percent on January 1, 2012—an implausible expectation.

That's the Doc Fix, I think. If suddenly all the past-due cuts in doctors' fees (building up, unexecuted) since 1995 were suddenly put into effect, sure, we could get all the way to 2024... but if we did that, seniors would have a very hard time finding a doctor at all.

Obama calls for across the board cuts in Medicare -- oddly, no one in the media wants to talk about him cutting, on paper, a trillion or more from Medicare.

He is cutting that by fiat, not by any smart mechanism, and he's taking a "meat axe" to the program, as Democrats said of Republicans' proposed automatic percentage-reduction cuts in spending. He's not suggesting any sort of way to get more with less; he's just saying "We're going to spend a trillion less on this. Period."

Now the only way that is typically undertaken is for Medicare to simply reimburse providers less. But Medicare already reimburses providers less. Obama, and the Democrats, and any fan of the current system, are currently voting for even sharper cuts in provider reimbursements.

Good luck getting anything treated when you're simply not able to pay what the market demands.

Without major changes in health care delivery systems, the prices paid by Medicare for health services [under the cuts required in the new law] are very likely to fall increasingly short of the costs of providing these services. By the end of the long-range projection period, Medicare prices for hospital, skilled nursing facility, home health, hospice, ambulatory surgical center, diagnostic laboratory, and many other services would be less than half of their level under the prior law. Medicare prices would be considerably below the current relative level of Medicaid prices, which have already led to access problems for Medicaid enrollees, and far below the levels paid by private health insurance. Well before that point, Congress would have to intervene to prevent the withdrawal of providers from the Medicare market and the severe problems with beneficiary access to care that would result. Overriding the productivity adjustments, as Congress has done repeatedly in the case of physician payment rates, would lead to far higher costs for Medicare in the long range than those projected under current law.

This is simply rationing. And this is, simply, pushing granny off the cliff.

This is what happens when one refuses to address problems. When one keeps putting them off because one don't wish to confront them. The situation builds and builds into true disaster. A disaster that could have been averted at any time, but for one's failure to realistically examine one's situation and act.

More at the link. I just stole the material Yuval Levin quoted.

Posted by: Ace at 02:43 PM | Comments (39)
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