Hospitals & Asylums
March 2016
By Anthony J. Sanders
Social Security
Amendments of January 1, 2016 HA-7-2-16
Retroactively Free DIRT (Disability Insurance Reallocation Tax)
and 3% COLA (Cost of Living Adjustment) Act of January 1, 2016
To amend the DI tax rate from 1.80% to 2.40% in 2016, 2.30% in
2017 and 2.20% in 2018; from 0.90% to 1.20% in 2016, 1.15% in 2017 and 1.10% in
2018 for employees and from 0.90% to 1.20% in 2016, 1.15% in 2017 and 1.10% in
2018 for employers under Sec. 201(b)(1)(S) of the Social Security Act
42USC(7)II¤401.
To amend the OASI tax rate from 10.60% to 10.0% in 2016, 10.10% in
2017, and 10.20% in 2018; from 5.30% to 5.00% in 2016, to 5.05% in 2017, to
5.10% in 2018 for employees under 26USC(C)(21)(A)¤3101 (a) and from 5.30% to
5.00% in 2016, 5.05% in 2017, and 5.10% in 2018 for employers under
26USC(C)(21)(A)¤3111 (a) to avoid depletion of the Disability Insurance (DI)
Trust Fund in 2016 without increasing the overall 12.4% OASDI or 15.3% OASDI
and Hospital Insurance (HI) Federal Insurance Contribution Act tax-rate under
26USC(A)(2)¤1401.
To legislate a 3% annual COLA at Sec. 225(i) 42USC425(i)
retroactive to January 1, 2016 under Sec. 204(c) 42USC¤404(c) and a minimum
wage of 'not less than 3% annual growth, rounded to the nearest nickel, from
$7.50 an hour in 2016, to $7.75 in 2017, to $8.00 an hour in 2018 etc. under
29USC¤206(a)(1).
To legislate a new voluntary 1% United Nations social security tax
on personal and corporate income, even poor social security beneficiaries could
pay or cease to pay by checking a box and filing a 1040, that would pay cash
benefits to the worldÕs poorest people.
To amend Annual Reports Sec. 1161 of Title 11 of the Social
Security Act 42USC(7)XI-B¤1320c-10 so that the Commissioner of Social Security
will sign a combined Federal OASDI Trust Fund and SSI Program Report and the
Administrator of CMS would sign a combined Annual Report on the Federal
Medicare, Medicaid and Affordable Care Act (ACA) (Medicaid nationalization from
2015?) by June 20th for perennial Summer Solstice issue beginning in
2016.
Be it enacted in the House and Senate, Assembled
Without Income Limit Law (WILL)
To abolish the maximum taxable limit on DI contributions on
January 1, 2016 and OASI contributions January 1, 2017 and repeal Adjustment of
the contribution and benefit base Section 230 of the Social Security Act
42USC(7)¤430.
To require the Social Security Administration to pay for SSI Costs
beginning January 1, 2017.
To share profits in excess of social security program costs with
the general fund of the U.S Treasury on a negotiable sliding scale beginning
year end 2016 DI 50/50 with the USPS, and OASI in 2017 to eliminate the true
federal budget deficit and maximize welfare payments. Even without any new
sources of revenues the true federal budget deficit is estimated to be only
-$71 billion in 2017 before disappearing and making a surplus in future years,
as opposed to the permanently wrong -$453 billion deficit estimate of the
Office of Management and Budget (OMB). Therefore there shall be a maximum
allowable deficit (mad) of $100 billion. In 2020, if the United States balances
the federal budget, the nation will be able afford to guarantee everyone a
poverty line income, without a balanced federal budget the nation will only be
able to afford to reduce poverty by half and eliminate child poverty in
schools. OASDI will save to pay for the peak in costs of Baby Boomer generation
in 2035 when the overall OASDI tax rate might be raised from 12.4%.
Be it enacted in the House and Senate Assembled
Maternity Leave Act
a. Demonstration projects Section 305 of
Title III of the Social Security Act 42USC¤505 will be repealed except for the
relevant sentence in (a)(1) to expedite the reemployment of individuals who have established a
benefit year and are otherwise eligible to claim unemployment compensation
under the State law.
Maternity Leave Section 305 of the Social Security Act 42USC¤505
(a) To expedite the reemployment of individuals who have
established a benefit year to claim unemployment compensation under the State
law the Secretary of Labor shall fulfill the 14 months of paid leave authorized
for Maternity Leave by International Labour Organization (ILO) Convention No.
183 (2000).
(1) The Family and Medical Leave Act shall be repealed except in
that workers's positions who have served their benefit year, shall continue to
be entitled to up to twelve weeks of (unpaid) sick leave, 14 weeks of maternity
leave and 24 weeks to care for an injured armed service-member.
(2) Employers shall provide at least 3 weeks of paid leave
annually to uphold the Holiday with Pay ILO Convention No. 132 (1970).
(b) On production of a medical certificate,
stating the presumed date of childbirth, a woman shall be entitled to a period
of maternity leave of not less than 14 weeks. Cash benefits shall be provided
at a level which ensures that the woman can maintain herself and her child in
proper conditions of health and with a suitable standard of living.
