[lbo-talk] Putting the schizzle in the dialectizzle

Jim Westrich westrich at nodimension.com
Wed Mar 16 11:20:44 PST 2005


Quoting "Max B. Sawicky" <sawicky at bellatlantic.net>:


> New, from moi:
>
> http://www.epinet.org/content.cfm/bp156
>
> http://online.wsj.com/public/article/0,,SB111089397931779810,00.html

The debate at the Wall Street Journal was both informative and entertaining (Tyler's hyperlinks to "evidence" were very entertaining).

I have not read your EPI budget piece yet but I think I have some thoughts on the Medicare part. While I still have some thinking and evidence gathering to do on the future of Medicare, there is a fundamental demographic flaw in all arguments about Medicare's future. One that was incorrectly argued for at least 40 years and fueled 40 years worth of incorrect projections of the future--that is that health spending on people as they age is both increasing (true) and that this gradient is fixed over time in future projections (FALSE FALSE FALSE!).

The point is that a future projection looks at how much 75 year-olds cost now (which is more than 74 year-olds) and project that onto a future (with loads of health care inflation which is the real issue) where there are more 75 year-olds. Well, 20 years from now (adjusting for inflation) 75 year-olds are going to cost a lot less than today's 75 and 74 year-olds.

There is also the "Fries Effect" (after the underappreciated observations of James Fries for at least 25 years) about the "compression of mortality" which if properly accounted for statistically would actually decrease the health care spending as society ages. The problem is that health care inflation is so large that it swamps a lot of the underlying trends. Thus, forecasting higher costs to the future due to aging AND health care inflation is a fancy form of double counting.

Jim

"the love i know to take for granted don't try to count the stars "

-It's Jo and Danny!



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