Medicare’s chief actuary Richard Foster has been a thorn in the side of both Republican and Democratic Presidents.

Back in 2003 he got on the Bush administration’s bad side by turning in an estimate of Bush’s Medicare prescription-drug program — then the largest new entitlement in a generation — that was significantly higher than the White House’s estimate. For that he was threatened by Medicare administrator Thomas A. Scully with termination for insubordination. The administration withheld Foster’s estimate until Congress had passed the bill.

During the recent debate over ObamaCare in Congress, Foster issued a report stating that national healthcare spending would rise by $222 billion over the next 10 years if ObamaCare became law, noting also that if coverage were to begin immediately instead of in 2014, the spending increase would be much higher. He also pointed out that the new long-term care program, used to make the balance sheet look better in ObamaCare’s early years because it will collect premiums for five years before paying any benefits, would likely be bankrupt by 2025.

Foster’s latest salvo against expanded healthcare entitlements, described by the Wall Street Journal as “the most damning fiscal indictment to date of the Affordable Care Act,” comes in the form of an appendix to the annual Medicare trustees report — the report that Democrats are hailing as a vindication of ObamaCare because it seems to indicate that passage of that legislation has improved the outlook for Medicare.

However, as Foster explains in his appendix, the body of the report is unrealistic because it is premised on the law as written as opposed to what will actually happen in the real world. In other words, the main body of the report is bunk designed to make the law’s supporters look responsible. Foster recommends instead an “alternative scenario” drawn up by his office using more realistic assumptions.

In his alternative scenario Foster demolishes the notion that there are any real Medicare cuts in ObamaCare (aside from those in Medicare Advantage, hated by Democrats because it involves the private sector). The alleged cuts, writes the Journal, “exist only on paper and were written so they could pretend to reduce the deficit and perform the miracles the trustees dutifully outlined.”

The paper continues:

One of the fictions Mr. Foster highlights is the 30% cut in physician payments over the next three years that Democrats have already promised to disallow. Republicans would do the same, we hasten to add.

Another chunk of ObamaCare “savings” are [sic] due to cranking down Medicare’s price controls for hospitals and other providers that Mr. Foster says are also “extremely unlikely to occur.” In the absence of “substantial and transformational changes in health-care practices” — in other words, a productivity revolution in medicine that has never happened — costs will simply rise for private patients, or hospitals will refuse to treat seniors insured by Medicare. Congress will never allow that to happen either.

In other words, under ObamaCare the “cost curve” will not be bent as the White House has advertised.

Is anyone surprised?

Foster also estimates that Medicare’s share of the economy will grow by 60 percent over the next 30 years, as opposed to the 35-percent increase estimated in the trustees report. Either way is disastrous, but Foster’s is even more so.

“Politicians have deliberately written the ObamaCare rules, as they have for all entitlements, so the real costs are disguised and hard for taxpayers to figure out,” concludes the Journal, which then calls for Foster to receive some sort of recognition for his honesty in the face of such political pressure. Perhaps the best recognition Foster can receive, however, is being hated by both political parties. He must be doing something right.

Photo of Richard Foster: AP Images

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JohnMD said:

over 500,000 Doctors Against Obamacare When I made the decision to become a physician, I wanted to dedicate my time and life to providing the best and most compassionate care possible. After receiving a bachelors in science (4 years), I went to medical school (4 years) and residency (5 years). These 13 years of my life was dedicated to developing my mind so I could provide the best care possible. So how does our President describe my physician colleagues and I? He states that instead of doing what’s best for the patient, we look at reimbursements to decide patient care. He states we do unnecessary tonsillectomies for a “sore throat” to make money (youtube video: Obama- Doctors taking tonsils out for money). My patients come first and I am dedicated to their best interest. I would never perform an unnecessary surgery.

August 09, 2010

JohnMD said:

over 500,000 Doctors Against Obamacare Also, the President stated we make $50,000 for an amputation. For an amputation for diabetes, medicare will reimburse $879.21. No surgeon makes $50,000 as the President stated (youtube video: Doctors Choose Amputations because Surgeons Get Paid More). In fact, malpractice insurance can be 50K, sometimes more. It’s embarrassing that our own President does not have correct information on how the billing in our health care system works. Does he even understand our health care system? If we truly want health care reform, why are we not focusing on tort reform or adjusting malpractice insurance rates? These factors make significant contributions to the cost of health care.

August 09, 2010

JohnMD said:

over 500,000 Doctors Against Obamacare I understand the President’s point- prevention of medical complications is important, but I do not agree with his slander of physicians and the misinformation he gives the American people. I strongly oppose Obamacare because I do not want the government interfering in my relationships with patients. When I look at government run systems (inefficient DMV and Postal Service, mismanaged funds of Social Security), I cannot trust the government to manage something so important as healthcare. Do you? If you want to learn more about over 500,000 doctors against Obamacare and the healthcare reform we hope to achieve, please search “Docs4PatientCare.” The majority of polls the last year, physicians, Americans in general are opposed to the (Patient Protection and Affordable Care Act) Obamacare legislation. The legislation will act to decrease the influence of physicians over time and promote non-physician 'extenders.' Non-physician 'extenders' are -- nurses, nurses that get doctorates in nursing (not doctorates in medicine) & introduce themselves to patients now as “doctors”, physician assistants, techs performing the roles of medical doctors. Nurses with doctorates in nursing have 4 years college and 2-3 years post-grad school vs Doctors of medicine have 4 years college, 4 years medical school, 3-7 years residency, and possibly 1-2 years fellowship training. We’re talking about 2-3 vs 7-13 years of post-graduate education and training differences. We want to preserve the patient-doctor relationship and not have it become patient-government, patient-tech, patient-nurse. Who do you want leading your healthcare team and managing your health?

August 09, 2010

R Jensen said:

ObamaKare I find "global warming" more believable than the claim that the "Affordable care act" will save money.

August 09, 2010

Patriotson said:

Obama's lie and Congresses corruption Obama touted the socialized medicare as cost savings oriented yet not one thing in the final bill cuts the cost of medical services mandated by the bill. Americans are already receiving notices from insurers that medical practices are being revised and dropped because of the new law. Premiums are increasing and services are being reduced. What is there that makes the American people want to support this corrupt law? Nothing! Congress lied; Obama lied therefore neither can be trusted to impose healthcare upon a people who do not want it. Vote buying; backdoor deals; hidden taxes; reduced medical services; higher national debt does not endear the American voter to Obama or to this congress.

August 10, 2010