Medicare Reporting: Fill & Download for Free

None. The places where we have policies that are actually somewhat socialist — the Post Office and Medicare are examples that come readily to mind — they generally work more efficiently and do more things than their “capitalistic” competition. The USPS will deliver a letter anywhere in the US in a few days for fifty cents, and Medicare’s overhead is tiny compared to any private insurer. People insured by Medicare report higher satisfaction than any private insurer.If anything, we need to identify more situations where the market does not work particularly well (such as the rest of the health insurance market) and add a bit more socialism to them.

I'll talk a little about where I've had first/second-hand experience:Medicine.In the medical industry, running Medicaid/Medicare reporting is often excruciatingly slow and error-prone, and medical records are very difficult to share between hospitals or even doctors.Finance.Addepar is working on a small segment of the latter problem: in the RIA industry, an advisor's primary goals are to (a) manage the money well and (b) clearly show the client what's going on with their money. The technology for (b) is woefully outdated.In general, any industry for which a tech upgrade would massively disrupt their business is unlikely to adapt quickly to technological change.

Let’s dig into this topic a bit.You didn’t supply a link, but I found a quote:“I think it’s pretty safe to say that entitlement changes, which is the real driver of the debt by any objective standard, may well be difficult if not impossible to achieve when you have unified government…”McConnell Blames Entitlements, Not GOP, for Rising Deficits“by any objective standard”. Hmm. Objective standards would presumably include data from the Social Security Trustees, or the Congressional Budget Office. Let’s see what we can find. Luckily, the federal government’s spending is still largely transparent, so anyone with an Internet connection, a bit of time and patience, and a modicum of analytical skills can check for themselves.“Entitlements” are GOP-speak for mandatory, non-discretionary federal spending. These programs lie outside the annual federal budget, and include Social Security and Medicare. Both of these are funded by payroll taxes, which at times provide a surplus, and other times a deficit.I thought the Social Security annual report might come in handy:In 2018, Social Security’s reserves were $2.9 trillion at the year’s end, having increased by $3 billion.So there are reserves to cover SS payments today. Excess funds are invested in interest-backed securities, according to federal law, and the interest payments on these securities have an impact on the deficit, but those interest payments in 2017 totaled about $93 billion. (More on this later.)The projected depletion date for the combined OASI and DI funds is now 2035, one year later than in last year’s report.In other words, projections are that including current and projected payments, current and projected revenue from payroll taxes, and the size of the current ($2.9 trillion!) fund, Social Security will be solvent until 2035, 16 years from now.Explain to me how an “entitlement” program that is funded for the next 16 years impacts today’s deficit? I’m scratching my head over that too.But that’s just one program, let’s look at Medicare:The Trustees project that the HI Trust Fund will be able to pay full benefits until 2026, unchanged from last year’s Medicare report.So Medicare will run out a bit sooner, but still has 7 years left. Medicare is of course impacted by the high costs of health services in the US, just as private insurance is.Let’s look at projected Medicare and Social Security deficits, as of 2007:Expenditures in the United States federal budget - WikipediaSo by 2019 we are supposed to be drawing $100 billion or so from those trust funds. Plus, we are making those interest payments noted earlier ($93B in 2017). Compare that to deficit spending:US Federal Deficit by YearAre you missing the “objective” correlation of those charts? Yeah, me too. I’m struggling to see correlation or causation, frankly. Besides, Social Security and Medicare are both funded from trust funds today, and the 2017 interest payments into these are $93 billion, or about 13% of the 2017 federal deficit.Ask McConnell where the other 87% of the deficit came from. I wonder if he has an “objective” explanation for that?A couple possible explanations I can see:Either McConnell doesn’t understand these facts at all, in which case he isn’t fit to serve the public in his capacity as Senate Majority Leader, orMcConnell is lying, perhaps to deflect attention away from other federal spending, or perhaps to try to build public support for entitlement reform. I’m honestly not sure which.In short, to answer the question:Do you believe Mitch McConnell that rising deficits are the fault of entitlements…I don’t “believe” him in the sense of taking him at his word, no. Because I don’t agree with his easily falsifiable statements.I believe that McConnell might think that is true himself. But more likely, I believe that McConnell is a partisan politician who has made a career of making statements designed to bolster the standing of his political party.Facts here are less important than political results, quite simply.That said, sooner or later we’ll want to talk about what to do after 2026. As the baby-boomer generation retires, we have more claims than ever, and people on average are living longer. These both stress the funds.Ideas I have heard include:Raise the age of retirement (squeeze more productivity out of the American worker!)Privatize social security, moving the funds to higher-yielding (riskier!) investmentsEliminate Medicare (but replace with what, exactly?)Or the IRS could eliminate the maximum withholding cap. In 2018, only the first $128,400 of annual earnings were subject to social security withholdings. In 2019, this cap was raised to $132,900. Presumably moving this cap reflects inflation, but it also increases contributions to social security.Why not eliminate the cap? This would impact the highest wage earners, but would ensure the fund is intact.Another idea—raise the federal minimum wage. The more people earn, the more they contribute to both social security and medicare.