Saturday, December 12, 2009

Quick thoughts on actuary report

That came out yesterday, full report here linked via TNR blog. Here is NY Times. More detailed comments later, but biggest picture:

*If we do nothing, from 2010-19 we will spend 35 Trillion, 260 Billion on health care and there will be about 56 Million uninsured in 2019.

*If Senate bill becomes law, we will spent 35 Trillion, 500 Billion on health care, and there will be around 23 Million uninsured in 2019.

So, health spending goes up by $260 Billion over 10 years, and 33 more people have health insurance, on a default base of over $35 Trillion (the T is correct) under do nothing.

Other notes are that Medicare solvency is extended by 7 years and trend lines within the report suggest a new system with better hopes of slowing inflation in the next decade (2020-29). Also, actuary notes that often Medicare cuts don't materialize...which means one congress can't bind another. For a bit of historical comparision, Balanced Budget act of '97 cut Medicare spending by 12%, and about 7-8% of it stuck...meaning carried through on. The Senate bill proposes Medicare cuts of 5% of total over 10, much smaller and a good chuck is overpayment to Risk Plans and reductions in DSH payments which should drop as uninsured drop.

I wish we would do more to control costs. Here are some thoughts I have had on that in the past.

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