Hospitals & Asylums
Health and Welfare (HAW)
To supplement Chapter
3 National
Home for Disabled Volunteer Soldiers ¤71-¤154, Subchapter
V Battle Mountain Sanitarium Reserve, ¤151-154. To end poverty in the
United States by 2020. To produce a federal budget surplus FY 18 by deleting
the Allowances, Other Independent Agencies (on-budget and off-budget) and Other
Defense - Civil Programs rows from the Government Outlays by Agency Ledger
(GOAL) under Art. 2(2) of the US Constitution. To amend the federal minimum wage from $7.25 an hour
2009-2017 to '$7.50 in 2018 and 3% more every year thereafter.' under
29USC¤206(a)(1)(D). To support the Treasury's decision to
abolish the refundable premium and cost sharing reduction subsidy FY 18 all the
action now takes place under the Federal Insurance Contributions Act (FICA)
<15.0%. To begin to experimentally reduce Medicare Part A HI tax revenues
received by the Hospital Insurance (HI) Trust Fund from the 2.9% payroll tax
rate to 2.6% payroll tax received, and continue to reduce federal outlays for
Parts B and D to 3% annual growth from FY 14 beginning FY 18 when a zero growth policy would take over for all three programs to
try to keep federal health outlays under the $1 trillion limbo bar until
national health expenditures are less than 10% of GDP. To raise the patient's
share in nursing homes to the greater of $300 or 30% of benefits, by Treasury
under 24USC¤14a or fee under 24USC¤414. To amend the 1.8% DI tax rate starting
January 1, 2019 in Sec. 201(b)(1)(T) of the Social Security Act under
42USC¤401(b)(1)(T) to either 2.1% DI tax, or 2.0% DI tax if OASI pays $240.4
billion including 2.5% interest for CY09-CY15 to replicate to the extent
possible revenue that would have been received if the OASDI tax had been
properly adjusted by Public Law 112-96. To replace the Adjustment of the
contribution and benefit base under Section 230 of the Social Security Act
42USC¤430 with 'There is created in the Treasury a Supplemental Security Income
Trust Fund.' To tax the rich the full 12.4% Old Age Survivor and Disability
Insurance (OASDI) tax on all their income to pay 16-24 million children growing
up poor SSI benefits FY18. To publish a highly simplified online SSI
application form without any In-kind-support maintenance (ISMs) and optional
disability questionnaire, for speedy Income and Eligibility Verification System
in Sec. 1137 of the Social Security Act under 42USC ¤132b-7. To end benefit attrition
with a 3% Cost of Living Adjustment (COLA) rule every year inflation continues
to run about 2.7% and the Trust Fund Ratio is greater than 20% under Sec. 215(i) of the Social Security Act 42USC¤415(i).
To make an exception to the rule to pay $777 mo. SSI a 5.7% COLA is needed from
CY17, a 2.7% COLA CY18 followed by 3% COLA to $777 SSI CY19 and 3% COLA every
year for low incomes to compete with 2.7% average annual inflation. To change
the due date of the Annual Reports from April 1, April foolÕs day, to 'summer
solstice June 20-21' in Sec. 1161 of the Social Security Act under
42USC¤1320c-10.
Be the Democratic-Republican (DR) two party system Fired
1st
Ed. 2003, 1st15 September 2004, 2nd 1 June 2005, 3rd
18 June 2006, 4th 17 June 2007. 5th 12 June 2009, 6th
31 July 2010, 7th 17 August 2011, 8th 14 July 2012, 9th
26 July 2015, 10th 7 September 2015 11th 17 September
2017
1.
Chapter 3 National Home for Disabled Volunteer Soldiers, Title 24
US Code Subchapter V Battle Mountain Sanitarium Reserve, ¤151-154. The budget
process of the federal government, the system of checks and balances, is led by
the President who is responsible for presenting a balanced budget for the State
of the Union address under Art. 2 Section 3 of the US Constitution. Art. 1
Section 7 and Art. 1 Section 9 Clause 7 states, No
money shall be drawn from the Treasury, but in Consequence of Appropriations
made by Law; and a regular Statement and Account of the Receipts and
Expenditures of all public Money shall be published from time to time. The President must submit his/her budget to Congress after
the first week of January and before the first week of February every year
under 31USC¤1105. Supplemental or additional budgeting changes and
re-appraisements are submitted to Congress before July 16th of every
year for the following fiscal year that begins on October 1 under 31USC¤1106. Concealment of the Excel Historical
Tables spreadsheet by the White House Office of Management and Budget (WHOMB)
was redressed by publication of the Historical Table by Fiscal Year in pdf. The
goal of a balanced budget was achieved by the Balanced Budget Act of 1997
(Public Law 105-33) that was improved in the Balanced Budget Refinement Act of
1999, but did not survive 9-11. This re-appraisement of Agency FY 18 budgets
under Annualized Continuing Resolution for Fiscal Year 2017 (CR17) produces a
budget surplus FY 18. The surplus cannot be attributed to any cruel and unusual
budget cuts of civilian officials to levy war, unlikely to prevail in any
Departments except health insurance, the FY 18 budget surplus is the product of
accurate accounting of Cabinet agency congressional budget requests. To produce a federal budget surplus FY 18 and reduce the
gross national debt by $2 trillion it is necessary delete Allowances, Other
Independent Agencies (on-budget and off-budget) and Other Defense - Civil
Programs rows from the Government Outlays by Agency Ledger (GOAL) under Art.
