October 22, 2019

July 30 Marks the 50th Anniversary of Medicare

Press Release from National Center for Public Policy Research:

Unfortunately for All Too Many, the Program Fails to Live up to Its Promise

Medicare Often Denies The “Healing Miracle of Modern Medicine” to Seniors

Medicare Constantly Interferes in the Doctor-Patient Relationship

Washington, DC – “A week from today, Medicare will mark its 50th anniversary,” says Dr. David Hogberg, senior fellow and health care policy analyst at the National Center for Public Policy Research. “Unfortunately, a historical analysis of what was intended half a century ago and what we now have show Medicare falls way short of expectations. In fact, there’s no reason to sugar coat what is the largest US Government health care program we have in place today. Medicare is a sick program that often fails to meet its promises…not only to patients, but to the healers as well.”

To demonstrate his point, Dr. Hogberg has compiled many heart-wrenching stories of Medicare patients who have suffered because of Medicare’s policies in both his new book, “Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians,” and the recent cover story in the Washington Examiner, “Medicare’s Midlife Crisis: Catastrophic Finances Pit Doctors against Patients.”

Hogberg reminds us that when President Lyndon Johnson signed Medicare into law on July 30, 1965, he claimed that, “No longer will older Americans be denied the healing miracle of modern medicine.”

“Regrettably, Medicare falls far short of living up to that promise,” says Dr. Hogberg. “As just one example, consider Frank Alfisi, who I profile in my book. He suffered from kidney failure and was unable to get dialysis in a timely fashion because of Medicare’s rules regarding hospital admissions. Because of these delays, he ultimately ended up in a wheelchair, needing portable oxygen, and lost much of his sight as a result. He died in the hospital about two months later.”

When Medicare became law in 1965, Hogberg reports, the first part of the legislation was titled, “Prohibition Against Any Federal Interference.” It states, “Nothing in this title shall be construed to authorize any Federal office or employee to exercise any supervision or control over the practice of medicine,” a very clear and explicit promise that Medicare would not interfere with the doctor-patient relationship.

“That’s a sad joke,” says Dr. Hogberg. “In doing my research, it didn’t take too long before doctors started complaining about how Medicare interferes with how they treat their patients.”

In his Examiner article , Hogberg demonstrated this point by referencing an interview he did with Dr. Eric Novack, an orthopedic surgeon who lamented about how Medicare treated one of his elderly patients. She had come to him for a broken ankle and needed rehab in a skilled nursing facility because she was frail and lived alone. Her surgery was fairly simple, but rather than allowing her to go directly to the nursing facility, Medicare rules required her to stay in the hospital for three days. If she refused, Medicare would force her to foot the bill herself. “This only added to her health risks,” Dr. Novack stated. “I like to tell patients that hospitals are full of sick people, and if you don’t have to be around them, you shouldn’t be. The longer you are in the hospital, the more likely you are to have other issues.”

“The Medicare system that we have in place today was not what President Johnson had envisioned. It’s a sick program and one that needs to be seriously revamped,” Dr. Hogberg laments.

The National Center for Public Policy Research, founded in 1982, is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from individuals, less than four percent from foundations, and less than two percent from corporations. It receives over 350,000 individual contributions a year from over 96,000 active recent contributors. Sign up for free issue alerts here.

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Medicare’s Harm to Patients, Doctors Detailed in New Book

As Medicare Turns 50 on July 30, New Book Exposes Medicare’s Problems and its Victims

“Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians ” Tells Tales of Harm to Patients, Struggles by Doctors

Explains Why “Medicare-for-All,” as Proposed by Some Politicians, Won’t Work

Washington, DC – “As Medicare nears its 50th anniversary, there will no doubt be much celebrating among politicians and pundits on the left,” says Dr. David Hogberg, senior fellow and health care policy analyst at the National Center for Public Policy Research. “Yet Medicare has a sick underbelly. Exposing the problem and reporting the true facts about this program should be the media’s main focus. There is no reason to sugarcoat this program. It’s broken and my book explains why.”

Dr. Hogberg’s new book, “Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians,”* shows that Medicare often fails to provide quality health care to patients.

“The media too often overlooks the many victims of Medicare, in part because Medicare has achieved this mythic status as a wonderful government program,” says Dr. Hogberg. “This book reports on the program’s many flaws, providing the reader with a more balanced view of Medicare.”