(1) Where a woman does not meet the
conditions to qualify for cash benefits under national laws and regulations or
in any other manner consistent with national practice, she shall be entitled to
adequate benefits out of social assistance funds, subject to the means test
required for eligibility for such assistance, from the Supplemental Security
Income Program for the Aged, Blind and Disabled under Sec. 1611 of Title XVI of
the Social Security Act 42USC¤1382.
(2) Medical benefits shall be provided for the woman
and her child. Medical benefits shall include prenatal, childbirth and
postnatal care, as well as hospitalization care when necessary.
Be it enacted in the House and Senate Assembled
Torture 18 U.S. Code ¤ 2340A(a) amended so 'outside the United States' is
removed so - Whoever commits or attempts to commit torture shall be fined under
this title or imprisoned not more than 20 years, or both, and if death results
to any person from conduct prohibited by this subsection, shall be punished by
death or imprisoned for any term of years or for life. Exclusive Remedies 18U.S.C¤2340B
may be replaced with ÔThe State shall ensure in its legal system that the
victim of an act of torture obtains redress and has an enforceable right to
fair and adequate compensation, including the means for as full rehabilitation
as possible. In the event of the death of the victim as a result of an act of
torture, his dependents shall be entitled to compensation under Art. 14 of the Convention against Torture and Other Cruel,
Inhuman or Degrading Treatment or Punishment of 26 June 1987Õ. To repeal the
word 'enforcement' in federal education statute, offending the Slavery
Convention of 1926 in at least two places yesterday (a) 'enforcement of Section
111' at 20USC¤112 needs to be repealed like Prohibition under the 21st
Amendment (1933) and, (b) the words 'enforcement of' must be removed from the
caption of Part 1200 so that it states, Nondiscrimination on the basis of
Handicap in programs or activities conducted by the National Council on
Disability at the end of Education statute 34CFR¤1200.170, and (c) General
Definitions of the Office of Museum and Library Services at 20USC¤9101(1)
replaced with (1) No stalking in the library 18USC¤2261A(2). Passing these
amendments the USA should be qualified to ratify the Optional Protocol to the
Convention on the Rights of Persons with Disabilities (2006), the International
Labor Organization Conventions Holiday with Pay Convention No. 132 (1970) and
Maternity Leave Convention 183 (2000), will reduce poverty by half and eliminate
child poverty in schools or completely end poverty by 2020. Blessed are the
poor (Matthew 5:3).
Book
4 State Mental Institution Library Education
(SMILE)
To amend Chapter
4 Saint ElizabethÕs Hospital ¤161-230 by
transferring ¤321-329 from
Chapter 9 Hospitalization of the Mentally Ill National Returned from Foreign
Countries to Article 11 ¤200-208
of this Chapter, to respect US Customs as the occupants of St.
ElizabethÕs Hospital. To abolish psychiatry, civil commitment, psychiatric drugs, and
all psychiatric hospitals, other than forensic or veteranÕs, and prescribe
Amantadine (Symmetrel) for flu and psychiatric drug tics. 25% of the world
population, about 1.3 billion students were enrolled in school, in 2004. There
are more than 70 million students in the US. About 98,000 elementary and
secondary schools have 50 million students in attendance and 3.3 million
teachers starting at $30k and earning more than $44k on average. A steadily
increasing percentage of children, 3.4%, 1.7 million children were homeschooled
in 2012. About 20 million students attend nearly 7,400 institutions of higher
education who employed 3.9 million employees, including more than 1.1 million
college professors with median earnings around $89k per year. In total, $209 billion
in federal aid were made available to education in fiscal year 2017. Adding
discretionary and mandatory spending total ED on-budget spending to $88.3
billion in 2015, $78.5 billion in 2016 and $79.5 billion in 2017. ED on-budget
spending should grow around 2.5% annually to $82 billion in 2018 and continue
to grow to $84 billion in 2019 and $86 billion in 2020. Public school teachers
should be enabled to contribute, on an individual and voluntary basis, the 2.4%
menopause as disability (mad) tax rate, and legislate 14 weeks of Unemployment
Compensation (UC) maternity leave. Despite $11,100 per pupil education spending
in excess of $718 billion child poverty is higher in the United States than any
other country, gradual growth is lagging in international rank. In 2016 24% of children under the age of 18, around 14
million, were growing up in poverty, the highest rate in any industrialized
nation. Of 18-to-64-year olds 20.5 million, 11.1% were poor and of people 65
and older 3.6 million, 10.1% were poor in 2011 The overall poverty rate is said
to be more than 15.4%. Temporary Assistance for
Needy Families (TANF) beneficiaries declined from 14.2 million in 1993 to less
than 5 million families today. The Education Goals of 2020 enables the WILL
(Without Income Limit Law) beginning in 2017: To reduce poverty by half and
eliminate child poverty in schools by 2020 while paying a $100 billion annual
maximum allowable deficit (mad), the true federal budget deficit, without new
revenues, is about -$71 billion in 2017 before it disappears. If the Social
Security Amendments of January 1, 2016 balances the true federal budget -
annual agency spending growth will be limited to 3 percent, a 3 percent annual
Cost-of-Living Adjustment (COLA) shall be legislated for all social security
beneficiaries and minimum wage workers - the nation could afford to end poverty
by 2020. School districts shall balance their budget, provide poor and nearly
poor families of an estimated 24 million children with food banks, showers,
free clothing, laundry and necessities operated by student volunteers. The US
shall expand SSI from 1.8 million juveniles and 6.5 million adults in 2015 to pay the families of 14 million children and 30 million
adults living below the poverty line in the United States by 2020. Welfare
benefits shall not be reduced until able to sustain an income >150% of the
poverty line.