2(2) of the US Constitution.
Government Outlays by Agency Ledger FY 16 Ð FY 18
FY 16 |
FY 17 |
FY18 Pres. |
FY 18 Untaxed |
FY 18 Taxed |
|
On-budget outlays |
2,824,011 |
2,874,767 |
2,970,583 |
2,926,538 |
2,864,658 |
On-budget receipts |
2,538,000 |
2,817,000 |
3,035,000 |
3,035,000 |
3,035,000 |
On-budget surplus or deficit |
-286,011 |
-57,767 |
+64,417 |
+108,462 |
+170,342 |
Legislative Branch |
4,700 |
4,600 |
4,700 |
4,700 |
4,700 |
Judicial Branch |
7,700 |
7,000 |
7,200 |
7,200 |
7,200 |
Agriculture |
138,248 |
133,062 |
140,035 |
140,035 |
140,035 |
Commerce and Small Business Administration |
10,200 |
10,100 |
8,200 |
8,200 |
9,500 |
Corps of Engineers Ð Civil Works |
4,700 |
4,600 |
4,700 |
4,700 |
4,700 |
Customs |
39,775 |
40,953 |
42,400 |
42,400 |
42,400 |
Education |
68,000 |
69,000 |
62,889 |
69,994 |
69,994 |
Energy |
29,100 |
29,700 |
27,300 |
30,300 |
30,300 |
Environmental Protection Agency |
8,300 |
8,224 |
5,656 |
8,451 |
8,451 |
Executive Office of the President |
750 |
761 |
755 |
755 |
755 |
General Services Administration |
631 |
249 |
509 |
509 |
509 |
Health |
982,636 |
985,199 |
1,066,043 |
965,523 |
965,523 |
Housing and Urban Development |
39,024 |
38,248 |
42,300 |
42,300 |
42,300 |
Human Services |
59,100 |
59,500 |
65,800 |
127,176 |
65,296 |
Interior |
13,400 |
13,300 |
11,700 |
11,700 |
11,700 |
Justice |
28,090 |
28,328 |
27,700 |
27,700 |
27,700 |
Labor |
46,500 |
46,000 |
44,200 |
47,300 |
47,300 |
Military |
580,000 |
595,000 |
639,000 |
609,000 |
609,000 |
National Aeronautics and Space Administration |
19,300 |
19,500 |
19,100 |
20,000 |
20,000 |
National Science Foundation |
7,493 |
7,449 |
6,653 |
6,653 |
6,653 |
Office of Personnel Management |
49,200 |
50,900 |
52,100 |
52,100 |
52,100 |
State and International Assistance |
54,713 |
54,268 |
40,176 |
55,624 |
55,624 |
Transportation |
76,000 |
78,900 |
76,000 |
76,000 |
76,000 |
Treasury |
535,451 |
568,526 |
532,901 |
534,351 |
534,351 |
Veterans Affairs |
166,100 |
171,600 |
183,200 |
183,200 |
183,200 |
Undistributed Offsetting Receipts |
-145,100 |
-150,200 |
-140,634 |
-149,333 |
-149,333 |
On-budget Outlays |
2,824,011 |
2,874,767 |
2,970,583 |
2,926,538 |
2,865,958 |
On-budget Receipts |
2,538,000 |
2,817,000 |
3,035,000 |
3,035,000 |
3,035,000 |
On-budget Surplus or Deficit |
-286,011 |
-57,767 |
+64,417 |
+108,462 |
+169,042 |
Social Security Administration Off-budget Outlays |
929,000 |
966,000 |
1,033,000 |
1,033,000 |
1,237,000 |
Off-budget Receipts |
945,000 |
997,000 |
1,055,00 |
1,055,000 |
1,371,500 |
Off-budget Surplus or Deficit |
+16,000 |
+31,000 |
+22,000 |
+22,000 |
+134,500 |
Total Outlays |
3,753,011 |
3,840,767 |
4,003,583 |
3,959,538 |
4,102,958 |
Total Revenues |
3,483,000 |
3,814,000 |
4,090,000 |
4,090,000 |
4,406,500 |
Total Surplus or Deficit |
-270,011 |
-26,767 |
+86,417 |
+130,462 |
+303,542 |
Gross Federal Debt |
19,433,000 |
20,149,000 |
18,062,583 |
19,018,538 |
17,844,158 |
Gross Domestic Product |
18,472,000 |
19,303,000 |
20,130,000 |
20,130,000 |
20,130,000 |
Debt as % of GDP |
105.2% |
104.4% |
89.7% |
89.5% |
84.9% |
Source: White House Office of Management and Budget Historical Tables FY 17, Congressional Budget Justifications FY 18, 2016 Annual Report of the Board of Trustees of the Federal Old Age Survivor Insurance Trust Fund and Federal Disability Insurance Trust Fund. June 22, 2016.
