#deficit commission

[facethefactsusa-blog]

#AlanSimpson says math and myth are 4-letter words in politics. Shoutout to @FaceFactsUSA for using #Facts.

[candice-rose]

Medicare: Cut Fraud, Not Performance

Yesterday, September 8, 2011, the American Hospital Association offered a money-saving suggestion to reduce Medicare costs: raise the eligibility age for beneficiaries from 65 to 67 years-old. Like most cost-reduction ideas, this policy will restrict access to care for a greater number of people. When patients who have delayed treatment of chronic conditions enter the Medicare system they are in poorer health and need more extensive services.

We should focus on solutions which provide the best and most efficient services for the broadest constituent group. Creating an effective system requires a focus on prevention and management of chronic diseases rather than acute care for emergencies. In addition to providing relevant value to patients, the Medicare system should operate without fraud, waste and abuse.

Previously I have discussed my 95-year-old Aunt June’s predicament in “Caught in the Medicare System.”  Like most Medicare beneficiaries, she rarely used her benefits until the last year of her life. But once she entered the hospital, she was trapped in a cycle of 7 institutional settings and Medicare footed the bill for 700 transactions. Were all the medical interventions medically necessary? Did they even happen?

For some patients, apparently not. On Wednesday, September 7, Attorney General Eric Holder and HHS Secretary Kathleen Sebelius, announced that the Medicare Fraud Strike Force charged 91 defendants, including, doctors, nurses, and other medical professionals in eight cities for their alleged participation in Medicare fraud schemes.  Defendants submitted claims to Medicare for treatments which were either not provided at all or which were medically unnecessary. Some Medicare beneficiaries received kickbacks for supplying information to providers. Investigators used data analysis techniques to uncover $295 million dollars in false billing.

These investigations are a good start in eliminating fraud so Senator Chuck Grassley (R-Iowa), ranking member of the U.S. Senate Committee on Finance, must be relieved. He has been concerned about the inadequate management and lack of oversight for federal contractors. Last spring, Grassley and Ron Wyden (D-Oregon) introduced the Medicare Data Access for Transparency and Accountability Act to help combat fraud. The bill would require Medicare claims and payment data to be available to the public. In 2009, the federal government spent $502 billion on Medicare. Don’t taxpayers have a right to see how their hard-earned dollars are being spent? Public accessibility may not only deter medical providers from wasteful practices and overbilling, it will give citizens a tool for community policing. Medicare data should also be reviewed and analyzed to understand changing trends and effective treatments. This will enable providers to prescribe the most appropriate and successful treatments for their patients. Congress is looking for solutions to control escalating Medicare costs. Go to your Senator’s page and let them know you support the Grassley-Wyden DATA legislation.

The author, Candice Rose, is a specialist on the topic of aging and elder care. She is currently serving as the Chairwoman of the Arlington County Commission on Aging in Virginia.  You can follow her on Twitter  www.twitter.com/CandiceRose. 

“Be the change you want to see in the world.” M. Gandhi

[dagwolf]

Ryan's Path to Prosperity: Making Catfood look good.

Don't be misled. The Paul Ryan Presents Ayn Rand's Path to Prosperity is what we might call an ideal benchmark for the corporatist conservatives in the GOP. It's meant to fuse the wishlists of idiot Tea Party members with asshole Libertarians. As bad as it is, it will be used to make the poorly received Deficit Commission proposal look moderate--sane, even.

That's what's up.  How do you make the changes the Deficit Commission suggested look good so soon after the Commission's report was so poorly received? Paul Ryan's plan makes it look good.

The entire discourse gets to shift right. Obama has a strong base of Democrats that support everything he does. He has a habit of ignoring his progressive supporters. When was the last time you heard anything about our Progressive Caucus?  And you're not likely to hear from them either.  The media won't cover it. The President won't address it.

I don't know what we can call Democrats liberal. Yeah, in the sense that liberal means being willing to work within the traditional social and governmental framework to achieve change and transformation, I guess liberal applies. On the other hand, we might consider referring to Democrats as members of America's liberal conservative party. I like how it sounds contradictory. Suits them.

[federalbudget-gl-blog]

SOCIAL SECURITY AND MEDICARE TRUST FUNDS EXHAUSTED

After reading the article "Understanding our Federal Budget and National Debt" relating to the hypothetical country explaining our national debt, this chart may actually make some sense.  Again, compliments of our friends at the Comeback America Initiative for generating such detailed charts and research, you can see that the Social Security and Medicare present values of unfunded trust fund balances are $7.9 trillion and $22.8 trillion respectively. If you are still unclear as to what these trust funds are, go back and read the hypothetical scenario in the prior post and pay close attention to the future obligations that our hypothetical citizens promised everyone when they retired.

