The Trustees Report is issued by major political appointees of the administration, people such as Turbo-Tax Timothy Geithner, Kathleen Sebelius, recess appointment to run Medicare Dr. Donald M. "Lets Kill Grandma" Berwick, and Labor Secretary Hilda L. Solis. In other words people with a vested interest in the acceptance of Obamacare.
The actuary department has a vested interest in accurate projecting. Their alternate report (embedded below) starts by declaring the other report wrong:
"The Trustees Report is necessarily based on current law; as a result of questions regarding the operations of certain Medicare provisions, however, the projections shown in the report do not represent the “best estimate” of actual future Medicare expenditures. The purpose of this memorandum is to present an alternative scenario to help illustrate and quantify the potential magnitude of the cost understatement under current law."The main reason is the projected reduction of payments to doctors will never happen:
In particular, Medicare payment rates for physician services as determined by the Sustainable Growth Rate (SGR) system are scheduled to be reduced by roughly 30 percent over the next 3 years. For most of the other categories of Medicare providers, the recently enacted Patient Protection and Affordable Care Act (ACA), as amended, calls for a reduction in payment rate updates equal to the increase in economy-wide multifactor productivity. As described in more detail below, in our view (and that of the independent outside experts we consulted), neither of these update reductions is sustainable in the long range, and Congress is very likely to legislatively override or otherwise modify the reductions in the future to ensure that Medicare beneficiaries continue to have access to health care services.Back in April the Actuary's office released a detailed report on the bill that was signed by the president, the report signaled an ominous future for medicare patients.
The report projects that Obamacare will drive doctors away from accepting medicare, and would expand insurance coverage to an estimated 34 million people who now lack it creating a demand for services that could be difficult to meet initially and could lead to price-increases, cost-shifting and/or changes in providers' willingness to treat patients with low-reimbursement health coverage.
The Actuary estimated that within ten years 15% of all medicare providing doctors will become unprofitable as a result of Obamacare's payment reductions. It also say the Independent Payment Advisory Board has been given the impossible task of keeping medical costs below medical inflation. Though the report doesn't officially say this the only way to make up that difference is to limit what is covered through rationing. Many doctors to quit seeing Medicare patients entirely.
The alternative report says that the number of facilities that would become unprofitable will grow to 25% by 2030 and 40% by 2050 if the health reform law is implemented as written.
Read the full report below
2010TRAlternativeScenario
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