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Federal aid programs expand at record rate

Old 03-17-06, 04:16 PM
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Federal aid programs expand at record rate

Republicans claim they favor smaller government.

Democrats accuse Republicans of cutting government spending on social welfare programs.

But take a look at this article.

http://www.usatoday.com/news/washing...tm?POE=NEWISVA

Federal aid programs expand at record rate

3/14/2006

By Dennis Cauchon, USA TODAY

A sweeping expansion of social programs since 2000 has sparked a record increase in the number of Americans receiving federal government benefits such as college aid, food stamps and health care.

A USA TODAY analysis of 25 major government programs found that enrollment increased an average of 17% in the programs from 2000 to 2005. The nation's population grew 5% during that time.

It was the largest five-year expansion of the federal safety net since the Great Society created programs such as Medicare and Medicaid in the 1960s.

Spending on these social programs was $1.3 trillion in 2005, up an inflation-adjusted 22% since 2000 and accounting for more than half of federal spending.
Enrollment growth was responsible for three-fourths of the spending increase, according to USA TODAY's analysis of federal enrollment and spending data. Higher benefits accounted for the rest.

The biggest expansion: Medicaid, the health care program for the poor. It added 15 million beneficiaries over five years to become the nation's largest entitlement program.

Not a factor: Social Security and Medicare. Those retirement programs will not see their enrollment explode until 79 million baby boomers start to become eligible for Social Security in 2008 and Medicare in 2011.

Programs that grew over the past five years are aimed at the under-65 population, especially families earning less than $40,000 a year. For example, the number of mostly low-income college students receiving Pell grants rose 41% over five years to 5.3 million.

Robert Greenstein, head of the liberal Center for Budget and Policy Priorities, says the growth in the number of people in many programs is due to a rise in the poverty rate from 11.3% in 2000 to 12.7% in 2004, the most recent year available. "It's certainly better that people falling into poverty can get Medicaid, but I'd prefer fewer poor people and employers not dropping medical coverage," he says.

Rep. Gil Gutknecht, a conservative Republican from Minnesota, says the number of people in entitlement programs should not be growing when unemployment is near a record low. "It's probably time to revisit food stamps and its goals and costs," says Gutknecht, chairman of the subcommittee that oversees food stamps. Food stamp enrollment climbed from 17.2 million in 2000 to 25.7 million in 2005.

USA TODAY found three major causes for soaring enrollment in government programs:

•Expanded eligibility: Congress has expanded eligibility for programs in ways that attracted little attention but added greatly to the scope and cost of programs. Congress added food stamp eligibility for 2.7 million people by ending a rule that disqualified people from receiving food stamps if they had a car or truck worth $4,650 or more. The change, one of a series of expansions in 2001 and 2002, was designed to make it easier for food stamp recipients to work.

•Increased participation: The government has made applying for benefits easier, prompting more eligible people to get them. Forms have been shortened, office visits reduced and verification streamlined.

•Welfare reform: 996 overhaul pushed millions of people off cash assistance and into the workforce. Congress expanded eligibility for benefits to support people with low-wage jobs.
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Old 03-17-06, 06:40 PM
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BEWARE: Anecdotes to follow....

Pell Grants are a good thing. I went to college on a Pell Grant. I took guaranteed student loans (the max) to pay my rent. I worked 35 hours a week at $3.35 an hour to eat (and drink ). I went to graduate school for free as an employment benefit.

With the manufacturing sector getting sucked dry, you either will be a "ditch digger" or a skilled worker. Seems logical to me we need to escalate the amount of people with education.