2. The federal ledger
can be replicated by anyone with due diligence of the budget requests of
Cabinet departments under Art. 2(2) of the US Constitution. This FY 16 Ð FY 18
budget request provides undistributed offsetting receipts to offset spending
and produce a budget surplus FY 18, that can be sustained with or without
taxing the rich to end poverty by 2020. There are
five rows in the Outlay by Agency table that need to be deleted from Table 4.1
of the Historical Tables of the White House Office of Management and Budget
(OMB) because they are actually zero federal outlays.
The rows are either not instrumental to calculating total on-budget outlays or
they are accounted for by a Cabinet agency under 31USC¤101 - (a) Allowances,
(b) Other Defense - Civil Programs, (c) Other Independent Agencies on-budget
and off-budget can be deleted because although the interagency transfers may or
may not exist as congressional budget authority they definitively do not
constitute federal outlays. (d) Small Business Administration (SBA) row does
not equate with the lending agency budget request and should be accounted for
the by Commerce Department budget request and (e) changing the name of Social
Security on-budget to Human Services and adopting the Administration for
Children and Families (ACF), Administration on Community Living and Substance
Abuse Mental Health Service Administration (SAMHSA) FY 18 ensure adequate child
and family social security benefit growth with a Cabinet Level Human Services
Secretary and keep closer tabs on federal health spending under Art. 2(2) of
the Constitution. Deleting the first three rows (a-c) result in an estimated $2
trillion - $1,950,164 million in debt relief. Treasury negotiations
might reduce the interest payments on debt to 86.5% of its current value of
$506 billion to $478 billion FY18. Then with a budget surplus pay only the 3.4%
average interest rate on t-bonds $494 billion FY19. This Federal outlay by
agency ledger compares the FY 18 Presidential budget request with CR 17
compliant untaxed and taxed settlements with the same tax deduction. The
President of the law of the land was right in regards to
Customs (fires his greedy General twice), Interior (hired to subtract revenues
from congressional budget authority to determine outlays plus $3 billion
undistributed offsetting receipts at normal 2.5% growth from FY 17 with the
President's 2.5% growth sustainable figure) and Agriculture budgets (the
congressional budget authority of two lending programs unlawfully add to the
outlay table totals and must be deleted). Next trillion-dollar federal health
outlay limbo bar crunch FY 2020.
FICA <15.0% Tax Rate and Revenues FY 18 Ð FY 20
(billions)
Year |
OASI |
Rev. |
DI |
Rev. |
SSI |
Rev. |
OASDI |
Rev. |
HI |
Rev. |
Total |
Rev. |
2018 |
10.03 |
751 |
2.37 |
177 |
-- |
-- |
12.40 |
928 |
2.90 |
282 |
15.30 |
1,210 |
2018 |
7.72 |
751 |
1.81 |
176 |
2.87 |
279 |
12.40 |
1,207 |
2.60 |
256 |
15.00 |
1,463 |
2019 |
10.60 |
835 |
1.80 |
142 |
-- |
-- |
12.40 |
978 |
2.90 |
298 |
15.30 |
1,276 |
2019 |
8.00 |
819 |
1.54 |
158 |
2.86 |
293 |
12.40 |
1,270 |
2.50 |
255 |
14.90 |
1,525 |
2020 |
10.60 |
880 |
1.80 |
149 |
-- |
-- |
12.40 |
1,029 |
2.90 |
314 |
15.30 |
1,343 |
2020 |
8.20 |
885 |
1.55 |
167 |
2.65 |
286 |
12.40 |
1,338 |
2.30 |
250 |
14.70 |
1,588 |
Source: SSA
3. The Federal Insurance Contributions Act for the 12.4%
Old Age Survivor Disability Insurance (OASDI) Trust Fund is established as a
6.2% OASDI tax and 1.45% HI tax + 0.9% tax on high incomes, that is collected
by the employer of the taxpayer under 26USC¤3101 and ¤3102. There is imposed on
employers a 6.2% + 1.45% excise tax under 26USC¤3111. HI payroll tax receipts
need to be experimentally limited to less than 2.6% FY 18, 2.5% FY 19 and 2.3%
FY 20 for the benefit of the General Fund that finances the
majority of Medicare Parts B & D and the federal outlay total
estimates in the Health and Human Services congressional budget request that
are the only reason the White House Office of Management and Budget (OMB)
currently declares a federal budget deficit FY 18. The HI tax is a generally
accepted revenue collector, hospital insurance revenues and benefit payments
however must be reduced to get federal health spending under the $1 trillion
limbo bar and reduce national health expenditures (NHE) from wildly high
official estimates of 17% of GDP no lower than 14% of GDP, to less than 10% of
GDP by 2030, achievable only if federal health insurance were completely
abolished FY 18. Supplemental Medical Insurance (SMI) premium hyperinflation,
>3% annually, has been settled again with three years of zero growth
beginning CY 18 to CY 20 when they again outrageously ask for 3.7% growth, not
having learned the 3% annual health inflation rule. The Board of Trustees must
learn to calculate the optimal distribution rate for the 12.4% OASDI tax, tax
the rich and limit Medicare revenues from the 2.9% HI payroll tax revenues to
<2.6% for <15.0% Federal Income Contributions Act (FICA) and going down,
revenues from OASDI tax on the rich going up FY 18. The three
year congressional budget request seems to be the most efficient method
of expressing social security operations to tax the rich to end poverty by 2020
by repealing the Adjustment of the contribution and benefit base under Section
230 of the Social Security Act 42USC¤430 and replacing it with 'There is
created in the Treasury a Supplemental Security Income Trust Fund'. Would gladly repeal the 0.9% additional HI
tax on the rich under 26USC¤3101(b)(2) for the privilege of repealing the
Adjustment of the contribution and benefit base under Section 230 of the Social
Security Act 42USC¤430, to tax the rich the full 12.4% OASDI tax to create an
SSI Trust Fund to end poverty in the United States by 2020. The temporary 2.37% DI rate CY 2016-2018
expires January 1, 2018. The 1.8% DI tax rate in Sec. 201(b)(1)(T) of the
Social Security Act under 42USC¤401(b)(1)(T) must be repealed and can be
replaced for the next few years with either 2.1% DI tax, or 2.0% DI tax if OASI
pays $240.4 billion in zero dollar damages plus 2.5% interest for damages
incurred during the years 2009-2015.
