Finding the Right Health Care Reform Equation

The challenge will be for legislators to use Medicare as a guide for enacting broad changes, and not to arbitrarily cut the government's commitment to America's seniors.
This post was published on the now-closed HuffPost Contributor platform. Contributors control their own work and posted freely to our site. If you need to flag this entry as abusive, send us an email.

If health care reform equals entitlement reform and Medicare equals health care then it's clear we can't truly improve our health care system by failing to factor in many of the changes needed to our nation's largest health care provider, Medicare. Everyone involved in this national health care reform debate knows there are many elements to consider in this equation. Thankfully, some key members of Congress and the Obama administration have done the math. They understand that there are savings to be gained from the Medicare program that can help pay for system-wide reform efforts. But what remains to be seen is, how much of those savings will go back into Medicare? Meaningful reform must include making Medicare stronger and healthier.

Our health care system is in critical shape and in need of immediate treatment. Medicare beneficiaries are not immune from the crippling costs of health care. In fact, projections by Medicare's actuaries estimate over one-half of the average senior's Social Security benefit check would be consumed by Medicare out-of-pocket costs by 2025. And the solution to the problem, both on the government side and for the private sector, is effective health care reform that ensures we are getting the most value for our health care dollars. This is the goal of some proposals to provide universal coverage for all Americans and to improve the delivery of health care through payment reforms and investments in comparative effectiveness research and health information technology that enhance the quality of care being provided. Innovating and reinvesting in Medicare must be a part of these reform remedies.

It is inevitable that policymakers will look to the Medicare model as they craft reform legislation. As this nation's largest purchaser of health services, Medicare influences costs in the private sector. In addition, many of Medicare's coverage decisions are adopted by private health insurers and incorporated into their own health care plans for those under age 65. The challenge will be for legislators to use Medicare as a guide for enacting broad changes in the way health care is provided, and not to arbitrarily cut the federal government's commitment to America's seniors.

Some of the potential savings in Medicare, appropriately gained by reducing wasteful industry subsidies in Medicare Advantage, must be reinvested back into the program to improve care for America's seniors. Some of those Medicare improvements include:

• lower drug prices through government negotiation
• close the prescription drug doughnut hole
• limit seniors' out-of-pocket costs

We have a historic opportunity to improve our health delivery system, touching the lives of virtually every American from the very young to the very old. Improvements to Medicare should be a part of the solution.

Anything less just doesn't add up.

Popular in the Community

Close

What's Hot