Hospitals & Asylums    

 

Welcome

Atlas

Litigation

Legislation

Statute

 

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 fool’s 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 – FY 18

(millions)

 

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 – 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 – 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 – 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

(billions)

 

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 – 51.7 million retirees and survivors (OASI) and 18.7 million disabled workers – 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

(millions)

 

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 – 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

(billions)

 

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 today’s 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 President’s 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 42USCŠ§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

(millions)

 

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

(billions)

 

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 80ľ 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 “county park” 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