Education Goals
of 2020 HA-18-3-16
25% of the world population is enrolled in school. In 2004, about 1.3 billion students were enrolled in schools around the world. Of these students, 685 million were in elementary-level programs, 503 million were in secondary programs, and 132 million were in higher education programs. More than 70 million people attend school in the United States. In the United States there are about 98,000 elementary and secondary schools with nearly 50 million students in attendance. About 20 million students attend nearly 7,400 institutions of higher education who employed 3.9 million employees in fall 2011. More than 1.1 million college professors in the are paid anywhere from $50k to $158k per year, but median earnings come to around $89k per year. Public schools employ more than 3.1 million full-time teachers. The pupil per teacher ratio is 16.0. A steadily increasing percentage of children, 3.4%, 1.7 million children were homeschooled in 2012. The average teacher salary for a public school teacher in 2001 was $43.3k, starting at $30k. Although average wages may have increased, more than $1,040 individual voluntary disability insurance (DI) contributions could be collected at the current 1.8% or 2.4% menopause as disability (mad) tax rate from as many a 3.1 million public school teachers and their employers, who might also be interested in contributing to state unemployment compensation (UC) policies that pay for 14 weeks of maternity leave. The goal of the Without Income Limit (WILL) is to balance the federal budget, reduce poverty by half and eliminate child poverty in schools by 2020. The number of children raised in poverty continues to rise. From 2006 to 2011 the percentage of children living below the official poverty line increased from 18% to 22%, and when we include the Ònear poorÓ, the percentage has changed from 40% to 45% - almost half Ð of all children in the United States under the age of 18 and might benefit from a school food bank and other voluntary non-profit services. The statistics are even worse for younger children: 49% of children under 3 years of age and 48% of those between 3 and 5 years of age are currently living in poor or near poor households. Only 10% of children living with both parents were below the poverty line whereas 40% living with only one parent were below the poverty line. Children living only with their mothers were twice as likely to live in poverty as those living only with their fathers. The Personal Responsibility and World Opportunity Reconciliation Act (PRWORA) of 1996 deprived families of 10 million relief benefits under 18USC¤246. From 1990 to 2000 the high school completion rate declined in all but seven states. Housing instability and homelessness among children and youth continues to rise. Between 1.6 and 2.8 million youth are homeless in a given year, and over 50% were not attending school regularly. The McKinney-Vento Homeless assistance act of 1987 was amended in 2001 for Part B to provide education for homeless children and youth. Because of the nature of the federal budget and dangling debt negotiation it seems fair for OASDI to pay the United States General Fund a flat $100 billion maximum allowable deficit (mad) a year for the privilege of taxing the rich, until OMB is competent to accurately account for the current agency on-budget spending and administrate the letter of the WILL. $100 billion mad money is more than enough for the -$71 billion true deficit estimate. $100 billion mad would leave SSA with $207.7 billion in 2017, $226.4 billion in 2018 $244 billion in 2019, and $262 billion in 2020 with which to pay for SSI and save in the OASDI Trust funds, particularly to shore up the DI trust fund. In this mad scenario 90% of these surplus OASDI tax profits would be committed to SSI and there would not be incremental growth in spending but a trust fund for late filers to receive underpayment from the $187 billion allocated to the new SSI program in 2017, $204 billion in 2018, $220 billion in 2019 and $236 billion in 2020 underpayment Sec. 204(c) of the Social Security Act of 42USC¤404(c) when the WILL goes into full 12.4% effect on the payroll taxes of all the income of the richest from January 1, 2017. At more than $11,100 per pupil education spending in the United State is higher than in any other country. The federal education department (ED) provides about 12% of nearly $1 trillion in annual education spending. Adding discretionary and mandatory spending brings total ED spending to $88.3 billion in 2015, $78.5 billion in 2016 and $79.5 billion in 2017. There is also another $50 billion or so in student loan repayments recirculated as student loans. OMB estimates education spending of $103.3 billion in 2015, $68.5 billion in 2016 and $73.7 billion in 2017. This is a difference of $15 billion in 2015, - $10 billion in 2016, and $5.8 billion in 2017, a margin of error of 17% in 2015, 12.7% in 2016 and 7.3% in 2017. Federal education spending growth needs to be stabilized at less than 3% a year, aiming for 2.5% like other agencies, and should never be negative. 1973 and 1974 seem to be the only years that positive ED spending growth was reported to be less than 3% by OMB historical tables. Real spending growth might be better than 1.3% between 2016 and 2017 to help pay the employer portion of teacher disability contributions and help schools provide poor children with free clothing and food bank with a total of $80 billion in discretionary and so-called mandatory federal spending in 2017 by which time mandatory spending fluctuations should be abolished and total ED spending should grow around 2.5% to $82 billion in 2018 and continue to grow to $84 billion in 2019 and $86 billion in 2020.
