Lawmakers, Public Urged To Make Changes To Medicare

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HHS Secretary Mike Leavitt said Tuesday that it is"simply unreasonable" to think Medicare can maintain its solvencywithout changes to the program and that if "we start now, the change canbe made over time and with genuine fairness," CQHealthBeatreports.

Leavitt, speaking at a Medicare forum hosted by the American Enterprise Institute, the HeritageFoundation and the Galen Institute, urged lawmakers and the public to join together to make changes toMedicare to ensure the program's solvency as millions of baby boomers begin toenter the program in 2011. He said that changing Medicare will be difficultbecause Congress has only three methods -- raising taxes, reducing benefits orlowering payments to providers -- for revising the program.

Leavitt suggested that a commission handle policy changes because thelegislative process "won't ever produce enough bipartisanship" torevise the program. Leavitt said that such a commission could resemble themilitary base closure commission, which must accept or reject a whole set ofrecommendations.

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Leavitt also said that Medicare legislation should include "triggerpoints" so that lawmakers could prepare "contingent plans if thingsgo beyond a predetermined point" instead of voting on specific measures. Headded that Congress should change how it "scores" Medicare policyinitiatives to account for savings in addition to their initial cost.

Leavitt recommended putting more emphasis on coordination of medical care inMedicare and paying providers based on quality. He also advocated changingMedicare to resemble the program's prescription drug benefit because it"provides a good example of how better transparency and competition candrive change." In addition, Leavitt supported "rebalancing the generationalobligation" to shift more costs to current beneficiaries instead ofrelying on payroll taxes from current workers.

Members of a health care panel who also spoke at the forum "generallyagreed" that Medicare requires modifications but did not come to aconsensus on how to alter the program, according to CQ HealthBeat.Stuart Butler of the Heritage Foundation said that higher-income beneficiariesshould pay more in premiums and that a commission should handle changes toMedicare. Robert Berenson of the Urban Institute said that the Bush administration'ssupport of higher Medicare Advantage payments limits its credibility to warnabout Medicare spending concerns. "We don't have a Medicare crisis,"Berenson said, adding, "I think there's plenty of opportunity if we hadthe political will to get Medicare spending under control" (Carey, CQHealthBeat, 4/29).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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