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Author Topic:   Health Care Policy ( for now) (for the future ) (your best observations )
Posts: 1111
Joined: 12-22-2015

Message 1 of 4 (810385)
05-29-2017 3:53 AM

I was just thinking about "free stuff" and what it means.

The cost to the nation.

The cost to the states.

I thought of Medicaid.

It has historically been "free" in the "free stuff" kind of way.

And it covers over 74 million people (close to 23% I suppose)


I know that Medicaid costs the federal government $389 billion a year.

But that is only going to be a bit more than 60% of the total cost since states pay about 40%

The total cost ( which I don't know ) will be about $250 billion more.

The number will be around $650 I suppose.

(conservatives claim that the Medicaid payments only cover 89% of the actual costs that the program pays, so that disputed claim complicates matters a bit, so be aware )

(Medicaid payments are ironically higher for the same prescription drug than the insurance companies pay )

We see the total cost now .


I got to thinking about the states that had the most "free stuff".

I already know that West Virginia has the most Medicaid recipients.

29% in West Virginia are on Medicaid.

So how is the tax situation there at the local level?

This link says they are among the lower half. It is The Register Herald of Beckley W. VA.


Here is a conservative source.

A quote from the latter


The Mountaineer State's overall tax burden is about average

My observations are going to be obvious to many .

The state that has about the most unhealthy people - on endless measures - , and the seemingly most poorly endowed finances (low incomes for a tax base ), nevertheless, finds itself able to fund its Medicaid program costs without some bloody apocalyptic blowout of its treasury. With not having too many noteworthy fiscal issues if any (the situation seems very noneventful really ).

I might add that there doesn't seem to be a flood of Virginia emigrants flocking to West Virginia for the "free stuff " fwiw.

( I will work in my FEDERAL GOV OBSERVATIONS now )

Yes the federal government pays its typical 60% as is standard ( a bit more with the Obama expansion ), but this poor state funds its state employed workers insurance plus it's Medicaid receiving legions.

Speaking of which, the federal costs are $389 billion a year.

About 2% of GDP, though state costs bring it up to 3% and some change.

Make it 3.5% if you factor in the conservative claim that it only pays 89%

This means that 23% of the nation on "free stuff" is 3.5% of GDP.

The VA covers another 2-3% so we only have about 74% to go.

The most expensive of the rest are the elderly and they get the vast majority of their bills already covered by Medicare and ( ironically ) Medicaid.

I don't see the scary math here.

I just don't.

Any of your observations? On anything else?

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Message 2 of 4 (810399)
05-29-2017 7:51 AM

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Posts: 1111
Joined: 12-22-2015

Message 3 of 4 (814128)
07-04-2017 4:55 PM

VA has 8 million on "free stuff" while Medicaid is 74.5 million (low price? )
I pointed out that the federal government payments for Medicaid were $389 billion a year (which happens to be no so different an amount as the $71.5 billion increase in annual military spending Congress just proposed added to the Trump tax cut proposals ) but I overstated the states bills a bit.

The current cost from the Federal Government plus the states is just under $600 billion a year (not $650 billion! ).

And the latest news I read has 74.5 million on the program.

The VA has around 8 million on its health care.

So 82 million on free stuff which is about 25% of the population.

One way or another, the government will pay roughly half of the rest of the costs.

Employers pay alot too.

The private insurance companies have a MLR measurement (which they share to get investors )that enables us to see that they add about 25% to the cost of healthcare. Getting rid of the insurance companies will nock almost 20% off of the private insurance portion of the health industry costs. It would be around 10% lower costs for our entire combined national bill. Instead of 17.3% of GDP, we could be at 15.5% with a single payer plan.

Employers and the government already pay for over 75% of the 17.3% already so that is 13% of GDP in costs.

Californian is going to need $400 billion dollars to fund a free stuff single payer system but $200 billion can be taken from existing state and federal government programs to place in a big pot, so that requires $200 billion new funding to fill the void or close the gap. Employers pay alot already. Individuals pay alot just in premiums already.

California is just about 1/8 of the population of the country so $200 billion times 8 would be $1.6 trillion for the whole nation to pay for a giant single payer system ( and one that doesn't have ruinous price controls ).

We need to see what the average employer pays then ask what the total dollar amount nationwide is in employer costs.

What is it that the average person spends on premiums then what is the total national dollar amount individuals spend total just in premiums.

I wonder what that would be compared to the $1.6 trillion in new funding needed.

Then the co pays and deductibles need to be looked at for all Americans.

I know that the end number would be 17.3% of GDP verses 15.5% but I still wonder how close we would come in the steps before the last one above. Before the co pays and deductibles, I wonder how much lower than 15.5% it really is.

Posts: 1111
Joined: 12-22-2015

Message 4 of 4 (814253)
07-05-2017 12:07 PM

Beware of the anti Medicaid propaganda (like Committee for Responsible Federal Budget
Marc Goldwein heads this fiscal watchdog group.

He says that Medicaid is unststainable as do most commentators.

But I should point out that Medicaid is only 2% of GDP if you look at the federal government spending (which is fair enough to look at absent the additional 1% of GDP that the states spending adds BECAUSE the states portion is mostly optional spending that the respective states have decided on via much deliberation ).

Federal Medicare spending is 3.1% of GDP.

Now look at the 30 year projections that all sides agree as an accurate analysis of 2047 spending projections.

Medicare will go from 3.1% of GDP to 6.1% of GDP spending funded by the Federal Government.

Medicaid cost will be up to 2.7% from the 2.0% today.

So this program will cost (2017 dollars are the index I use ) another $140 billion per year in 2047.

And the people covered will actually be around 100 million as opposed to 74 million today. Infact by 2026 ,Medicaid is projected to cover over 85 million. Interesting that over two decades later, the cost will be in a pretty manageable condition.

Remember that the Congress just proposed a $72.5 billion increase to yearly military spending ($71.5 was an incorrect amount I posted above ) and that says nothing of the endless increases that will likely be proposed in addition over the next 29 years.

If Federal Medicaid costs are so out of control (according to popular propaganda ) with a $140 billionyearly increase gradually reached by 2047, then a sudden $72.5 billion military increase should really make us talk about the need to make defense cuts to get control of an out of control spending situation.


Check out the June 27, 2017 USA Today article by Dhruv Khullar and Anupam Jena

Medicaid cuts would hurt more than help

The article mentioned a 2015 study that compared poor children both covered AND not covered by Medicaid, then found that the benefits of children covered (verses not being covered ) would, by the time they reached 60, would bring back half the Medicaid cost just in higher tax payments alone.

Plus a new Commonwealth Fund study shows that the Congress bill cuts would cause 1 million jobs to be lost by 2026, with Gross State Products decreasing by $93 million each, and business output dropping by $148 billion. 47 states would suffer lost jobs.

A 2014 study showed that Medicaid children have a 4%-6% lower dropout rate in highschool and a 3% higher four years college graduation rate.

The studies understate the benefits of the FREE STUFF healthcare benefit. Medicaid is pretty difficult to remain on and requires lots of endless signing up and difficult eligibility examinations. A Canadian style single payer (with no signups and absent the difficult eligibility requirements ) would multiply benefits many times the Medicaid program offers ( plus the approved coverage in the Canadian system doesn't become worthless once a state border is crossed ).

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