World Health Day or April Fool? Excerpt from Public Health Department
Medical Progress
A. The United States
patents more new drugs than any other nation. Sometimes, the cures are
miraculous like Zmap that ended the ebolavirus epidemic in western Africa in
2014 after the antibody had been cloned in tobacco plants in sufficient
quantities. The 2015 tobacco harvest were possibly genetically contaminated
with green tomatoes that cause a long-lasting damage to the throat. Modern
surgical, radiological and chemotherapeutic procedures are 95 percent effective
at curing throat cancer. Gleevec (Iminitab) is an oral anticancer drug
developed through cooperation between hematology and oncology that has 95
percent cure rate for lymphoma and leukemia, when used in combination
chemotherapy, however it currently costs about $20,000. Methotrexate is another
generic oral anticancer drug that costs less than a dollar a week. It is however
left to the patient's Bachelor of Medicine to purchase necessary generic
medicine online with a discount from rxmedsdoctor.net since the Indian
Parliamentary elections of 2014 exiled generics-discount.com from the city.
Broad spectrum antibiotics are the best medicine from the 20th century and have
a 90 percent cure rate for bacterial infections. The discoveries of the
sulphonamide (1939), penicillin (1945) and streptomycin (1952) classes of
antibiotics won the Nobel Prize for Medicine. Ampicillin (Principen), made from
penicillin nucleus and 3H2O is the first choice organic antibiotic for
bacterial pneumonia. Doxycycline (1967), the once a day antibiotic, was the
cheapest cure for Methicillin Resistant Staphylococcus Aureus (MRSA)
causes permanent yellowing of developing teeth in children under age 8 the
global supply was however adulterated and only American manufactured Vibramycin
(doxycycline) might be tried without much anxiety. Metronidazole (Flagyl ER)
(1960) treats antibiotic resistant Clostridium difficile that causes
antibiotic associated colitis. The best new generic drug, that might make flu
vaccination campaigns and psychiatric drugs obsolete, is the antiparkinson,
antiviral Amantadine (Symmetrel) cure for flu and psychiatric drug tics in one
dose.
1. Zika virus disease
(Zika) is a disease caused by Zika virus that is spread to people primarily
through the bite of an infected Aedes species mosquito. The most common
symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The
illness is usually mild with symptoms lasting for several days to a week after
being bitten by an infected mosquito. People usually donÕt get sick enough to
go to the hospital, and they very rarely die of Zika. For this reason, many
people might not realize they have been infected. Once a person has been
infected, he or she is likely to be protected from future infections. The
symptoms of Zika are similar to those of dengue and chikungunya, diseases
spread through the same mosquitoes that transmit Zika. During the first week of
infection, Zika virus can be found in the blood and passed from an infected
person to a mosquito through mosquito bites. There is no vaccine to prevent or
medicine to treat Zika virus. Zika virus can be spread from a pregnant woman to
her fetus and has been linked to a serious birth defect of the brain called
microcephaly in babies of mothers who had Zika virus while pregnant. Other
problems have been detected among fetuses and infants infected with Zika virus
before birth, such as absent or poorly developed brain structures, defects of
the eye, hearing deficits, and impaired growth. CDC recommends special
precautions for pregnant women. Women who are pregnant should not travel to
areas with Zika.
a. In May 2015, the Pan
American Health Organization (PAHO) issued an alert regarding the first
confirmed Zika virus infection in Brazil and on Feb 1, 2016, the World Health
Organization (WHO) declared Zika virus a public health emergency of
international concern (PHEIC). Local transmission has been reported in many
other countries and territories. Zika virus likely will continue to spread to
new areas. Prior to 2015, Zika virus outbreaks occurred in areas of Africa,
Southeast Asia, and the Pacific Islands. In May 2015, the Pan American Health
Organization (PAHO) issued an alert regarding the first confirmed Zika virus
infections in Brazil. Currently, outbreaks are occurring in many countries.
Zika virus will continue to spread and it will be difficult to determine how
and where the virus will spread over time. Local mosquito-borne transmission of
Zika virus has been reported in the Commonwealth of Puerto Rico, the US Virgin
Islands, and America Samoa. No local mosquito-borne Zika virus disease cases
have been reported in US states, but there have been travel-associated cases.
Because hosts become immune after a brief period of mild illness Zika virus
seems like a good candidate for a vaccine for girls to prevent microcephaly in
affected areas. The challenge is to manufacture a vaccine that doesn't cause
the illness and in particular the infectious form of the illness. Every hobbled
pertussis vaccine developmental hip injury compensation girl's eye's are red.