Budget Request of
SSI and OASDI Trust Funds 2018-2020
12.4 Tax |
Total Revenues |
Tax Revenues |
GF Reimbursement |
Tax on Benefits |
Net interest (3.0) |
Total |
Scheduled Benefits |
Administrative Costs |
R&R Interchange |
Net increase end of year |
Assets at end of Yer |
Trust fund Ratio |
2018 |
1,056 |
928.4 |
(62) |
41.3 |
86.5 |
1,015 |
1,004 |
6.3 |
4.9 |
41 |
2,948 |
287 |
2018 |
1,335 |
1,207 |
0 |
41.3 |
86.5 |
1,237 |
1,221 |
10.6 |
4.9 |
98.3 |
3,012 |
235 |
1.81 |
187.2 |
176.2 |
0 |
2.1 |
8.9 |
155.7 |
152.6 |
2.9 |
0.1 |
31.5 |
343.9 |
200 |
7.72 |
867.8 |
751.0 |
0 |
39.2 |
77.6 |
859.0 |
850.9 |
3.3 |
4.7 |
8.8 |
2,610 |
302 |
2.87 |
279.4 |
279.4 |
0 |
0 |
0 |
221.8 |
217.4 |
4.4 |
0 |
58.0 |
58.0 |
0 |
2019 |
1,406 |
1,270 |
0 |
45.5 |
89.0 |
1,317 |
1,301 |
11.0 |
4.9 |
89.1 |
3,101 |
229 |
1.54 |
170.5 |
157.7 |
0 |
2.4 |
10.4 |
163.4 |
160.3 |
3.0 |
0.1 |
7.1 |
351.0 |
211 |
8.00 |
940.8 |
819.4 |
0 |
43.1 |
78.3 |
922.9 |
914.6 |
3.5 |
4.8 |
17.9 |
2,628 |
283 |
2.86 |
294.7 |
293.0 |
0 |
0 |
1.7 |
230.6 |
226.1 |
4.5 |
0 |
64.1 |
122.1 |
25 |
2020 |
1,481 |
1,338 |
0 |
49.8 |
93.1 |
1,398 |
1,381 |
11.6 |
5.1 |
82.7 |
3,184 |
222 |
1.55 |
180.3 |
167.3 |
0 |
2.5 |
10.5 |
170.4 |
166.9 |
3.3 |
0.2 |
9.9 |
360.9 |
206 |
8.20 |
1,011 |
884.8 |
0 |
47.3 |
78.8 |
987.8 |
979.3 |
3.6 |
4.9 |
23.2 |
2,651 |
266 |
2.65 |
289.3 |
285.6 |
0 |
0 |
3.7 |
239.7 |
235.1 |
4.6 |
0 |
49.6 |
171.7 |
51 |
Source: Repeal of Adjustment of the contribution and benefit base Section 230 of the Social
Security Act under 42USC¤430.
