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Medicare’s money problems in pictures

November 28, 2012 in health care costs, Medicare

Another great infographic from the Kaiser Family Foundation (published in the Journal of the American Medical Association this week).

4 responses to Medicare’s money problems in pictures

  1. The chart you have reprinted from the Kaiser Insurance Company foundation by way of JAMA is grossly misleading in a variety of ways. It is so unfortunate that people cannot have a meaningful debate in today’s highly partisan atmosphere because companies such as Kaiser would rather twist statistics in this way for whatever reason:

    1. The top row is a variety of basically meaningless slanted cuts of rather obvious data. For example

    A. When the chart shows that 50% of Medicare beneficiaries have less than $22,000 in income it fails to tell your readers that 40% of Medicare beneficiaries are over 75 years old and made much less income in their working lives than people think of as a “good income” today. Nor does it mention that the statistic does not account for couples. This statistic also does not take into account that Social Security (the source of the statistic) does not count income from all sources nor does it factor in money used in retirement from savings accounts (you know, the way you’re supposed to do it; save for retirement). Not to bore you with the tricks of being a senior citizen but our ideal situation is to have no income (so as to pay no taxes); unfortunately we cannot achieve the ideal without turning down SS (and if we turn down SS, we can’t get Medicare)
    – There is no question that many of us have multiple chronic conditions including cognitive impairments. It sucks to be old except for the alternative. But we aren’t so cognitively impaired as not to see through these statistical tricks: cognitive impairment is one of the chronic conditions but Kaiser shows it twice (and there are a lot of people who disagree with the 23% statistic but I won’t; like I said, it sucks to get old).
    – What an odd way for an insurance company to express the 80/20 rule. Kaiser says 10% of beneficiary account for 57% of spending. Yeah, what’s the point? Was the person who put together these illustrations trying to explain the basics of how insurance works?

    2. The next row of Kaiser data is also kind of meaningless. Except for home health care, those statistics are probably the same as for the general population. But look at how Kaiser misleads the reader, showing an ambulance for ER visits when the vast majority of ER visits are walk ins. You also need to find out if the “inpatient” hospital stay statistic was for an admitted stay or someone in there for observation which is really outpatient from Medicare’s point of view.

    3. The pie chart is the most seriously misleading illustration of statistics by Kaiser, apparently (based on the use of the word “balancing… fair payments to providers and plans) intending to further the attack on Part C Medicare Advantage plans. (Just guessing here but probably the Kaiser insurance company doesn’t have a big share of the Part C business in its territory.) You’ve heard of mixing apples and cherries. This is an example of mixing slices of apple pie and cherry pie. Managed care is a type of payer; all the rest of the slices of the pie are to providers. Why would Kaiser mix them in one illustration other than to deceive readers? Kaiser apparently wants the reader to think that the managed care insurance companies that administer Part C Medicare health plans (in Massachusetts they are pretty much the same companies that administer all other kinds of healthcare insurance plans) take the money and jet off to Rio. What the Part C insurers actually do with the money is pay the 22% of spending in its slice of the pie to all the providers in the rest of the pie on behalf of Part C Medicare beneficiaries. But telling the reader that would ruin the apparent Kaiser propaganda message.

    4. The middle bar chart to the right of the pie chart is the second most decrepit deception in this totally biased piece of information. Notice that it supposedly measures Part B and D out of pocket spending for 2000, 2010 and 2020, showing a huge increase from 2000 to 2010 and flat spending from 2010 to a projected number in 2020. Of course Kaiser does not mention that there was no Part D in 2000. That’s pretty dishonest, don’t you think?

    5. The deceit in the lower left arrows is the so-called slower growth in the Medicare vs. private insurance projected over the next 10 years. Well of course that’s the case. The Patient Protection and Affordable Care Act fixes the growth of Medicare spending at 1% over GDP (or .5%, I’m not sure). I can’t even understand why the illustration has Medicare spending growing as fast as the chart shows (perhaps it’s not per capita growth but also takes into account a growing Medicare base?) Whatever, private healthcare prices have to increase to make up the difference

    All in all, a pretty disappointing effort by Kaiser for whatever purpose. Equally disappointing that you and Jama published it.

    • I absolutely did not deny the WHO data, I smpliy put it into context. Their data may in fact be correct, but it’s not complete, and that’s missleading. I didn’t add that just to argue. Again, the additional information I provided is critical to this discussion.Anyway, I’ll end by saying, I like how you avoid the substance of my posts, ignore the concernes I’ve brought up, and make generalizations instead.

  2. You don’t seem to understand the bill, dear. No one is ofeirfng socialized medicine. The government doesn’t control hospitals or pricing. Pricing is controlled by the hospital administrators and HMO’s. You should really read the bill instead of freaking out about issues not included or suggested.

  3. High Risk Insurance Pools – Some states can decline health insurance applications if you have a pre-existing medical condition. However, many states offer health plans that are similar to the coverage in comprehensive individual health insurance plans. :^..,

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