Trillion Dollar Limit
A. This Chapter amends Title 24 US Code Chapter 9 ¤321-
¤329 Hospitalization of Mentally Ill Nations Returned from
Foreign Countries, the contents of which have been transferred to Article 6 of
Chapter IV State Mental Institution Library Education (SMILE). To set a
trillion dollar limit for the Department of Health and Human Services (DHHS)
budget, including the Center for Medicare, Medicaid and State Health Insurance
Programs (CMS) and the Affordable Care Act (ACA) premiums from 2015. To require
that the DHHS budget account for the trillion spending limit, and that CMS
account for Medicaid, the ACA, and abolish federal financing for psychiatry and
psychiatric drugs, in their amended annual report for summer solstice issue
beginning in 2016 to respect the Education Goals 2020. To raise the Public
Health Service, to the highest attainable level of health by conferring the
title of Public Health Department (PHD) to the Department of Health and Human
Services (DHHS), as should have been done in the Department of Education
Re-organization Act on May 4, 1980, as codified at 20USC(48)V¤3508.
1. The foundation of the public health service is
typically attributed to July 16, 1798, when President John Adams, author of the
despised Alien and Sedition Act of 1800, created what we now know as the U.S.
Public Health Service by establishing the U.S. Marine Hospital Service. After
the Pure Food and Drug Act of 1906 the Public Health Service was created in the
Public Health Service Act of 1912. It was however not until the Department of
Health Education and Welfare (HEW) was founded on April 11, 1953 that the
Public Health Service became a genuinely civilian form of government. The
Social Security Amendments of 2001 changed the name of the Health Care
Financing Administration (HCFA) to Centers for Medicare, Medicaid and State
ChildrenÕs Health Insurance Programs (CMS) and gave the Social Security
Commissioner an ungainly 6 year term. HCFA was cheaper. Federal medical
spending administrated by HHS must be limited to less than $1 trillion
annually, from 2015 when HHS spending first crested the trillion dollar mark,
until federal health spending is not more than 10 percent of Gross Domestic
Product (GDP).
B. US medical spending is the most in the world in
dollar terms of about $2.4 trillion in public and private spending and also as
a percent of GDP at about 17%. Although inflation in medical prices needs to be
limited to less than 3 percent annually HHS spending is peculiar in that it
needs to be limited to less than one trillion dollars for quite some time.
Agency spending is hoped to go down. HHS budget estimates for 2015 are much
higher in the FY 2017 budget. There seems to be at least five separate issues
that HHS must deal with to limit HHS spending to less than one trillion dollars
in the reckoning of the CMS Administrator due on the summer solstice June 20,
2016 and FY 2018 HHS budget - (1) social exclusion of mandatory programs, other
than CMS health insurance programs, to the independence of the Social Security
Administration (SSA) Annual Report on SSI (2) accounting errors and rules
needed to regulate the HHS budget (3) abolition of psychiatry to reduce CMS
spending from 2017, (4) gradual inclusion of federal public health service
program in CMS payments for salaried patient care, (5) account for revenues
from taxes, fees, premiums, salaried patient care and the nationalization of
ACA refundable premiums and tax credit from 2015 and other inefficient health
sector resources.
HHS Spending by Agency in billions 2000-17
|
2000 |
2008 |
2014 |
2015 |
2016 |
2017 |
|
|
Total HHS Spending |
400 |
698 |
958 |
1,010 |
1,111 |
1,145 |
|
OMB HHS Spending |
382 |
700 |
936 |
1,028 |
1,110 |
1,145 |
|
Food and Drug Administration |
1.1 |
1.6 |
2.7 |
2.9 |
2.5 |
2.6 |
|
Health Resources and Services Administration |
4.3 |
6.2 |
9.1 |
9.5 |
10.3 |
11.5 |
|
Indian Health Service |
2.3 |
3.5 |
4.6 |
4.8 |
5.1 |
5.3 |
|
Centers for Disease Control and Prevention |
2.7 |
5.8 |
6.7 |
6.6 |
7.3 |
7.9 |
|
National Institutes of Health |
15.5 |
28.6 |
31.1 |
29.7 |
30.2 |
32.3 |
|
Substance Abuse and Mental Health Services Administration |
2.5 |
3.1 |
3.7 |
3.4 |
3.8 |
3.7 |
|
Agency for Healthcare Research and Quality |
0.09 |
0 |
0.3 |
0.1 |
0.2 |
0.4 |
|
Centers for Medicare and Medicaid Services |
333 |
599 |
844 |
897 |
993 |
1,018 |
|
Administration for Children and Families |
38 |
46 |
50.1 |
51.1 |
52.4 |
58.3 |
|
Administration for Community Living formerly Agency on Aging |
1.0 |
1.3 |
1.6 |
1.9 |
2.2 |
1.9 |
|
Office of the National Coordinator |
0.06 |
0.4 |
0.05 |
0.06 |
0 |
|
|
Office of Medicare Hearings and Appeals |
0.07 |
0.09 |
0.1 |
0.1 |
0.1 |
|
|
Office for Civil Rights |
0.04 |
0.04 |
0.04 |
0.04 |
||
|
General Departmental Management |
0.5 |
0.4 |
0.9 |
0.6 |
1.2 |
1.2 |
|
Health Insurance Reform Implemen-tation Fund |
0.2 |
0.1 |
0 |
0 |
||
|
Public Health and Social Services Emergency Fund |
2.6 |
1.8 |
1.9 |
2.3 |
1.8 |
|
|
Office of the Inspector General |
0.2 |
0.08 |
0.6 |
0.8 |
93 |
116 |
|
Program Support Center |
0.3 |
0.5 |
1.1 |
0.6 |
1.1 |
0.7 |
|
Offsetting Collections |
-1.1 |
-1.3 |
-0.8 |
-0.8 |
-0.8 |
-0.8 |
|
Total HHS Spending |
400 |
698 |
958 |
1,010 |
1,111 |
1,145 |
|
Full Time Equivalents |
61,847 |
66,890 |
77,520 |
75,567 |
77,583 |
79,406 |
HHS Budgets 2000, 2008, 2015, 2017
C. Overall Public Health Service (PHS) spending must
first be reduced by excluding the social spending programs as independent
federal agencies so as not to distort health spending statistics and justify
renaming HHS Public Health Department (PHD). HHS Social programs should be
accounted for by SSA beginning in the May 20, 2016 report of the Social
Security Commissioner on SSI and on-budget social security spending by OMB.
