The war savings gimmick is back! As the debate over how to offset a permanent "doc fix" to Medicare's Sustainable Growth Rate formula heats up, the idea of "paying for" it with "savings" from the war drawdown already underway has resurfaced.
Military personnel costs continue to increase as a share of the defense budget. One of the fastest growing components is military health care, where spending has outpaced even overall health care spending growth, according to the CBO. With base defense spending being reduced in recent years and through 2021, as a result of the Budget Control Act and sequestration, controlling health care spending will be important, or it will crowd out other defense priorities.
On Monday, the Centers for Medicare and Medicaid Services (CMS) released their annual update on health care spending growth, showing that 2012 was another year of slow cost growth and lending further insight into the burning question of what’s causing the recent slowdown.
The Murray-Ryan budget deal would mitigate some of the 2014 and 2015 sequester, but it actually still leaves the sequester’s cuts to mandatory programs entirely in place, including those to parts of the Affordable Care Act (ACA). While the subsidies to help people afford health insurance premiums at the core of the law are exempt from sequestration because they are structured as individual tax credits, little has been written about the other important aspects of the ACA that are still set to be sequestered.
With the end of the year fast-approaching and the looming prospect of a 24 percent cut to Medicare physician payments on January 1, the House of Representatives has introduced a bill to delay the Sustainable Growth Rate (SGR) mechanism through the end of March.
A good piece in the Washington Post over the weekend takes a look at why Medicare physicians continue to use an expensive drug to help prevent blindness when what appears to be an equally-effective drug is available for a fraction of the price.
According to the article, Lucentis costs Medicare about $2,000 per injection. Avastin costs only around $50.
Earlier this year, we discussed how the prospects for a permanent fix to the Sustainable Growth Rate formula had improved given CBO's dramatic reduction in its estimate of the cost of a fix.
As the conferees met yesterday, any doubt that we can afford to wait on the long-term debt problem should have quickly been erased after CBO Director Doug Elmendorf's testimony to the conference committee. While the budget outlook has improved somewhat in the short term, little progress has been made on the long-term problem. And fixing the long term will likely require greater reforms to entitlement programs and the tax code.
It's no secret that a significant portion of the federal budget is devoted to our national defense and insurance programs like Social Security, Medicare, and Medicaid. As Ezra Klein wrote almost three years ago, the federal government can be thought of as essentially "an insurance conglomerate protected by a large, standing army." But the army's getting smaller too.