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Behind the Medicare Numbers

Last update on: Feb 02 2017

Each year the trustees of Social Security and Medicare issue a report. The main focus of the report is the financial condition of the “trust funds.” In recent years one of the public trustees, Charles Blahous, wrote his own summaries of the annual reports with an emphasis on the points he believes are important. Not surprisingly, he believes most media reports emphasis the wrong points or misinterpret those points. Here’s his latest review of Medicare.

His main point this year is that the media overstated the improvement in the program’s finances and the benefits of the recent reduction in the growth of medical costs. But the program isn’t going to go bankrupt, because the law requires contributions from the government’s general taxes to make up for any shortcomings in the program’s funding. So, the pressure really is on the federal government’s budget, not on Medicare.

There is no reason to believe that the recent reported slowdown in health care cost growth will improve the long-term picture significantly relative to current projections. At our press conference announcing the release of the trustees’ report, I was surprised to hear questions asking in effect whether a recent slowdown in health care cost growth might have a significant effect on the outlook and debate surrounding the Medicare program. To my ear the questions reflected an incomplete understanding of the factors underlying current projections. It would be mistaken to conclude that the recent slowdown in health care cost growth (partially though not wholly attributable to the recent recession) should relax pressure for much-needed Medicare reforms.

It’s important to understand that our long-term projections already assumed a substantial slowdown in health care cost growth relative to historical rates. This is because the projections are based on demonstrated trends in the elasticity of health care cost growth – in layman’s terms, how much people’s health care consumption patterns change as a result of factors that include health care prices, income levels, and insurance coverage. To put it more crudely, we have never expected that historical rates of health care cost growth will continue to the point where health care services absorb our entire economy. We are not going to have a society in which we are all walking around homeless, naked and starving but with impeccable health care.

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