Temporary assistance for needy families (TANF) benefits are temporary and
enrollment went gone down from 14 million in 1994 to 4 million 2014. Child
poverty consequentially increased from 15 percent to 22 percent. 14 million
Supplemental Security Income (SSI) benefits are now needed to end child
poverty. Around 40 percent of poor people in the United States are children
although children only make up about 20 percent of the population. The
condition is that Child Support surrender 'Enforcement' to be abolished under
the Slavery Convention of 1926 and be amended to 'child support' in Sec. 466 of
Title IV-D of the Social Security Act 42USC(IV-D)¤666 et seq. The
Administration for Children and Families (ACF) is estimated to cost the federal
government $51.1 billion in 2015, $52.4 billion in 2016 and $58.3 billion in
2017. After being incorporated into SSA all or the majority of the ACF budget
should reinvested into child SSI benefits to eliminate child poverty by 2020.
The Administration for Community Living (ACL) formerly Agency on Aging cost
$1.9 billion in 2015, $2.2 billion in 2016 and $1.9 billion in 2017. The total
value of the child welfare benefits and social services subsidy currently
administrated by HHS, calculated to have be $34.5 billion in 2015, $33.4
billion in 2016 and will be $38.1 billion in 2017, may be deducted from the
estimate on ACF spending. Social exclusion would reduce ACF spending in the HHS
budget to $13 billion in 2015, $19 billion in 2016 and $20.2 billion in 2017.
ACF spending would remain PHS spending unless administrative costs for their
temporary employment service are dramatically reduced by converting
administrative costs to SSI benefits for the elimination of child poverty by
2020. Accounting for mandatory social spending and child care independent of
HHS would reduce total federal health spending from $1,010 billion to $975.5
billion in 2015, from $1,111 billion to $1,078 billion in 2016 and from $1,145
billion to $1,107 billion in 2017.
D. To this we must add responsibility for the
refundable premium and cost sharing reduction, unacceptably inflating the Treasury
budget, to the HHS budget, whereas the ACA is a federal health insurance
program. Refundable Premium Tax Credit and Cost Sharing Reductions were
re-negotiated from $60.1 billion in the FY 2015 Treasury budget to $30.1
billion (2015), 39.3 billion (2016), 57.7 billion (2017) matched by the 'other
mandatory programs' in the HHS budget. These sums must be added to the revised
HHS spending total for total federal health spending of $1,006 billion (2015),
$1,117 billion (2016) and $1,165 billion (2017) until Medicaid nationalizes
these inefficient quasi-private state regulated corporations and gets what
money back, including health insurance premiums, Medicaid can administrate more
efficiently. The importance of excluding social agencies from the HHS budget is
that, unlike every other agency, but the Department of Defense, that also has a
durable $500 billion spending limit, federal health spending must go down to
less than one trillion dollars. Social welfare spending, particularly the child
welfare programs that stayed in HHS after SSA became an independent agency in
1996 and lost more than ten million permanent child welfare benefits, causing
child poverty to double to over 22 percent today, on the other hand must learn
grow Title XVI Supplemental Security Income for the Aged, Blind and Disabled
independently under the supervision of the annual report of the Commissioner of
Social Security on the summer solstice.