“Medicare’s Victims” tells the intimate stories of patients and physicians who have struggled with Medicare’s policies. They include:

-Clay Bell, whose death was hastened because Medicare denied the physical therapy he needed to slow the progression of his Multiple Sclerosis.

-Sean Plomann, who suffered in agonizing pain while languishing in Medicare’s waiting period for the disabled.

-Donna Dennis, who came very close to suffering a stroke because she could not afford her medication after falling into Part D’s donut hole.

-Dr. Scott Braddock, who, despite getting stellar results with his hard-to-treat diabetes patients, had to close his practice, thanks to Medicare.

-The book also recounts how the American Hospital Association and Federation of American Hospitals used Medicare to stop competition from physician-owned specialty hospitals, although such hospitals often provided the highest quality of care.

“The book is also timely because there are some more liberal politicians who are now pushing for a ‘Medicare-for-All’ single-payer system,” says Dr. Hogberg. “Specifically, Senator Bernie Sanders recently called for such a system. The book yields insight into why such a system wouldn’t work.”

“Medicare’s Victims” shows that the beneficiaries who do get good treatment under Medicare are the ones who have the ability to influence Congress on Medicare policy. That generally includes senior citizens, who vote at rates higher than almost any other group.

“Under a system of Medicare-for-All, resources would flow to those with political power,” says Dr. Hogberg. “The problem is that people without political power will lose out, and they are likely to be some of the sickest patients.”

“For starters, there are relatively few people who get seriously ill each year, too few, in fact, to have much impact on Election Day. Second, because of their health, they aren’t going to be organizing, protesting and doing other things necessary to influence Congress. And finally, some of them are so sick that they won’t be around for the next election. Given that, it is inevitable that sicker patients are most likely to suffer under a system of Medicare-for-all.”

The National Center for Public Policy Research, founded in 1982, is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from individuals, less than four percent from foundations, and less than two percent from corporations. It receives over 350,000 individual contributions a year from over 96,000 active recent contributors. Sign up for free issue alerts here.

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New Book Tells Stories of People Suffering Thanks to Medicare

Press Release from the National Center for Public Policy Research:

New Book, “Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians,” To Be Released

Tells Intimate Stories of People Who Suffer Because of Medicare’s Policies

Why Senator Bernie Sander’s “Medicare-for-All” Won’t Work

Washington, DC – Dr. David Hogberg, senior fellow and health care policy analyst for the National Center for Public Policy Research, is scheduled to release his new book, “Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians,”* on July 6, 2015.

“So many people think Medicare is a wonderful program,” says Dr. Hogberg. “My extensive research in writing this book shows just the opposite… there are often hidden victims of Medicare and my book examines how Medicare’s policies harm them,” he reports.

The victims of Medicare, Dr. Hogberg notes, not only include the patients but also doctors themselves, each of whom share a common trait. “The patients who receive poor treatment and the physicians, who are stymied in their efforts to provide good care, tend to lack political power,” he says. “That is, they lack the ability to compel Congress to make changes in Medicare. Usually the victims are too few in number to have any real impact at the ballot box. Furthermore, they are often too ill to engage in the sorts of activities, such as organizing, protesting and so forth, that can help change policy,” he says.

“Medicare’s Victims” examines the disabled on Medicare who struggle with Medicare’s two-year waiting period and Medicare’s cost sharing. It looks at seniors who fell into Part D’s donut hole, and patients who either received insufficient treatment or received too much care under Medicare.

The book also reveals why primary care physicians are either leaving Medicare or are limiting the number of Medicare patients they accept; how concerned physicians who try to spend more time with their Medicare patients are, in effect, penalized; and how lobbying groups for large hospitals used Medicare to squash their competitors, smaller physician-owned specialty hospitals.

“The book is timely because there are some more liberal politicians who are now pushing for a ‘Medicare-for-all’ single-payer system,” says Dr. Hogberg. “Specifically, Senator Bernie Sanders recently called for such a system. The book yields insight into why such a system wouldn’t work.”

“Medicare’s Victims” explains why the beneficiaries who do get good treatment under Medicare are the ones who do have political power, particularly seniors ages 65-74.

“They vote at rates higher than almost any other group and since many of them live in retirement communities or belong to senior centers, they are easy to organize if needed,” says Dr. Hogberg. “With that sort of political clout, members of Congress are going to make sure that, in general, seniors receive good treatment under Medicare.

“The problem with the Medicare-for-all approach is that you’d be extending Medicare to all sorts of diverse groups who don’t collectively have the political clout or wherewithal to institute any change within the system. As such, politicians will have little incentive to ensure that such groups are even receiving the good care they should expect under Medicare.”