Medicaid is needed. My mother underwent one of the most invasive and costly cancer surgeries. Instead of dying a horrible death, she was able to live. If there is one social program we need, it is Medicaid. I'd add that my mother went to one of the finest hospitals in the country and was treated by a renowned surgeon. We did not encounter one bit of red tape. I'd also add that the benefit should be available to every American citizen.
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Old 03-18-06, 02:57 AM
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CRM I'm glad your mother is doing well.
I would add though, that the reason she was treated in one of the finest hospital and by a renowned surgeon was that they have other patients who don't have medicaid. Medicaid pays hospitals and doctors even less than Medicare. Hospitals would go out of business and have if the patient population becomes has a significant increase in their Medicaid and Medicare population. (Medicare typically pays around 20c for every $ charged and medicaid is even less).
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Old 03-18-06, 06:40 AM
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Democrats accuse Republicans of cutting government spending on social welfare programs.
that's becasue in the bizzarro world of gov't going from an 8% <i>increase</i> to a 4% <i>increase</i> is called a spending cut
I call it an increase. a smaller increase eys, but still an increase
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Old 03-18-06, 08:12 AM
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Originally Posted by mikehunt
that's becasue in the bizzarro world of gov't going from an 8% <i>increase</i> to a 4% <i>increase</i> is called a spending cut
I call it an increase. a smaller increase eys, but still an increase
If you were told to expect an 8% raise at work, and they only gave you 4%, what would your feelings on the matter be?
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Old 03-18-06, 08:16 AM
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If you were told to expect an 8% raise at work, and they only gave you 4%, what would your feelings on the matter be?
It is reasonable to continually expect an 8% annual raise at work though? W/ that said the real issue is not necessarily money, it's services provided by that money. So if the 4% increase still doesn't buy the level of service that last year's money bought then it is a cut. W/ that said though there is plenty of excess waste/fraud/abuse that can be cut out of the system, and that doesn't even get into the whole issue/debate about whether some of these programs should even really exist in the first place.
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Old 03-18-06, 11:05 AM
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Originally Posted by bhk
CRM I'm glad your mother is doing well.
I would add though, that the reason she was treated in one of the finest hospital and by a renowned surgeon was that they have other patients who don't have medicaid. Medicaid pays hospitals and doctors even less than Medicare. Hospitals would go out of business and have if the patient population becomes has a significant increase in their Medicaid and Medicare population. (Medicare typically pays around 20c for every $ charged and medicaid is even less).
I'm not sure I understand that last statistic. What do you mean by "every $ charged." The reason I ask is that I have private insurance and I sometimes get statements from the doctor and/or the insurance indicating that the doctor charges one price -- say $150 -- and the insurance company will only pay another price -- say $120 -- for that particular service. Are you saying Medicare only pays 20% of the $150 or 20% of the $120? If the former, do you know what private insurance pays on the dollar on average?
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Old 03-18-06, 12:03 PM
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Originally Posted by JasonF
I'm not sure I understand that last statistic. What do you mean by "every $ charged." The reason I ask is that I have private insurance and I sometimes get statements from the doctor and/or the insurance indicating that the doctor charges one price -- say $150 -- and the insurance company will only pay another price -- say $120 -- for that particular service. Are you saying Medicare only pays 20% of the $150 or 20% of the $120? If the former, do you know what private insurance pays on the dollar on average?
Medicare only pays 20% of the $150 charged by the doctor. With Medicaid there is no insurance company in the middle; it's just the doctor and the Medicaid. From what I've heard, private insurance typically pays somewhere about 60-70% but bhk probably knows more on that.
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Old 03-18-06, 01:33 PM
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I'm not sure I understand that last statistic. What do you mean by "every $ charged."
OK, let's say that I charge $500 for a procedure. Medicare pays $100. Medicaid pays even less. For hospitals, it's worse.
For example Mr. Otter is 89 years old and gets admitted to the hospital for pneumonia. Let's say it is regular community acquired pneumonia. But Mr. Otter is 89 years old and it hits him fairly hard and instead of a 4 day hospitalization, he needs 7 days. Medicare will only pay for the 4 days of hospitalization because for the diagnostic ICD-9 code for comm. acq. pneumonia, the medicare standard of treatment is 4 days hospitalization. Medicaid pays even less
Private insurance ranges from what medicare pays(20%-30%) to 90% of billed charges depending on the area, type of practice, and insurance. That's why I said that if everyone had medicare or medicaid, hospitals would be out of business.
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Old 03-18-06, 02:15 PM
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Thanks, bhk. That helps me understand. So basically, if a hospital or doctor bills $100 for a procedure, typically:

Medicaid will pay something like $10-$20 (or maybe less)
Medicare will pay somewhere in the neighborhood of $20
Private insurance will pay anything from $30-$90, depending on the insurer and the particular procedure and patient at issue

Is that basically right?
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Old 03-18-06, 02:32 PM
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Is that basically right?
Yes. Basically correct.
There is also variability for what all of them pay for office visits and consults(non-procedure related) and procedure related.
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Old 03-18-06, 02:38 PM
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Originally Posted by Jason
If you were told to expect an 8% raise at work, and they only gave you 4%, what would your feelings on the matter be?
It's still crap, because there is no incentive for the government entities to try to cut costs, in fact they benefit from spending every dime they can.