Mandatory HHS Spending 2000-17
|
2000 |
2008 |
2014 |
2015 |
2016 |
2017 |
|
|
Medicare |
215 |
387 |
513 |
526 |
589 |
598 |
|
Medicaid |
115 |
202 |
309 |
336 |
367 |
385 |
|
ChildrenÕs Health Insurance |
1.9 |
6.6 |
10.3 |
10.6 |
14.5 |
15.2 |
|
Other Mandatory Programs |
1.0 |
1.9 |
12.6 |
24.6 |
21.3 |
20.9 |
|
CMS Total |
333 |
598 |
845 |
898 |
992 |
1,019 |
|
Temporary Assistance for Needy Families |
14.1 |
17.3 |
17.6 |
17.5 |
16.9 |
17.7 |
|
Foster Care and Adoption |
5.5 |
6.8 |
6.7 |
7.0 |
7.5 |
8.1 |
|
Child Support Enforcement formerly Family Support |
2.9 |
4.1 |
3.9 |
4.1 |
4.2 |
4.3 |
|
Child Care |
3.7 |
2.8 |
2.9 |
3.5 |
3.0 |
5.9 |
|
Social Services Block Grant |
2.5 |
1.7 |
1.9 |
2.4 |
1.8 |
2.1 |
|
Social Security Spending |
28.7 |
32.7 |
33.0 |
34.5 |
33.4 |
38.1 |
|
Offsetting Collections |
-1.1 |
-1.3 |
-0.8 |
-0.8 |
0 |
0 |
|
Total Mandatory Spending |
360 |
629 |
877 |
931 |
1,025 |
1,057 |
HHS Budgets 2000, 2008, 2015 & 2017
E. Before cutting CMS benefits, or even abolishing
psychiatry, it is first necessary to redress the accounting errors in the FY
2017 HHS budget by cross-examination of the Annual Report of the Board of
Trustees of the Federal Hospital Insurance and Supplementary Medical Insurance
Trust Funds. Medicare spending will be limited to three percent growth provided
total federal health spending does not exceed $1 trillion. This is a very
difficult to account for because total Medicare spending in 2014 is even higher
than the artificially high figure given in the HHS FY 2017 for 2015. For the
accuracy of the HHS budget estimates for federal spending on Medicare is
necessary to deduct revenues from other sources Ð interest, premiums, transfers
from states, and other Ð from total Medicare spending Ð for total 2014 Medicare
spending of $508.1 billion in 2014, official estimates in the FY 2015 HHS
budget were $513 billion for 2014. These figures, $513 billion in Medicare
spending in 2014, should increase at a rate of three percent annually to $528
billion in 2015, the FY 2015 budget went up to $526 billion, 2.5% growth. The
FY 2017 HHS budget has higher estimates for 2015 than the FY 2015 HHS budget
that is more authentic. In 2016 Medicare spending was estimated to increase to
$589 billion, 11.9% growth, over the more authentic FY 2015 HHS Budget
estimates for 2015. The FY 2017 HHS budget report uses baseline Medicare
spending of $540 billion, fourteen
billion dollars more than the FY 2015 HHS budget estimated to justify 9 percent
growth, from a fraudulent $540 billion 2015 baseline, to $589 billion in 2016
and then 1.5 percent growth to $598 billion in 2017. Nine percent growth in
2016 is not acceptable. Investigation of this case of boom bust budgeting
reveals a fraudulently high baseline from 2015 in the HHS FY 2017 budget. Therefore,
it is necessary to re-estimate Medicare spending with 2.5 percent annual growth
from $526 billion in 2015 to $539 billion in 2016 to $553 billion in 2017. This
truth reduces total federal health spending by $14 billion in 2015, $50 billion
in 2016 and $45 billion in 2017 to an acceptable $992 billion (2015), $1,067
billion (2016) and $1,120 billion (2017).
F. The FY 2017 HHS budget will have to be redone using
the FY2015 HHS budget as a baseline so that efficiency from sustained economic
growth of nearly three percent annually is not lost to the recovery of
overpayments by incompetent 'enforcement' abolitionists of everything but
slavery and the trillion dollar limit on federal health spending. The CMS
Administrator and Actuary must be extra careful to use authentic statistics and
Apple computers, when preparing the 2016 Annual Report due on April 1 and the
new report on Medicare, Medicaid, SCHIP and ACA spending on the summer solstice
and are hoped to obey the 3 percent annual growth limit and abolition of
psychiatry, that would reduce Medicare and Medicaid spending by anywhere from
$66 billion in 2000 to $100 billion annually. HHS spending would be reduced to
less than one trillion dollars if CMS permanently abolishing more than $68
billion in payments for psychiatry, psychiatric institutionalization and
psychiatric drugs in 2016. Completely abolishing federal health spending on
psychiatry is not expected to be quite enough to keep HHS spending below $1
trillion in 2017 when another $60 billion in spending reductions will be needed
and more spending reductions will be needed until total health spending is less
than ten percent of gross domestic product (GDP).
