In a recently published piece, AEI health care policy expert Thomas (Tom) Miller explains why current Medicare reform proposals are mostly "policy concepts devoid of structural details." Miller points out that even the Ryan-Wyden proposal which "makes an honest effort to start this process at the ‘high-concept’ level,” needs “a more detailed script that begins to answer at least 13 more questions."

Miller first asks:

"What is the primary policy goal of premium support (or other Medicare reform alternatives)? Is it a more efficient and higher-value health care? To lower the future rate of growth of Medicare spending? Or, just to keep currently happy beneficiaries reassured of little if any disruption to their existing health care arrangements?"

Miller points out that "the resulting prescription for solving several simultaneous equations remains likely to be contradictory, unaffordable, and unsustainable. . . . Clearer answers to resolve the tradeoffs between those major policy goals and their relative order of precedence will go a long way in determining other settings for the various elements of premium support."

Click here to see all of Miller’s questions.

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