Congress of the Congressional Budget Office (CBO) gave some assumptions, the computer came with the mixture of adjustments required, to give a magic number less than $1 trillion in 10 years and created "Affordable care Act" (ACA).
"Affordable" trillions apparently means the net additional Federal Government expenditure, with the Ministry of finance, that as a big pot of liquid gold presented.All revenue gets mixed, and the financial engineers turn valves, Outgo to leiten.Weniger will go some channels ("savings") and more others.
Numbers are thrown about - but where is a spreadsheet of the cash flows?The President could hold no line item veto even though he had one, because it not Einzelposten.Zum example, how can budget for each of the new bureaucracies if you don't even know exactly how many there are (159 - more or less)? And are counted costs in the $1 trillion?
See Medicare, the key to the whole calculation. The net trillions is about half a trillion in "Savings" of Medicare, about 10 years from 2010 onwards.(If we start in 2014, it is $800 billion in 10 years and up to $3 trillion in 20 years.) Apply pass the savings despite the influx of baby boomers. As we pass this?
Medicare revenue for part A (hospital) comes from the Lohnsummensteuer Medicare.Das is a dedicated tax law. Anything not immediately spent going on benefits in the Holy of trust fund.ACA are prey of the Trust Fund for numbers expanded Medicaid, the new civilian medical corps or improved support for "health inequality populations" or community health centers? that would be not illegal?
Congress could easy legalize the looting - except that it is impossible, anyway. There is nothing in the Medicare Trust Fund except notes.It has already plundered for other government spending, and is part of unconfirmed public debt.
The latest Medicare trustees report showed a dramatic decrease of $6.2 trillion over a 75 year horizon Medicare's unfunded liabilities - the amount expected expenditure exceed forecasted revenue.A statement by the White House said that shows "How is the affordable care Act help to reduce costs and to make it stronger Medicare."
Medicare's Chief Actuary, noted, however, that it is that this will occur as it depends on no "reasonable expectation", cut physician payment of 30% now and later mehr.Aber adopted it happened - the Congress Clears a liability of absagend his promise, seniors. You can use the same money both to cancel a liability and to finance a new claim.
And how will the savings? ACA has all kinds of mechanisms for controlling the wird.Denken apply with special force for seniors remember that "Control" means, cost reduction, only payment reduction, translate to reduce maintenance.The money is not paid to doctors and hospitals or oxygen suppliers could well "saved," if it channeled the controllers ist.Und doctors and other providers not will be paid that it for seniors or anyone else - leads to more "savings".
The not Medicare sector is even more imponderable. premiums for private insurance will cover far more generous services himself - now the mandate "Minimum" - and are quickly escalated.Insurers who can for ACA lobbying swelling revenue from millions of reluctant new customers expected are haben.stattdessen politically influential companies such as McDonald's request and weak small companies or individuals can always Freistellungen.Politisch or decide it not insured to pay penalties for that.
It is not clear where to go the "sanctions", but you will make up to 400% of the poverty unable of subsidies amounting to approximately $10,000 on premiums for people to meet federal (more than $80,000).Still to cover the cost of the swelling Medicaid May 16 million new account registration - eligible persons.
Covers all that "taxes on the rich"?Let's say that everything we need is the CBO (below) estimate of half a trillion, which not Medicare taken from: $500 billion, or $500 thousand million.To grab in $10,000 chunks would control a big bite out of 50 million Americans.
The controller means direct expenditure of both the Government and the private fund.The mandates are first funded get: bureaucrats, smoking setting guides, multicultural health educators, translators for patients with weight monitors, hemoglobin A1c limited measurements, IRS agents and quality assurance staff who assure that you get an aspirin for your heart attack.
On the preferred list are treating cancer, stroke rehabilitation, trauma surgery, or coronary artery bypass - the modern treatments for the big killers.
There is no means for death panels, but it is not required.
ACA was with fiction-based billing of phantom verkauft.Umsetzung means savings and revenue and illusion-based benefits real money from real people and productive enterprises, distraction extract it from the care of patients in untraceable channels at the discretion of the unaccountable bureaucrats who and pouring much of it in politically correct money sinkt.Einige would describe different there, but also in the best view, the numbers on the cash flows just don't add up.
We must end - ACA or it will at the end of the life of American medicine.
Jane M. East, m.d., is an on air contribution to healthcare reform sprechen.Dr.Orient is general internal medicine since 1981 in solo practice and instructor is clinical medicine at the University of Arizona College of Medicine.Sie is author of Sapira's art and science of bedside diagnosis and their doctor is need in: healthy skepticism about National Health Care.Sie is the Managing Director of the Association of American physicians and surgeons.
Well said, Dr. Orient.Medicare has become the piggy bank for the Government and doctors and patients is picked pockets, to fill it.
I'm a little surprised you missed writing the $ billions for HIT to zahlen.HIT makes little sense his UACA said to execute in its current badly usable iterations, improve patient care, but not much to the U.S. Government to collect data (UN affordable care Act) while the elements of a physical examination, violations of privacy of the patient, paradoxically endanger patients, interruption of work assessing flow and cognitive processes of doctors select Enable while bankruptcy with slow care and obscene implementation and maintenance costs.
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