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This Week Congress May Pass Bill that Pays Medicare Doctors More if They Avoid Sickest Patients

Press Release from the National Center for Public Policy Research:

Are Republicans and Democrats Creating a Mini-Death Panel for Medicare in the “Bipartisan” Doc Fix Bill?

New “Merit-Based Incentive Payment” System is Eerily Similar to Independent Payment Advisory Board

Sickest Medicare Patients Likely to Suffer Under IPAB-Like Payment System

Medicare Access and CHIP Reauthorization Act (MACR) Restructures Medicare’s Payments So Doctors Have Incentives to Avoid the Sickest Patients

Washington, DC – Congress is set to establish an IPAB-Like payment system in Medicare, argues a new National Policy Analysis paper from the National Center for Public Policy Research.

“Medicare’s Independent Payment Advisory Board has never gotten off the ground, thanks in part to the work of conservatives and libertarians,” says Dr. David Hogberg, senior fellow at the National Center. “Now a coalition of politicians, including many Republicans, are on the verge of passing a bill that will introduce a payment system that is consistent with IPAB’s mission, incentive structure, and likely outcomes.”

In “Medicare Doc Fix Bill is IPAB-Lite,” Dr. Hogberg points out that the Medicare Access and CHIP Reauthorization Act (MARC) re-structures Medicare’s payment system so that physicians will have incentives to avoid treating the sickest patients.

“MACR is supposed to repeal Medicare’s unworkable Sustainable Growth Rate,” says Dr. Hogberg. “Fine. But why use it to do the business of the highly unpopular IPAB?”

Dr. Hogberg points out that the new payment system, the Merit-Based Incentive Payment System (MIPS), grades physicians based on how well physicians’ patients score on quality measures and how many medical resources physicians use to treat patients. Physicians will either receive bonuses or penalties based on how well they score. It is easier for physicians to receive a high grade and, thus, receive a bonus under MIPS with only moderately ill patients since such patients will score well on quality measures and require fewer treatment resources.

By contrast, sicker patients will score poorly on quality measures. Treating them will require more resources. A sicker caseload likely means a physician will fare poorly under MIPS and see his Medicare fees cut.

In short, the sickest Medicare patients will have a harder time finding physicians who will treat them thanks to MIPS.

“MIPS is exactly the sort of proposal you would expect out of IPAB,” said Dr. Hogberg. “Its ostensible purpose is to improve quality and cut costs. Its likely outcome is that it will harm the sickest patients.

“This is what happens when an unaccountable group of people pay no cost if the decisions they make are wrong. That’s the set of incentives that board members of IPAB would face. MIPS is similar. It will be run by unaccountable bureaucrats at the Centers for the Medicare and Medicaid Services with advice from professional medical organizations. Neither will pay a cost – such as a loss of employment – if the decisions they make about MIPS are wrong, harming patients. That’s a recipe for bad outcomes.”

The National Center for Public Policy Research was founded in 1982. Sign up for free issue alerts here and go here to make a tax-deductible contribution to help us fight for liberty.

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Sustainable Growth Rate Repeal Bill Will Harm Medicare Patients

“Merit-Based Incentive Program” Will Encourage Physicians to Avoid the Sickest Medicare Patients

Senate Should Repeal SGR Without the Merit-Based Incentive Program

Washington, DC – As the U.S. Senate prepares to consider legislation to repeal Medicare’s Sustainable Growth Rate (SGR), senators need to know the bill will replace the SGR with something worse.

“The SGR is unworkable and needs to go,” said Dr. David Hogberg, senior fellow at the National Center for Public Policy Research. “But the bill under consideration creates a new Medicare payment system that, ultimately, will harm the sickest Medicare patients.”

In a new National Policy Analysis, “SGR Repeal Bill Will Harm Medicare Patients,” Dr. Hogberg explains the Medicare Access and CHIP Reauthorization Act will reward physicians for avoiding the patients most in need.

The bill creates a new payment system called the Merit-Based Incentive Program (MIPS). Under MIPS, physicians will be paid in part by how well they do on various quality measures. If they score above the average score on a quality measure, they receive a bonus. If they score below, they will be penalized.

Dr. Hogberg explains this will incentivize physicians to eschew sicker patients.