I belong to a local chapter of a wildlife conservation group and one of our members is also a member of the Mule Deer Foundation, which is a similar group which seeks to preserve lands for healthy animals, so we can shoot them. Anyway, they raised about $900 for a project that was to put basically water troughs in an area that the deer are. It was spring fed, so it just increased the amount of water that stuck around. They worked it through with the Forestry Service and Dept. of Wildlife. They provided all the labor and materials.

A week after getting the project done, a check for $3,900 shows up for the foundation from the Forest Service. They call them up and tell them there was a mistake, etc. Naturally they say there was no mistake, but they don't cash the check, because they figure it was a mistake and they will figure it out soon. A week later the Forest service calls and says there was a mistake with the check and asks them to bring it in. They do, and they take the check back and replace it with one for $3,400. After going around and around with them, they are told that the project qualified for some certain type of grant money they had, and if they didn't use it all, they would get that amount cut back the next year.

You see the same thing in schools and other publicly funded places as well. There is generally a mad rush to spend whatever you have left at the end of the fiscal year so that you don't get funds cut and can justify the increase you are asking for.
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Old 03-18-06, 05:06 PM
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Originally Posted by Jason
If you were told to expect an 8% raise at work, and they only gave you 4%, what would your feelings on the matter be?
That I got a smaller increase than expected, but I'd still call it an increase because it is
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Old 03-18-06, 07:50 PM
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Originally Posted by kvrdave
It's still crap, because there is no incentive for the government entities to try to cut costs, in fact they benefit from spending every dime they can.

I belong to a local chapter of a wildlife conservation group and one of our members is also a member of the Mule Deer Foundation, which is a similar group which seeks to preserve lands for healthy animals, so we can shoot them. Anyway, they raised about $900 for a project that was to put basically water troughs in an area that the deer are. It was spring fed, so it just increased the amount of water that stuck around. They worked it through with the Forestry Service and Dept. of Wildlife. They provided all the labor and materials.

A week after getting the project done, a check for $3,900 shows up for the foundation from the Forest Service. They call them up and tell them there was a mistake, etc. Naturally they say there was no mistake, but they don't cash the check, because they figure it was a mistake and they will figure it out soon. A week later the Forest service calls and says there was a mistake with the check and asks them to bring it in. They do, and they take the check back and replace it with one for $3,400. After going around and around with them, they are told that the project qualified for some certain type of grant money they had, and if they didn't use it all, they would get that amount cut back the next year.

You see the same thing in schools and other publicly funded places as well. There is generally a mad rush to spend whatever you have left at the end of the fiscal year so that you don't get funds cut and can justify the increase you are asking for.

we used to do this in the army

last day of september was crazy shopping day with the Army Corporate VISA card for junk that people would take home or would sit in the closet. Just because we had to get rid of the money.
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Old 03-18-06, 08:23 PM
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Sounds like a very convenient taxpayer scam to me.
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Old 03-19-06, 12:39 AM
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Originally Posted by mikehunt
That I got a smaller increase than expected, but I'd still call it an increase because it is
But that's not what he asked you. He asked what your feelings would be. Would you be happy or unhappy about it?
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Old 03-19-06, 09:32 AM
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This article doesn't tell us anything about the number of people who became uninsured during the last 5 years. A 17% increase in Medicaid enrollments might be quite paltry compared to that number.
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Old 03-19-06, 09:40 AM
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Originally Posted by JasonF
Thanks, bhk. That helps me understand. So basically, if a hospital or doctor bills $100 for a procedure, typically:

Medicaid will pay something like $10-$20 (or maybe less)
Medicare will pay somewhere in the neighborhood of $20
Or maybe (probably) more
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Old 03-19-06, 09:59 AM
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Or maybe (probably) more
Uh, no, those figures are about right(give or take 5-10% depending on the service being charged for)
We update our charge schedule yearly and get a reimbursement schedule from medicare and medicaid yearly.
But that's not what he asked you. He asked what your feelings would be. Would you be happy or unhappy about it?
He should be happy he's getting a raise. I would.
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