4. The Social Security Administration
(SSA) must learn account for the combined SSI and OASDI Trust Fund tax rates to
enable Congress to repeal the Adjustment of the contribution and benefit base
under Section 230 of the Social Security Act 42USC¤430. SSA is a model of administrative efficiency with
administrative costs less than 1% of expenses and about one worker for every
thousand beneficiaries. For only $10 billion, 70,000 SSA workers administrate
more than $1 trillion to more than 70 million beneficiaries, including $955
billion from the OASDI Trust Funds and $54 billion for the SSI program from the
General Fund FY 17. There shall be adequate staff to provide that all
individuals wishing to make application for assistance under the plan shall
have opportunity to do so, and that such assistance shall be furnished with
reasonable promptness to all eligible individuals in Sec. 2 of the Social
Security Act under 42USC¤302. SSA is very administratively
efficient compared with any other benevolent program of any sort, with
administrative costs less than 1% of benefits. Simplified online income
verification SSI application forms will be filled out for healthy poor children
by schools, hospitals, obstetricians and pediatricians, without the extra
dozens of pages pertaining to medical disability. SSI administrative contract
spending growth in excess of 5%, 7.2% 2015-16, will be limited to 3% annually,
as is the norm for all three SSA trust funds, as the result of the
simplification of disability optional SSI application form data entry. Treasury
volunteers, whose spending growth is limited to 2.5%, will help to limit the
costs of SSA administrative spending growth to 3% annually for social workers =
net new employment % + pay raise % after possible one-time 5% surge in SSI
entry expenses caused by the creation of the SSI Trust Fund with all the
proceeds of the tax on the rich. Only the usual 3% administrative growth is
projected, a difference of $100 million to $300 million at the current
inefficient 7% rate of growth in back-payments. The first accounting challenge
of the combined Annual Report of the Social Security Administration is to
calculate the total number of Social Security beneficiaries from the estimates
provided in the 2017 Annual Report of the OASDI Trustees and 2016 Annual Report
of the SSI Program. Year-end 2017 the United States Social Security
Administration (SSA) is estimated to administrate monthly benefits to 70.4
million people Ð 51.7 million retirees and survivors (OASI) and 18.7 million
disabled workers Ð 10.6 million Disability Insurance (DI) and 8.1 million
Supplemental Security Income (SSI). 173 million covered workers
pay taxes on income less than $127,200 (2017). If those making more are taxed
Old Age Survivor and Disability Insurance (OASDI) Trust Funds will have to be
required pay every child growing up in poverty an SSI benefit, the first
calendar year the law is in operation, and everyone living below the poverty
line by 2020. Congress may tax the rich as soon as October 1, 2017 the first
day of fiscal year 2018 to begin paying 16-24 million poor children calendar
year 2018. Low current beneficiary estimates in 2016 report of the SSI program
may not be taking into consideration that non-contributing Baby Boomers who
become automatically eligible for SSI payments at age 65.
Social Security Beneficiaries in Current-Payment Status 2010-2018
Benefits |
2010 |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
2017 |
2018 |
2018 tax |
COLA |
0 |
0 |
3.6% |
1.7% |
1.5% |
1.7% |
0% |
0.3% |
2.7% |
2.7% |
OASI |
43.8 |
44.8 |
45.9 |
47.0 |
48.1 |
49.2 |
50.3 |
51.7 |
53.0 |
53.0 |
DI |
10.2 |
10.6 |
10.9 |
10.9 |
10.9 |
10.8 |
10.6 |
10.6 |
10.8 |
10.8 |
SSI |
7.7 |
7.9 |
8.0 |
8.1 |
8.2 |
8.2 |
8.1 |
8.1 |
8.3 |
25.0 |
Total |
61.7 |
63.3 |
64.8 |
66 |
67.2 |
68.2 |
69 |
70.4 |
72.1 |
88.8 |
Workers |
157 |
158.6 |
160.8 |
163.1 |
165.6 |
168.4 |
170.8 |
172.8 |
172.8 |
172.8 |
Source: 2017 Annual Report of the Board of Trustees of the Federal Old Age
Survivor Insurance Trust Fund and Federal Disability Insurance Trust Fund; 2016
Annual Report of the Supplemental Security Income Program, pg. 130-131, 139-140
5. The
Treasury has chosen to abolish the refundable premium and cost sharing
reduction subsidy FY 18. Supplemental Medical
Insurance (SMI) premium hyperinflation has been punished with a zero-growth
policy CY 18 Ð CY 19 when unacceptably high inflation >3% is predicted CY
20. It will be a long time before
health benefits will grow at the usual average annual rate of 3%. The source of
health hyperinflation and the oil price hyperinflation crisis in the early
1970s seems to be that HI payroll tax revenues increase at an average annual
rate of about six percent. 6% is twice the 3% usual growth rate for health care,
social work, and education welfare professional subsidy programs. 6% annual
growth in HI outlays had a carcinogenic effect on the Supplemental Medical
Insurance (SMI) Trust Funds, who also demand >5% annual growth. These
hyper-inflationary tendencies are neoplastic. All three federally financed
Medicare programs are being treated or punished with negative, zero to low
growth until NHE is <10% of GDP. Part B outlays are frozen at $300 billion
benefit spending and $200 billion general revenues. Part D interest must be
estimated after record asset accumulation in 2016 and outlays are frozen at
exactly $100 billion in benefits and a commensurately diminishing amount of
general revenues from $71.9 billion FY 17 to $66.6 billion FY 20. To reduce
overall Medicare spending, an effort must be made to cut the HI Trust Fund
payroll tax rate by an estimated 0.3% to 2.6% FY 18. Federal outlays for the HI
Trust Fund would continue to go down to 2.5% FY 19 and 2.3% FY20 for the nice
round figure of $250 billion federal health outlays to hospitals for zero
growth until national health expenditures (NHE) are less than 10% of gross
domestic product (GDP). Under the gradual reduction approach payroll tax
receipts for Part A would reduce the payroll tax $281.7 billion FY 18 to the
desired federal outlay figure of $255.9 billion FY 18, 3% growth from FY 14,
for the HI Trust Fund, a reduction of $11.3 billion, - 4.2%, from $268.2
billion in FY 17, and $25.8 billion in general revenues to reduce the federal
deficit at year end, and stay under the $1 trillion federal health outlay limbo
bar until NHE is <10% of GDP. The tax rate in is rounded. The precise tax
rate figure is not very important because payroll tax revenues tend to grow
faster than cancer cells. It seems best to keep budget total cuts gradual,
intangible and health inflation expectations at zero before settling on these
nice round numbers in FY 20 for a zero growth policy
to try to maintain total federal health outlays <$1 trillion until NHE is
<10% of GDP.
