Designed to Fail

The President's Medicare plan contains nothing innovative or new, and does not change the structure of the program. Instead, it focuses on providers, adjusting payments and adding utilization hurdles without changing financial incentives. Most of the ideas were swept up from the CBO budget options book, so they score as savings. The provider cuts are not painless, but also not unexpected. Increasing premiums and cost-sharing is delayed until 2017, which makes no budget or policy sense but plenty of political sense. That adds up to acceptance by the "super" committee. However, if the tax changes are included, the package will fail to be enacted even though Congress could support the Medicare pieces. That gives Obama what he wants: an election-year debating point without having to sign even routine health spending reductions into law.

Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI

 

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