G. In FY 2017, the federal share of current law
Medicaid outlays are expected to be approximately $376.6 billion. The HHS
budget is the only federal agency responsible for studying the Medicaid
program. The CMS Administrator and Actuary need to take responsibility for
Medicaid spending in their Annual Report. Medicaid is the primary source of medical
assistance for millions of low_income and disabled Americans, providing health coverage to many
of those who would otherwise be unable to obtain health insurance. In FY 2015,
more than 1 in 5 individuals were enrolled in Medicaid for at least 1 month
during the year, and in FY 2017, more than 70 million people on average will
receive health care coverage through Medicaid. These health insurance coverage
statistics are however misleading. What is important is that 12.2 million
health care professionals are paid enough money for decent wages and necessary
medical supplies with only $845 billion in federal health insurance payments Ð
an average per capita annual payment of $69,262 from the federal government
alone, per health care professional. This would be enough for every health care
practitioner to purchase antibiotics and other generic drugs and medical
supplies to provide for free to their patients and still afford a home of their
own. The clinic and hospital however obviously require more money than the
federal government spends, so they bill private insurance and patients into 60
percent of all bankruptcies. It is a crime that medical b(k)ills are 'enforced'
by the same National Credit Bureaus highly unemployed lawyers no longer have
recourse to. As the largest single payer of health professionals the federal
government needs to command a three percent limit on inflation in medical
spending and wages with higher growth of three percent for lower earners one
percent growth for well-behaved medium high earners and negative growth for the
richest, necessary medical expenses allowed.
H. The Patient Protection and Affordable Care Act
(ACA) provides for refundable and advance able premium credits to eligible
individuals and families with incomes from 133 to 400 percent of the Federal
Poverty Level (FPL) to purchase insurance through exchanges. 37 States and the
District of Columbia have received over $4.9 billion in grants to operate
Marketplaces since 2011. In 2014 17 states and the District of Columbia began
operation of their marketplace. Seven are conditionally approved to partner
with HHS. HHS has begun implementing a federally-facilitated marketplace (FFM)
in the remaining states that chose not to implement a marketplace. In addition
to enrolling individuals, marketplaces also determine eligibility for premium
tax credits and cost-sharing reductions, or Medicaid and CHIP in some states.
Individuals who enroll in qualified health plans through the Marketplaces may
qualify for insurance affordability programs to decrease their premium costs
and have their out-of pocket health care costs reduced. CMS makes advance
payments of the premium tax credit to issuers each month on behalf of
qualifying individuals with income between 100 and 400 percent of the federal
poverty level (FPL). Individuals with income below 250 percent of FPL, and
American Indians/Alaska Natives with income below 300 percent FPL, may also
qualify for lower deductibles, coinsurance, co-pays and out-of-pocket limits,
and CMS reimburses Marketplace issuers for these cost-sharing reductions. These
payments are funded by the Department of Treasury and are therefore not part of
HHSÕ budget. It is however destroying the TreasuryÕs budget to spend roughly as
much money as a Medicaid could have brought in collecting premiums for their
Basic Health Plan that is the only program that actually pays for office
visits.
1. The federal government cannot sustain the costs
hidden in the deceptive language of the refundable premium tax credit and
cost-sharing reduction. These subsidies are seriously harming the Treasury
budget. HHS will need to account for the new Medicaid premiums off-budget
revenues used to reduce federal Medicaid spending in their budget request, so
far, without trust fund, estimated to operate on a -$2.7 billion deficit at its
inception. If the number of beneficiaries doubles to 16 million premium payers
in 2015, paying $60,100 in premiums, the account deficit might double to -$5.2
billion. But for every eight million people who stop receiving the ESI the
federal government should receive $10.7 billion in old revenues. If Medicaid is
kind and remains open to the Medicaid marketplace, more ESI payers and rich
people will choose to buy the policies and it not inconceivable that the
program could pay for itself if the population stays healthy. Paying 100% of
state/federal costs until 2020 the federal government is due 100% of premiums.
Why isnÕt CMS efficient enough to run a profitable health insurance company for
the price of premiums?
Treasury Budget
|
2015 |
2016 |
2017 |
|
|
Interest Payments |
372.5 |
405.1 |
464.1 |
|
Mandatory |
135.4 |
138.1 |
172.5 |
|
Mandatory Offsetting Receipts |
-26.9 |
-21.8 |
-24.0 |
|
Total Mandatory Treasury Spending |
481 |
521.4 |
612.7 |
|
Treasury Appropriations |
13.8 |
14.1 |
15.5 |
|
Total Treasury Outlays |
494.8 |
535.5 |
627.2 |
|
OMB Treasury Outlay Estimates |
485.6 |
540.3 |
618.3 |
Credit: FY 2017 Treasury Budget-in-brief, OMB
Historical Table 4.1 3-29-16
I. Treasury Department mandatory budget includes $613
billion dollars in interest payments, mandatory accounts and offsetting
collections (offsets). Refundable Premium Tax Credit and Cost Sharing
Reductions were re-negotiated from $60.1 billion in the FY 2015 Treasury budget
to $30.1 billion (2015), 39.3 billion (2016), 57.7 billion (2017). 10-14%
annual increase in Treasury spending is primarily the result of interest
payments. Nonetheless, (1) 46.9% inflation in the cost of Refundable Premium
Tax Credit and Cost Sharing Reductions between 2016 and 2017 should be the
responsibility of the Department of Health and Human Services and not tarnish
the books of the Treasury, (2) Payment Where Certain Tax Credits Exceed
Liability for Corporate Tax is proposed to increase from $198 million in 2016
to $3.4 billion in 2017.