CMS Total Federal
Outlays 2014-2020
Year |
2014 |
2015 |
2016 |
2017 |
2018 |
2019 |
2020 |
Total CMS Outlays |
806 |
855 |
926.2 |
921.7 |
908.1 |
917.3 |
934 |
Part A |
227.4 |
241.1 |
253.5 |
267.2 |
255.9 |
255.0 |
250.0 |
Part B |
188.4 |
203.9 |
235.6 |
215.5 |
210.0 |
200.0 |
200.0 |
Part D |
58.1 |
68.4 |
82.4 |
71.9 |
71.5 |
68.0 |
66.6 |
Sub-Total Medicare |
473.9 |
513.4 |
571.5 |
554.6 |
533.4 |
549.4 |
565.9 |
Medicaid |
317 |
326 |
336 |
346 |
357 |
350 |
350 |
CHIP |
9.0 |
9.3 |
12.3 |
14.5 |
11.0 |
11.0 |
11.0 |
Administration |
6.1 |
6.3 |
6.4 |
6.6 |
6.7 |
6.9 |
7.1 |
Total CMS |
806 |
855 |
926.2 |
921.7 |
908.1 |
917.3 |
934 |
Source: 2016 CMS
Statistics. CMS Office of Financial Management. March 2017; 2017 Annual Report
of the Board of Trustees for the Federal Hospital Insurance Trust Fund and
Federal Supplemental Medical Insurance Trust Fund. July 2017
6. A
Health Department or Public Health Department (PHD) and Department of Human
Services (DHS) need to graduate from the Department of Health and Human Service
(DHHS) to fulfill the requirements of the Department of Education
Re-organization Act of May 4, 1980 under 20USC¤3508..
The foundation of the public health service is typically attributed to July 16,
1798, when President John Adams signed a bill into law that created what we now
know as the U.S. Public Health Service by establishing the U.S. Marine Hospital
Service, predecessor to todayÕs U.S. Public Health Service, to provide health
care to sick and injured merchant seamen at naval hospitals under 24USC¤14. Medical bills cause an estimated 67% of bankruptcies
today, up from 8% in 1980 and it is necessary to nullify and repeal 'Medical
records and payments' from the Fair Credit Reporting Act under
15USC¤1681a(x)(1) like legal bills in 2009; student loans never sent a bill
without murder tampering under 18USC¤1512. The PresidentÕs Budget FY 18 request for HHS proposes $69 billion
in discretionary budget authority and $1,046 billion in mandatory funding, that
comes to $1,115 billion FY 18. The budget-in-brief requests $1,113 billion to
comply with CR 17 budget authority, but actually demands
a total of $1,131 billion FY 18 when outlays are added, $18 billion, 1.6% more
than CR 17. Administrative spending cuts, especially for un-discontinued
research in contravention to the Nuremburg Code, and FY 17 Part B and D cuts
are sustained into FY 18 and beyond. ACF child and family benefits should grow
4% annually plus historical interest in undistributed offsetting receipts and
anti-welfare fraud loans of Secretary Price under Sec. 406 of the Social
Security Act under 42USCá¤606 and 18USC¤228. To balance the federal budget, 6%
annual growth in Part A tax revenues must run over into 3% health benefit
growth in Parts A, B & D benefits beginning FY 18. Hospitals must charge
< 2.6% HI tax FY 18 to reduce total federal outlays reported by HHS and OMB.
Federal health spending will be going down for some time with a zero growth policy until NHE is <10% of GDP.
Health and Human
Services Departments Federal Outlays FY 16 - FY 18
FY 16 |
FY 17 |
FY 18 |
|
Health Department total |
982,636 |
985,199 |
965,523 |
Health and Human Services total |
1,041,441 |
1,048,446 |
1,030,736 |
Human Services Department total |
-58,805 |
-63,247 |
-65,213 |
Public Health Service sub-total |
56,436 |
63,499 |
57,423 |
Centers for Medicare & Medicaid Services |
926,200 |
921,700 |
908,100 |
Source:
HHS Budget Outlays FY 18
7. The United States needs to reduce health spending to
less than 10% of GDP. National health expenditure as a percent of GDP increased
from 5.6% in 1965, to 7.1% in 1970, to 8.9% in 1980, to 12.6% in 1990 to more
than 16% in 2000 to as high as 17.8% without applying the GDP deflator in 2013
and 17.5% in 2016 with the new 17.3% deflator 2009-2013. Since the inception of
the HI tax in the 1970s, national health care spending has on average grown
nearly twice as fast, about 2.5 percentage points faster than the economy, that
has grown at a rate of 3 percent annually since all other forms of inflation
worldwide were brought under control since 1980. After four decades of high
inflation averaging 8.9% annually for Medicare and 9.8% annually for private
health insurance between 1970, when inflation was over 20% and 2005, when it
was about 6.6%, the inflation in health care prices has nearly been brought
under control- defined as less than 3% annual inflation since 2012-2016, when
hyper-inflation again reared its ugly head, and government health budgets began
to be cut. Medicare spending has increased as
state payments for Medicaid expansion patients dwindled from 40-50% to 10%,
estimated at 11% of federal outlays for Medicaid. FY 17 and FY 18 Medicare cuts
regain some control over, at least, the government budget aspects of neoplastic
health inflation. In 2005, national health expenditures totaled $2 trillion
or 16 percent of the GDP, and grew to 17.4 percent of the GDP where it stayed
from 2009 to 2013, as the result of the application of a GDP deflator by the
CMS Actuary. Health, United States, 2014 is the last credible report on national health expenditure. Editors
must abolish the GDP deflator, plug in private health insurance estimates from
the 2014 Health Insurance Industry Analysis Report of National
Association of Insurance Commissioners and Center for Insurance Policy and
Research for a proven NHE of 15.6% FY 13 and 15.5% FY 14, that inched back-up
to 15.6% FY 15 & 16 before Medicare and public health service spending cuts
reduce spending to 15.3% FY 17 to 14.8% FY 18 with a 2.6% HI tax-spending rate.
