Medicare Trust Fund Lifetime Extended

Score another one for Obamacare, the exhaustion date for the exhaustion of the Medicare trust fund has been pushed back:

Falling health-care costs are brightening the financial outlook for Medicare, extending the life of the trust fund that supports the program until 2026 — two years later than previously forecast.

The new projections, released Friday by the program’s trustees, credit President Obama’s Affordable Care Act in part for the improvement in the finances of the federal health insurance program for the elderly. The act’s limits on Medicare Advantage, a more expensive form of Medicare run by private insurers, are proving more effective than previously forecast, the report said.

The trustees also cited lower-than-expected spending in “most . . . service categories — especially skilled nursing facilities,” a development that is not well understood. Costs have been slowing throughout the health-care industry, partly because of the recent recession, economists say, but also because of what appear to be more fundamental changes aimed at reducing waste and improving health outcomes.

This is particularly interesting when juxtaposed against the New York Times article on the pricing of colonoscopies:

A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.

………

But she noted that gastroenterologists in Austria do have their financial concerns. They are complaining to the government and insurers that they cannot afford to do the 30-minute procedure, with prep time, maintenance of equipment and anesthesia, for the current approved rate — between $200 and $300, all included. “I think the cheapest colonoscopy in the U.S. is about $950,” Dr. Ferlitsch said. “We’d love to get half of that.”

Dr. Cesare Hassan, an Italian gastroenterologist who is the chairman of the Guidelines Committee of the European Society of Gastrointestinal Endoscopy, noted that studies in Europe had estimated that the procedure cost about $400 to $800 to perform, including biopsies and sedation. “The U.S. is paying way too much for too little — it leads to opportunistic colonoscopies,” done for profit rather than health, he said.

The real problem here is that prices are are not transparent, and they are excessive to boot, being many times for routine procedures compared to the rest of the industrialized world.

The idea of market driven healthcare does not work, because there is no transparency in pricing, and even if there were, much of the time there is no opportunity to engage the market as a rational actor (auto accident, gun show wound, etc.).

It's why, even with its apparent benefits, Obamacare, does not address the core of the problem, which is that healthcare in the US is tremendously overpriced.