Both of these trust funds will completely exhaust in approximately 25 years if changes are not made - which means that we will have to go out and borrow external dollars just to pay our own citizens their Social Security and Medicare payments because ALL the money that we will bring in by the the current citizens paying into those funds will not be enough to fund the obligations of those citizens drawing benefits.  This is REAL and a very critical component of our current deficit reduction program currently being worked on by several groups, including a commission that was assembled by President Obama called the National Commission on Fiscal Responsibility and Reform. 

The 18 person bipartisan group was co-chaired by Alan Simpson (R) and Erskine Bowles (D).  Their final report was appropriately titled, "The Moment of Truth" and failed to gain the 14 votes necessary to send the proposal on to congress.  However, the attention gained from preparing the proposed spending cuts and tax increases stirred things up enough in Washington where the topic of reducing the deficit has risen dramatically in the polls.  Now, Senators and Representatives in Washington will be paying close attention to this issue as the 2012 election approaches.  It is the official position of the Giving Legacy organization to not side with one party or the other.  We will, however, voice our strong viewpoints on the bipartisan actions that need to be taken now, and in the future, to ensure that the children of tomorrow are not left holding a 100 trillion dollar credit card balance with no assets to show for it.

[federalbudget-gl-blog]

UNDERSTANDING OUR FEDERAL BUDGET AND NATIONAL DEBT

The federal budget of the United States of America can be an overwhelming concept to grasp if you are not one who reads such 1,000 page documents on your free time.  I have read such documents and have read our country's document and that is why I have decided, through the Giving Legacy organization, to break our federal budget down to something that we can all relate to.  The chart above, compliments of the Concord Coalition, is a very easy way to look at our annual revenues and expenses to see just what our budget consists of.  Click on the chart and then return to this posting to further explore the nature of our economic state here in the United States.

After reviewing the chart, you can see that we spent approximately 1.3 trillion dollars more than we brought in for the 2010 fiscal year. [The 2010 fiscal year for the US government runs from October 1, 2009 through September 30, 2010 - this fiscal year system allows the incoming congress in January to take part in the preparation of the following year's budget which starts in October.]  This "Trillion" word can be difficult to grasp so let us look at it in more manageable terms.

Let us create a hypothetical country that we live in.  And let's say that your household in this country makes $210,000 per year.  Hopefully, you will not spend more than $210,000 during that same year or you would have to dip into your savings or retirement accounts to pay the difference, right?  Not exactly, there is another option, you can borrow the money.  So, let's say that you spend an additional $130,000 that year and you borrow that money using a home equity line of credit and some credit cards - are you feeling the crunching feeling in your stomach yet for borrowing over 60% of what your annual income was?  Well, let's say that you did that year after year and accumulated a total of $1,400,000 (One Million Four Hundred Thousand Dollars) in debt. Mind you your annual salary is only $210,000 per year and you now have to figure out a way to pay off seven times your annual salary over time while continuing to pay your bills of $340,000 per year, $130,000 more than you make...crunching feeling arrived yet?

Now for the "Trillion" analogy.  Let's say that you live in a country of 10,000,000 (Ten Million) people and you all pool your revenues and expenses and use those funds to pay for all expenditures for the country.  And...EVERYONE, all 10,000,000 people spent $130,000 more than what they made for this past year - that is equivalent to the United States 2010 fiscal deficit = $1,294,000,000,000 (One Trillion, Two Hundred Ninety Four Billion Dollars.)  Additionally, the same proportions apply to the year-after-year deficits in the past for the United States that now all add up to 14 trillion dollars.

Now that you may have a better grasp of our annual deficits and our entire national debt, let me begin with the bad news.  Yes, if the 14 trillion dollar debt was all we had to deal with, that would actually be somewhat manageable with some difficult decisions.  However, the promises that our country has made to our citizens in the form of future promises amounts to a much greater number. Before we talk about what the United States owes, let us revisit our hypothetical country to finish the financial analysis.

Let's say that in addition to the $130,000 of additional expenses that we incur each year, and the total debt of $1,400,000 that each citizen owes, that we promised to pay living expenses and medical costs for every one of the people in our country when they retired until they died. And, let's say that we asked those people to pay us a certain amount of money every year and we would put that money in the bank and save that money to pay for their future retirement and medical costs.  We then figured out the exact amount of money that we would need in the bank today, earning interest at 5% per year, to pay for those future obligations that we promised.  That number for every one of the 10,000,000 people in our hypothetical country would be an additional $4,800,000 (Four Million Eight Hundred Thousand Dollars.) 

Remember, we already have $1,400,000 in debt that we have to pay off and now we add an additional $4,800,000 for a total of $6,200,000 (Six Million Two Hundred Thousand Dollars) to pay over time with our $210,000 salary - almost 30 times our annual salary!  Ok, this is getting downright ridiculous and at this stage most any accountant would have to recommend that each citizen just file for you know what (bankruptcy) and start over.  Unfortunately, in our hypothetical country, bankruptcy is not a possible solution for us, so we have to figure out a fiscal solution to our $6,200,000 debt per person, or our collective 62 trillion dollar nightmare - the crunching feeling in the stomach should have arrived by now.