In 2013, personal health care expenditures in
the United States totaled $2.5 trillion, a 3.8% increase from 2012, mostly
driven by 4% growth in private health insurance premiums. It is against the
2.7% average consumer price index (CPI) inflation for health insurance premium
prices to increase more than 3%. The per capita personal health care
expenditure for the total U.S. population was $7,826 in 2013, up from $7,597 in
2012. Despite the high cost, the U.S. does not appear to provide greater health
resources to its citizens or achieve substantially better health benchmarks
compared to other developed countries. For instance, in 2000 the United States had the highest birth rate (12.5 per 1,000 population),
infant mortality rate (6.1 infant deaths per 1,000 live births and 8 under age
5 deaths per 1,000 ) and maternal mortality rate (32
deaths per 100,000) of any industrialized nation. It is essential that the
United States has the goal to reduce national health expenditures to less than
10% of GDP by 2030. Only Great Britain spends more than 10% of GDP on health,
and they are reported to be unpleased with their national health service. State
Medicaid cuts to 10% of the federal share FY 15-18 do to 3% annual growth from
Health United States, 2014. are honored.
National Health Expenditure
Account Balance 2013-2018
2013 |
2014 |
2015 |
2016 |
2017 |
2018 |
|
Private Health Insurance Net Premiums |
451 |
525 |
541 |
557 |
573 |
591 |
Administration and net cost of private health insurance |
127 |
130 |
133 |
137 |
140 |
144 |
Medicare |
582 |
600 |
638 |
694 |
708 |
669 |
Medicaid total |
407 |
352 |
362 |
373 |
384 |
396 |
Federal |
235 |
317 |
326 |
336 |
346 |
357 |
State |
172 |
34.9 |
35.9 |
37.0 |
38.1 |
39.3 |
CHIP total |
10.3 |
12.6 |
13.0 |
14.3 |
16.7 |
12.0 |
Federal |
7.8 |
9.1 |
9.4 |
12.3 |
14.5 |
11.0 |
State |
3.5 |
3.5 |
3.6 |
2.0 |
2.2 |
1.0 |
Other health insurance programs |
89 |
92 |
94 |
96 |
99 |
101 |
All Health Insurance Payments Subtotal |
1,667 |
1,712 |
1,781 |
1,871 |
1,921 |
1,913 |
Other third party payers and programs |
221 |
227 |
232 |
238 |
244 |
250 |
Out-of-pocket payments |
339 |
348 |
357 |
366 |
375 |
384 |
Investment |
152.5 |
153.9 |
156 |
157 |
159 |
160 |
Public Health |
239 |
245 |
251 |
257 |
264 |
270 |
Total National Health Expenditures |
2,619 |
2,686 |
2,777 |
2,889 |
2,963 |
2,977 |
Gross Domestic Product 3% |
16,768 |
17,271 |
17,803 |
18,472 |
19,303 |
20,130 |
NHE as % of GDP |
15.6% |
15.5% |
15.6% |
15.6% |
15.3% |
14.8% |
Source: 2017 Annual Report of the Board of Trustees
of the Federal Hospital Insurance Trust Fund and Federal Supplemental Medical
Insurance Trust Fund, July 2017. Health,
United States, 2014. Daveline, Dan; Koenigsman, Jane; Rivers, Bill, 2014 Health Insurance Industry Analysis Report National