“Consider A1c, the level of a patient’s blood sugar and a common quality measure for diabetics,” said Dr. Hogberg. “Physicians who are subject to this quality measure can boost their score by limiting their diabetic patients to those who are easy to treat. They will avoid diabetic patients who need much more encouragement and monitoring, since taking on too many of those patients could result in a below average score on the A1c measure and, hence, a penalty.”

Furthermore, this system encourages more talented physicians to pursue the less challenging avenues of medicine, since that is where the healthiest patients are likely to be, making it easier to receive a bonus under MIPS. They will avoid the more challenging avenues where the sickest patients are likely to be.

“Ultimately, the sickest patients will suffer as MIPS incentivizes the best physicians to avoid the,” said Dr. Hogberg.

“The House has already passed this bill without giving much thought to what they are replacing the SGR with,” said Dr. Hogberg. “It would be wise for the Senate to slow down the process and eliminate MIPS from the legislation.”

The National Center for Public Policy Research was founded in 1982. Sign up for free issue alerts here and go here to make a tax-deductible contribution to help us fight for liberty.

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Governor John Kasich (R-OH) Should Stop Insisting Christians Must Support ObamaCare’s Medicaid Expansion

New Parody Exposes Kasich’s Absurdity

Christian Charity Is Voluntary; Medicaid Expansion Is Government Force

Is Kasich Aware “How Lousy Medicaid Is”?

Washington, DC – “If John Kasich actually thinks people will suffer eternal damnation for not supporting ObamaCare’s Medicaid expansion, then he’s not fit to be dog catcher, let alone Governor of Ohio,” says Dr. David Hogberg, senior fellow at the National Center for Public Policy Research.

Prompted by Governor Kasich’s recent remarks that Medicaid expansion is in keeping with the Gospel according to Matthew, Chapter 25, Dr. Hogberg has written, “Parody: Why All Good Christians Must Support ObamaCare’s Medicaid Expansion.”

“Normally I would write a straight-up research article,” Dr. Hogberg says. “But Kasich’s thinking, such as it is, was so silly that a parody was the better way to go.”

Dr. Hogberg notes that Matthew, Chapter 25, urges Christians to help the poor, hungry and sick. “It doesn’t say, use government to force people to help the poor, hungry and sick.”

Christian charity is voluntary. By contrast, the government forces people, via taxation, to support Medicaid expansion. That Governor Kasich doesn’t seem to know the difference doesn’t speak well of either his supposed conservatism or his understanding of Christianity.

In 2013, Kasich told a state legislator who opposed Medicaid expansion, “Now, when you die and get to the… meeting with St. Peter, he’s probably not gonna ask you much about what you did about keeping government small, but he’s going to ask you what you did for the poor. Better have a good answer.”

“King Solomon, in all of his wisdom, could not have been more eloquent,” laughs Dr. Hogberg. “In all seriousness, I won’t be so presumptuous as Kasich to tell people what will get them into Heaven, but I think it’s debatable as to whether forcing people to support Medicaid will score many points with St. Peter.”

“I’d also like to ask Kasich if he is aware of how lousy a program Medicaid is,” Dr. Hogberg continued. “The evidence shows that it has no noticeable effect on patient health. Furthermore, Medicaid patients have a lot of trouble getting access to a physician and often have worse health outcomes than people with private insurance. There are many ways to describe condemning poor people to such a program, but I don’t think ‘Christian’ is one of them.”

The National Center for Public Policy Research, founded in 1982, is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from individuals, less than four percent from foundations, and less than two percent from corporations. It receives over 350,000 individual contributions a year from over 96,000 active recent contributors.

Contributions to the National Center are tax-deductible and greatly appreciated.

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Physicians Are Leaving Medicare Because of “Doc Fix” Process

Press Release from National Center for Public Policy Research:

Threat of Drastic Cuts to Medicare Physician Fees Create Immense Uncertainty for Physicians

Congress Always Suspends the Cuts and Will Do So Again this January – It’s Time to End this Fraud Permanently

Washington, DC – “It’s a sad state of affairs when doctors are forced to risk the financial health of their practices just to take on new Medicare patients,” said Dr. David Hogberg, senior fellow at the National Center for Public Policy Research. “But that’s the result of the uncertainty created by threatened cuts to Medicare physician fees.”

In an a new National Policy Analysis paper entitled “To Bring Doctors Back to Medicare, Fix The ‘Doc Fix’,” Dr. Hogberg argues that it is time to end the threat of physician cuts.