Wait!  There is something we might have forgotten.  You might ask about all the money that the people were paying in over the years that is in the bank for us to use to pay for their retirement and medical expenses - good question.  After looking up the bank balance for what we will call the "Trust Funds" for the retirement and medical costs for those citizens we find out that there is a grand total of $0 (ZERO Dollars) available.  We spent all of it already to pay for the additional expenses over the years.  Just to be clear on what just happened here, we took money that people paid us over time to save for their retirement and medical costs and we withdrew that money and paid for our annual expenses over time until there was no more money in the trust funds for future payments...Clear?  Crystal!

So, in our hypothetical country of 10,000,000 (Ten Million) people, every person makes $210,000 per year and they currently spend $340,000 per year and each one owes a total of $6,200,000 (Six Million Two Hundred Thousand Dollars.)  Alright, now it is time to exit our hypothetical country [whew, that was downright depressing] and come back to the United States to look at our own federal budget.

Well, the situation is identical, except for adding a zero or two or seven. According to the Final Monthly Treasury Statement of Receipts and Outlays of the United States Governemnt, the United States Government in fiscal year 2010 brought in 2.162 trillion and spent 3.456 trillion for an annual deficit of 1.294 trillion.  The total debt recorded is approximately 14 trillion and the total obligations that have a zero bank balance from which to pay those obligations is right around 62 trillion dollars at the end of 2010.  The present value of our unfunded Social Security obligation is approximately Eight trillion and the Medicare obligation sits around 23 trillion (See Posting on Social Security and Medicare Funds Exhausted).  Somewhere right around when our children's children will be inheriting our fiscal policies, these trust funds will be completely exhausted and we will have to start borrowing real dollars from external sources to pay our own citizens their Social Security and Medicare obligations.  This is REAL and this is not going away.

Now What?  The Giving Legacy organization is bringing together resources from across this country to create solutions so this country can take the baby steps forward that have been long overdue.  On the surface, the problem appears too large to solve.  However, with some hard decisions, political cooperation, individual and corporate philanthropy redirecting, tight fiscal policies, and some concessions from our citizens that will need to understand that it isn't if they will need to compromise, it is how much and in what areas they will need to compromise, we can weather this storm and bring America back to fiscal sustainability.  For the sake of the children of tomorrow, let us buckle down and create the solutions necessary to maintain sustainability and give those children a land of opportunity to live in.

If you want to read up on the national debt in more detail, visit this site as it will explain in relatively simple terms the different components of our federal budget and how they accumulate to comprise our national debt.  http://en.wikipedia.org/wiki/United_States_public_debt

[healthcare-gl-blog]

In an effort to begin understanding how a country as sophisticated as the United States of America can run into such problems creating a health care system for its citizens, allow me to point out the obvious in a fascinating video illustration relating to life expectancy.  Once you have viewed the above link, return to this section to see how the life expectancy issue has created such a quagmire for our government.

[yathzee-blog]

Deficit Commission Moves Goalpost, Disses Leading Progressive #P2 Member Rep. Jan Schakowsky D-IL

Rep. Jan Schakowsky, D-Ill., says that as of this morning she had not been shown the latest proposal of the White House deficit commission, even as she says it is being "shopped around" by its co-chairs in an effort to get the support of a simple majority of its 18 members—not the support of 14 members as was its original goal. Schakowsky confirmed this shift in an interview with OurFuture.org after giving a private briefing to members of the Tuesday Group, a meeting of progressive organization leaders convened by the Campaign for America's Future. The deficit commission—formally known as the National Commission on Fiscal Responsibility and Reform—was scheduled to hold a public meeting today in advance of its planned release of its recommendations Wednesday, but the meeting was abruptly canceled. Instead, its co-chairs, Erskine Bowles and Alan Simpson, were tweaking the deficit reduction plan they made public earlier this month, which includes proposals to cut Social Security benefits, Medicare and Medicaid, and other key programs.  

read more: Deficit Commission Moves The Goalpost, Disses Leading Progressive Member | OurFuture.org

Schakowsky has released her own deficit-reduction plan, which does not cut Social Security or other human needs programs but tackles excessive spending in other areas, such as the military budget. Elements of Schakowsky's plan were adopted by the Citizens' Commission on Jobs, Deficits and America's Economic Future, which released its report formally today.

[yathzee-blog]

Bottom line: this document [Simpson-Bowles mark Deficit Commission] isn't really aimed at deficit reduction. It's aimed at keeping government small.

Is the Deficit Commission Serious? | Kevin Drum. Mother Jones