Association of Insurance Commissioners and Center for Insurance Policy and
Research, 2015. OMB FY 17 Table 10.1
8. No opes.
To escape the severe pain epidemic caused by hospital acquired methicillin
resistant Staphylococcus aureus + pyromania acquired Streptococcus
pyogenes = toxic shock syndrome, it is necessary to advertise the only
antibiotic(s) to be proven effective against Staph infection in Food and
Drug Administration (FDA) studies, doxycycline and clindamycin. Doxycycline or
doxycycline hyclate, the once a day antibiotic,
should therefore be prescribed to all patients discharged from the hospital or
who are believed to have a Staph infection, Clindamycin (Cleocin)
for children under 8 and pregnant women. Unadulterated doxycycline is also
thought to uniquely effective against Lyme disease, bubonic plague and
syphilis. Color safe bleach should
be required to be included in, and prominently displayed on, the label of
chemical hospital and institutional cleansers to prevent outbreaks of
methicillin resistant Staphylococcus aureus (MRSA) on other public
benches. Hygienists should not need to know that they must measure out the
chlorine bleach themselves, to avoid toxic liability for Staph infections,
caused by adulterated or misbranded products in Sec. 301 of the Food,
Drug and Cosmetic Act under 21USC¤331. The Center for Disease
Control (CDC) recommends 1 teaspoon (4.9 mL) per gallon (308 L) for
food-surfaces and 1 cup (240 mL) per 5 gallons (18.9L) for hard surfaces and 1
cup (240 mL) per 1 gallon (3.8L) for mold growth on hard surfaces. The
United States has chilled the waters of the Atlantic and Gulf Coasts, and needs
to chill the Pacific to look good in the news media extinguishing forest fires
to end drought with Rainmaking US Patent No. (1966) 3,429,507. Canada and
Russia seem to have become the leading thermal polluters in the northern
hemisphere. The Southern hemisphere continues to cause East African drought as
the result of a belt of oceanic warming along 40¡S.
9. The United States Department of Agriculture (USDA) has been subjected to
due diligence and this budget no longer conflicts with USDA or the Veteran's
Administration (VA) growth. The National Oceanic and Atmospheric Administration
(NOAA) of the Department of Commerce requires a second glance at the Sea
Surface Anomaly map in the forthcoming review of the 2017 fire season to see if
they should be forgiven their budget cuts although it is cool, not hot, ocean
water, that creates clouds and prevents hurricanes, and Forest Service cloud
seeding uses iron dust to make lightning rather than silver iodide to make rain
in clandestine weather modification operations. The FY 18 budget makes changes
to FY 16 and FY 17 spending to explain much lower outlay totals, $138 billion
FY 16, $133 billion FY 17 and $140 billion FY 18, than previously given $153
billion FY 16 to $152 billion FY 17. Reason being the wild inflation in
Commodity Credit Corporation (CCC) and off-budget lending of the Rural Business
Cooperative, financed with electricity fees, must be deleted from the outlay
table, to begin to count the historical undistributed offsetting receipts since
FY 15. The public is highly dissatisfied with SNAP welfare benefit growth that
should be 3% annually = % increase in benefit amount + % increase in
beneficiaries. The United States Forest Service was convicted of committing
arson within the special maritime and territorial jurisdiction under 18USC¤81.
Interior Department Budget Total Subtraction Error
Correction FY15 - FY18
(in billions)
FY 2016 |
FY 2017 |
FY18 |
FY 18 subtracted |
|
Budget Authority |
19.0 |
19.1 |
17.8 |
19.8 |
Receipts |
8.8 |
10.7 |
11.2 |
11.2 |
Total Outlays |
10.2 |
8.5 |
6.8 |
8.6 |
Federal Outlays |
13.4 |
13.3 |
11.7 |
11.7 |
Undistributed Offsetting Receipts est. |
3.2 |
4.8 |
4.3 |
3.1 |
OMB |
14.0 |
15.0 |
15.3 |
15.3 |
Source: FY2018 The
Interior Budget-in-brief. May 2017
10. Oceanic cooling pumps, patented in 2012 by AS Trust &
Holdings US Patent R441A by the American Society of Heating, Refrigerating and
Air-Conditioning Engineers, can prevent hurricanes by reducing water
temperature below 80¼ F US under Patent No. (2002) 0008155 and US Patent No.
(2008) 0175728 A1. The only peaceful purpose of oceanic heating pumps is to
generate winds blowing in the direction of oceanic cooling pumps along the
coast, to make clouds to be seeded with silver iodide missiles pursuant to
Rainmaking US Patent No. (1966) 3,429,507 that can cause flooding if trees
aren't removed from waterways. Due process shall be given to abolishing the Forest Service for
their involvement in the 2017 fire season and investing the entire $5.3 billion
FY 18 budget in Trump Trails. This one-time donation of land and $5.3 billion
of money to the National Parks would be dedicated entirely to improving the
hourly wage, benefits, fire safety, cartography and logistical support of
Òcounty parkÓ supervised Trump Trails workers. The
Secretary of the Interior Department (ID) or National Park Foundation shall
receive the donations of National Forest land and Forest Service money and
property surrendered to country park supervision under 54USC¤101101-¤101120.
Trump Trails will cross-connect the nation's parks, coast to coast, and
decommission logging and other roads to improve maps, land value, fire safety,
pedestrian accessibility, recreation, swimming, drinking water, beneficial and
edible plants, endangered species and wildlife habitat by limiting economic
cooperation in forested, mountainous and otherwise deserted roadless
areas, exclusively to cartographic and logistical support of the National Trail System Act
of 1968 under 16USC¤1246(h)(1). The end of the law is that, any person or
instrumentality who destroys, causes the loss of, or injures any parkland is
liable to the United States for response costs and damages resulting from the
destruction, loss, or injury under 54USC¤100722.
Sanders, Tony J. Book 3:
Health and Welfare (haw). 12th Ed. Hospitals & Asylums
HA-9-11-17. 422 pgs. PDF
; Word