Every one to two years, Medicare threatens to drastically cut what it pays physicians. The cuts are the result of a formula known as the Sustainable Growth Rate (SGR). When Medicare physician fees exceed an expenditure target, the SGR is supposed to result in automatic, across-the-board cuts.

“But it’s a fraud,” says Dr. Hogberg. “Congress is unwilling to make the cuts, so it routinely suspends the cuts and replaces them with a one to two percent increase in fees, a process known as the ‘Doc Fix.'”

“Congress will be doing it again come January, when a 25 percent cut in Medicare physician fees is scheduled to take place,” he continued. “Congress will undoubtedly suspend it. But the problem is that this creates uncertainty among physicians. As a result, more and more physicians are limiting their exposure to Medicare. This is a big factor in helping to drive doctors away from Medicare.”

In 2001, about 10 percent of physicians were no longer seeing new Medicare patients. Now it’s 17 percent.

A 2010 American Medical Association survey found that over three-quarters of the physicians who limit the Medicare patients they see cited the “ongoing threat of future payment cut makes Medicare an unreliable payer” as a reason.

The National Policy Analysis paper points to the example of Dr. John Slatosky, a primary care physician in rural North Carolina. In 2007 he stopped seeing new Medicare patients because he worried the government might suddenly and dramatically cut the amount it paid him to treat Medicare patients. It was a decision that bothered him greatly, as now there would be Medicare patients in his area who would have to look for a doctor elsewhere.

“But, in the end, it was better to have a physician here seeing some of the Medicare patients in the area than me losing my business and having no physician here at all,” said Dr. Slatosky.

By 2030, the number of Medicare patients will increase 50 percent above present levels. “We need more physicians taking Medicare patients, not fewer,” notes Dr. Hogberg. “Ending the SGR is a good first step.”

The National Center for Public Policy Research, founded in 1982, is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from individuals, less than four percent from foundations, and less than two percent from corporations. It receives over 350,000 individual contributions a year from over 96,000 active recent contributors.

Contributions to the National Center are tax-deductible and greatly appreciated.

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How to Get Doctors Back to Seeing Medicare Patients

If We Want Doctors to Return to Medicare, It Is Time to End The “Doc Fix”

Physicians Are Leaving Medicare in Part Because of the Uncertainty Created by the Regular Threat of Drastic Cuts to Medicare Physician Fees

Congress Always Suspends The Cuts and Will Do so Again This January – It’s Time to End This Fraud Permanently

Washington, DC – “Every one to two years, Medicare threatens to drastically cut what it pays physicians. This is a big factor in helping to drive doctors away from Medicare,” says Dr. David Hogberg, senior fellow at the National Center for Public Policy Research

In an op-ed for the Washington Examiner published today, “To bring doctors back to Medicare, fix the ‘Doc Fix’,” Dr. Hogberg argues that it is time to end the physician cuts.

“The cuts are the result of a formula known as the Sustainable Growth Rate. When Medicare physicians fees exceed an expenditure target, the SGR is supposed to result in automatic, across-the-board cuts,” he explains. “But it’s a fraud. Congress is unwilling to make the cuts, so it routinely suspends the cuts and replaces them with a one to two percent increase in fees, a process known as the ‘Doc Fix.’

“Congress will be doing it again come January, when a 25 percent cut in Medicare physician fees is scheduled to take place,” he continued. “Congress will undoubtedly suspend it. But the problem is that this creates uncertainty among physicians. As a result, more and more physicians are limiting their exposure to Medicare.”

A 2010 American Medical Association survey found that over three-quarters of the physicians who limit the Medicare patients they see cited the “ongoing threat of future payment cut makes Medicare an unreliable payer” as a reason.(1)

The op-ed points to the example of Dr. John Slatosky, a primary care physician in rural North Carolina. In 2007 he stopped seeing new Medicare patients because he worried the government might suddenly and dramatically cut the amount it paid him to treat Medicare patients. It was a decision that bothered him greatly, as now their would be Medicare patients in his area who would have to look for a doctor elsewhere.

“But, in the end, it was better to have a physician here seeing some of the Medicare patients in the area than me losing my business and having no physician here at all,” said Dr. Slatosky.

In 2001, about 10 percent of physicians were no longer seeing new Medicare patients. Now it’s 17 percent.(2)

By 2030, the number of Medicare patients will increase 50 percent above present levels. We need more physicians taking Medicare patients, not fewer, notes Dr. Hogberg.

