That law has produced the welcome and unexpected result of actually cutting Medicare expenditures in the first half of this fiscal year.

But a major reason for the increase in Medicare expenditures is that we have more advanced ambulance units on the street, saving more lives.

At the time, roughly a quarter of Medicare expenditures were for people in the last year of life.

Critics have argued that this is a workforce measure which limits the supply of general practitioners, and therefore reduces federal government Medicare expenditure.

But Medicare expenditures are still expected to increase by $10 billion, to $116 billion.

A famous American study indicated that as much as 28% of Medicare expenditure was spent on those in the last year of life.

We are not saying those are medically inappropriate services, but they do increase Medicare expenditures.

"Increasingly," he said, "we are finding Medicare expenditures for medical equipment for items that are of little or no use to the beneficiary."

But over seven years, the difference in the predictions of Medicare expenditures alone is $70 billion.

Many Republicans want to cap Medicare expenditures but uncap provider charges.