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The Two-Way Street of Medicare Reform

February 03, 2012
3:57 pm

Earlier this week, I posted in this space about the need for Congress to take the issue of entitlement reform seriously, and to avoid undermining serious discussion about proposals to improve Medicare with glib 30-second sound bites and attack ads during the upcoming campaign season.

But I only addressed half of the equation that is instrumental to constructive discussion on this issue.  As a group of physicians serving in Congress pointed out this week, organizations representing the interests of different population groups also have critical roles to play in this dialogue.

In an open letter to AARP, 18 doctors serving in the House and Senate point out, accurately, that “the American people deserve a mature, informed and thoughtful conversation about how to save the Medicare program and shore up its financing.”  They add that, absent reform, “AARP members aged 50-56 today – as well as future members – will see the end of Medicare as we know it.”

The doctors, in the letter, invite AARP to participate in publicly urging all members of Congress, regardless of political party, to “acknowledge the approaching insolvency of the Medicare trust fund and the program’s structural financing challenges.”

They’re right.  Structural change to Medicare, which is necessary if we’re to achieve long-term sustainability while maintaining quality and innovation for patients, will face a steep uphill battle if influential interest groups marshal their resources in opposition.  To the contrary, progress relies not just on officeholders, but also powerful advocacy groups, acknowledging that the status quo cannot be maintained and that change is necessary.

All of us who are engaged in healthcare policy advocacy bear this responsibility.

The Inadequacy of 30-Second Sound Bites

February 01, 2012
12:55 pm

In its annual budget and economic outlook, the Congressional Budget Office has clearly outlined one of the most serious fiscal challenges the country is facing.  As the U.S. population ages, healthcare spending is expected to rise by eight percent annually between 2012 and 2022.  This means that government spending for Medicare, Medicaid and other healthcare programs will more than double to $1.8 trillion over the next decade.

The significance of this CBO report cannot be overstated.  Medicare’s financial challenges aren’t in some distant, far-off future.  They’re happening right now.  Ignoring these problems today brings us closer to a tomorrow in which Congress will have to either significantly raise taxes or enact harmful cuts to Medicare services in order to keep the program solvent and prevent this spending escalation from becoming a drag on the economy.

This warrants serious discussion by our elected officials.  To their credit, Senator Ron Wyden (D-OR) and Congressman Paul Ryan (R-WI) have advanced this dialogue through their bipartisan efforts on Medicare reform.  Whether their colleagues in Congress will follow suit is an open question.

Last week, the New York Times’ Robert Pear authored an article, “Medicare Seen as Battleground Issue in Congressional Races.”  In this story, it’s pointed out that congressional candidates are being urged by Washington, DC advisors to make Medicare a focal point of their campaigns, but not in any meaningful way that lead toward solution-focused discussions.  Rather, the issue is being raised in 30-second radio advertisements and ‘robocalls’ to voters claiming that lawmakers who supported the initial Ryan reform proposal “favor millionaires over Medicare.”

I’m not naïve and I don’t wear rose-colored glasses where partisan politics are concerned.  I know that candidates have to take actions that move polling numbers.  But elections have consequences, and needed Medicare reform has already been set back years by scalding campaign attacks against those who have advocated change.  The success of those attacks has reduced the number of lawmakers willing to take on this critical, yet politically dangerous, issue.

The juxtaposition of the CBO report – and director Doug Elmendorf’s testimony before the House Budget Committee this morning – and the Pear story is a matter of concern.  CBO has laid down the challenge.  We can hope that Congress responds with more than attack ads and glib sound bites.