“It’s a sad state of affairs when doctors are forced to risk the financial health of their practices just to take on new Medicare patients,” said Dr. Hogberg. “Congress needs to stop the Doc Fix kabuki dance and enact a permanent repeal of the SGR.”

The National Center for Public Policy Research, founded in 1982, is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from individuals, less than four percent from foundations, and less than two percent from corporations. It receives over 350,000 individual contributions a year from over 96,000 active recent contributors.

Contributions to the National Center are tax-deductible and greatly appreciated.

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Government: Only Places We Can Cut are ‘Entitlement’ Programs

Really? Here’s a list. It’s real from 2011. These cuts have been proposed, but how many of them have been cut? None. Instead they want your Social Security and Medicare.

Sources: Here and here and here.

Corporation for Public Broadcasting Subsidy. $445 million annual savings.

Save America’s Treasures Program. $25 million annual savings.

International Fund for Ireland. $17 million annual savings.

Legal Services Corporation. $420 million annual savings.

National Endowment for the Arts. $167.5 million annual savings.

National Endowment for the Humanities. $167.5 million annual savings.

Hope VI Program. $250 million annual savings.

Amtrak Subsidies. $1.565 billion annual savings.

Eliminate duplicative education programs. H.R. 2274 (in last Congress), authored by Rep. McKeon, eliminates 68 at a savings of $1.3 billion annually.

U.S. Trade Development Agency. $55 million annual savings.

Woodrow Wilson Center Subsidy. $20 million annual savings.

Cut in half funding for congressional printing and binding. $47 million annual savings.

John C. Stennis Center Subsidy. $430,000 annual savings.

Community Development Fund. $4.5 billion annual savings.

Heritage Area Grants and Statutory Aid. $24 million annual savings.

Cut Federal Travel Budget in Half. $7.5 billion annual savings.

Trim Federal Vehicle Budget by 20%. $600 million annual savings.

Essential Air Service. $150 million annual savings.

Technology Innovation Program. $70 million annual savings.

Manufacturing Extension Partnership (MEP) Program. $125 million annual savings.

Department of Energy Grants to States for Weatherization. $530 million annual savings.

Beach Replenishment. $95 million annual savings.

New Starts Transit. $2 billion annual savings.

Exchange Programs for Alaska, Natives Native Hawaiians, and Their Historical Trading Partners in Massachusetts. $9 million annual savings.

Intercity and High Speed Rail Grants. $2.5 billion annual savings.

Title X Family Planning. $318 million annual savings.

Appalachian Regional Commission. $76 million annual savings.

Economic Development Administration. $293 million annual savings.

Programs under the National and Community Services Act. $1.15 billion annual savings.

Applied Research at Department of Energy. $1.27 billion annual savings.

FreedomCAR and Fuel Partnership. $200 million annual savings.

Energy Star Program. $52 million annual savings.

Economic Assistance to Egypt. $250 million annually.

U.S. Agency for International Development. $1.39 billion annual savings.

General Assistance to District of Columbia. $210 million annual savings.

Subsidy for Washington Metropolitan Area Transit Authority. $150 million annual savings.

Presidential Campaign Fund. $775 million savings over ten years.

No funding for federal office space acquisition. $864 million annual savings.

End prohibitions on competitive sourcing of government services.

Repeal the Davis-Bacon Act. More than $1 billion annually.

IRS Direct Deposit: Require the IRS to deposit fees for some services it offers (such as processing payment plans for taxpayers) to the Treasury, instead of allowing it to remain as part of its budget. $1.8 billion savings over ten years.

Require collection of unpaid taxes by federal employees. $1 billion total savings.

Prohibit taxpayer funded union activities by federal employees. $1.2 billion savings over ten years.

Sell excess federal properties the government does not make use of. $15 billion total savings.

Eliminate death gratuity for Members of Congress.

Eliminate Mohair Subsidies. $1 million annual savings.

Eliminate taxpayer subsidies to the United Nations Intergovernmental Panel on Climate Change. $12.5 million annual savings.

Eliminate Market Access Program. $200 million annual savings.

USDA Sugar Program. $14 million annual savings.

Subsidy to Organisation for Economic Co-operation and Development (OECD). $93 million annual savings.

Eliminate the National Organic Certification Cost-Share Program. $56.2 million annual savings.

Eliminate fund for Obamacare administrative costs. $900 million savings.

Ready to Learn TV Program. $27 million savings.

HUD Ph.D. Program.

Deficit Reduction Check-Off Act.

TOTAL SAVINGS: $2.5 Trillion over Ten Years

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