If there's one thing that the Disease Management Care Blog has learned over the years, it's never ever second-guess an actuary. When those brainiacs measure and monetize future risk using today's dollars, it's their job to be prudent, morose and unsympathetic. While their forecasts may not be perfect, their methodologies have enabled modern society to financially withstand small mishaps and huge disasters. We mess with that process at our peril.So when Medicare's Chief Actuary Richard Foster says the ACA wont bend the cost curve, the DMCB listens. The White House, on the other hand, has decided to blog, pointing to a letter signed by nearly 250 Nobel laureates, former Council of Economic Advisors members, one former Congressional Budget Office chief, high ranking economists and budget experts who "disagree."
Aside from the truism that one actuary always beats 250 experts, the DMCB is surprised that the White House hasn't learned from what the State Commissioners do when they are vexed by bad news about premium adequacy: they double down by hiring their own highly qualified actuaries to render nominally independent opinions. The Administration's failure to fight fire with fire makes the DMCB wonder if enough people in the White House really understand just how insurance works.
Speaking of government incompetence, you know it's getting pretty bad when the pro-reform Kaiser Health News allows this critical Michael L. Millenson opinion piece to see the light of day. Michael is shocked, shocked that the Medicare Physician Compare web site is failing to exceed consumer expectations! Alas, the DMCB predicts this won't be the first disappointment for its pro-government enthusiast friends who need to really ponder whether any government bureaucracy is capable of handling what is on this chart. If they still naively think it's all just going to come about because a law says so, the DMCB has a Medicare Health Support pilot that it would like to sell them.
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