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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About the Author

 

Joseph
Antos
  • Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute (AEI), where his research focuses on the economics of health policy — including the Affordable Care Act, Medicare, the uninsured, and the overall reform of the health care system and its financing. He also studies the impact of health care expenditures on federal budget policy.

    Before joining AEI, Antos was assistant director for health and human resources at the Congressional Budget Office (CBO). He has also held senior positions in the US Department of Health and Human Services, the Office of Management and Budget, and the President’s Council of Economic Advisers. He recently completed a seven-year term as health adviser to CBO, and two terms as a commissioner of the Maryland Health Services Cost Review Commission. In 2013, he was also named adjunct associate professor of emergency medicine at George Washington University.

    Antos has a Ph.D. and an M.A. in economics from the University of Rochester and a B.A. in mathematics from Cornell University.



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