In article ,

The $400B figure is over 10 years. About 1/3 of that would be from
elimination of subsidies to private insurance companies for Medicare
Advantage (Medicare part C).
This BS. Everybody on the MCare Advantage would have to go elsewhere.
So a lot of this is transferring the same dollars around hoping people
get lost.

This is a insurance company subsidy used by
maybe 20% of Medicare recipients. I have not seen a clear explanation of
the rest of it. Fraud is a major Medicare problem. One of the ways
health costs, in general, can be reduces is by looking at 'best
practices', which is in the bill. It is highly unlikely there would be
major cuts to health care that is provided under Medicare. That simply
does not work politically. Reducing medical costs, in general, needs a
lot more work.


Everything I have seen indicates that the single biggest money batch
comes from changing Dr.'s and hospital reimbursments. Of course this is
also the largest part of "magic money". I call this magic money because
it is just supposed to appear. The major reason this is MM is because a
day or two before the bill passed with all of these"savings" in doctor's
payment the COngress voted to suspend a 30% cut in Dr's payments. The
reason it was so big was because that is the cumulated "cuts" since that
had not occurred since the "Sustainable Medciare Growth formula had been
passed in 1997, and overruled every year since.
(Another piece of irony, the SMG formula was part of the Balanced
Budget Act of 1997).
Reducing medical costs isn't a politically viable option. If
anything, the hooha around the healthcare bill last year shows that
EVERYBODY now not only views healthcare as a right, but an absolute
right to however they much that they want at no (unhidden) cost to them,

This is, of course, not taking place in a vacuum. How much would
Medicare be reduced if republicans got what they wanted? The only
concrete proposal I remember was from Paul Ryan which the CBO scored at
$650B/10yr cuts to Medicare (with Medicare becoming a voucher system).
That is, of course, a lot larger than the $400B that the republicans and
Fox were hyping.
In real life? Probably about as much as the Dems, meaning little or
nothing.


One of the Medicare changes is elimination of the "donut hole", a major
problem for some people.
But still a lot less than before with NO coverage whatsoever. Also,
if you followed the debate at the time, the hole was largely put in to
placate a couple of Democrats who were concerned about not "paying for
it".

--
"Even I realized that money was to politicians what the ecalyptus tree is to koala bears: food, water, shelter and something to crap on."
---PJ O'Rourke