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42 IRET Congressional Advisory 1 (1995)

handle is hein.taxfoundation/iretcgadv0040 and id is 1 raw text is: May 16, 1995 No. 42
MEDICARE: CRISIS AND
OPPORTUNITY
Medicare faces two crises. First, Medicare Part
A, Hospital Insurance (HI) will run short of
spending authority in 2002, when its trust fund dries
up. Second, even if HI were
patched up, Medicare does not
serve the public well.   If    It is impossib
continued in its present form,  federa  budg
Medicare    will   become      dealing  with
ruinously   expensive   for    reform of Med
workers and retirees. It will  everone's
continue to drive up health    proiding be
care costs. It will force higher  protection ai
payroll   taxes,  impeding
people's ability to save for
their  retirement   needs,
including long term health care for chronic illness or
age related frailties not covered by Medicare.
Medicare    cannot    continue   without
Congressional action. HI is already running deficits,
and is only being kept current in its payments to
hospitals by general revenues from the Treasury
redeeming the trust fund.   When the fund
vanishes, payroll tax receipts increasingly will lag
behind accumulating bills. HI will have to delay
payments to providers for longer and longer periods,
incurring ruinous, escalating interest penalties, and
cash-strapped providers will begin refusing service
to the elderly. Something must be done just to keep
the program afloat.

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It is impossible to deal with the federal budget
deficit without dealing with HI and Medicare Part B
(Supplemental Medical Insurance (SMI), covering
physicians' charges and outpatient treatment). The
projected deficits (outlays less tax and premium
income) in HI and SMI account for $158 billion, or
70%, of the total federal budget deficit of $227
billion in FY2002.
Outlays for HI will exceed payroll tax revenues
and other non-interest income by $6 billion in
FY1995, rising to $44 billion by FY2002, a $35
billion jump.
Only about 30% of SMI outlays are currently
covered by premiums paid by the program's
enrollees. The remaining 70% of SMI outlays are
paid for by taxpayers as a direct subsidy from the
Treasury. Premiums will fall
to  25%  of outlays under
deal with the     current law next year, and to
ficit without     19% by 2002, with taxpayers
licare.   Can     making up the difference. The
be turned to      taxpayer subsidy is set to
t,  eventually    explode, from $47 billion in
ire and better    FY1995 to $114 billion in
cost? Yes.        FY2002, a $67 billion jump.
Furthermore,     these
FY2002 Medicare deficits are
only the beginning.  The combined Medicare
deficits are projected to reach $400 billion a year by
2010, and $1 trillion a year by 2020 as the baby
boom generation begins to retire.
The House and Senate Budget Committees'
1996 Budget Resolutions each call for significant
deceleration of Medicare's outlay growth. These
proposals have  been   severely  criticized  as
balancing the budget by slashing medical care for
the elderly. Medicare is not being sacrificed to
eliminate a budget deficit originating in other areas.
These programs ARE the budget deficit.  The
Bipartisan Commission on Deficit and Entitlement
Reform made this point loud and clear. The only

Institute for
Research on the
Economics of
Taxation

IRET is a non-profit, tax exempt 501(c)(3) economic policy research and educational organization devoted to informing the
public about policies that will promote economic growth and efficient operation of the free market economy.
1730 K Street, N., Suite 910, Washington, D.C. 20006
Voice 202-463-1400 * Fax 202-463-6199 0 Internet www.iret.org

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