Medicare silver bullets
What's the best way to control costs?

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Article Highlights

  • If we expect to bend the Medicare cost curve, we must change the financial incentives that promote the use of services.

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  • The federal subsidy can’t grow without the limit, and Medicare’s payment arrangements must make that clear.

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  • Giving Medicare beneficiaries a choice of competing health plans will promote efforts to contain cost.

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Editor's note: Kaiser Health News asked a range of health policy experts the following question:  If you could make only one change to Medicare to control costs, what would it be and why? Joseph Antos' answer to their question follows. 

If we expect to bend the Medicare cost curve, we must change the financial incentives that promote the use of services. The federal subsidy cannot grow without limit, and Medicare’s payment arrangements must make that clear to both consumers and providers. Giving beneficiaries a choice of competing health plans, providing a defined contribution subsidy, and maintaining an appropriate oversight role for the government will promote more vigorous efforts by the health sector to contain costs without sacrificing access to care. The goal should be to get the incentives right to promote system improvement rather than a good budget score created by politically unsustainable spending limits. 

Other experts' answers to the question can be found here

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About the Author

 

Joseph
Antos

  •  


    Mr. Antos's research focuses on the economics of health policy—including Medicare and broader health system reform, health care financing, health insurance regulation, and the uninsured—and federal budget policy. He has written and spoken extensively on the Medicare drug benefit and has led a team of experienced independent actuaries and cost estimators in a study to evaluate various proposals to extend health coverage to the uninsured. His work on the country’s budget crisis includes a detailed plan to achieve fiscal stability and economic growth developed in conjunction with AEI colleagues.  


    Joseph Antos is also a health adviser to the Congressional Budget Office and recently completed two terms as a commissioner of the Maryland Health Services Cost Review Commission.  Before joining AEI, Mr. Antos was Assistant Director for Health and Human Resources at the Congressional Budget Office and held senior positions in the U.S.Department of Health and Human Services, the Office of Management and Budget, and the President’s Council of economic Advisers.


     



    Watch Mr. Antos in an interview with Bill Erwin of the Alliance for Health Reform on "Will Health Reform Reduce the Federal Deficit?"


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  • Phone: 202-862-5938
    Email: jantos@aei.org
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    Email: catherine.griffin@aei.org

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