Medicare Must Be Addressed Before U.S. Can Overhaul Health Care System, Opinion Piece States

"Fiscally speaking, the U.S. government has been living on borrowed time for decades" because it "has promised massively expensive benefits -- mainly Social Security, Medicare and Medicaid -- heedless of the enormous tax burdens these promises implicitly place on our children and grandchildren," according to a Washington Times opinion piece by Robert Bixby, executive director of the Concord Coalition, Stuart Butler, vice president for domestic policy issues at the Heritage Foundation and Isabel Sawhill, a senior economic studies fellow at the Brookings Institution.

According to the authors, "If the Wall Street crisis has taught us nothing else, it has shown there are financial limits -- even for America." They write, "Health care reform is a good and noble goal. But if we do only that -- without fundamentally redesigning the Medicare commitment -- our grandchildren will inherit a crushing financial burden." The authors state, "Medicare has led before and can do it again," asking, "Why hold Medicare reform hostage to a global 'fix' of health care?"

The authors recommend that the U.S. government:

• "Use Medicare to leverage wholesale change in reimbursement policies, encourage use of electronic medical records, and experiment with new health care delivery methods" and allow "competitive bidding on medical equipment for home-based seniors";
  
  
• "Reduce the commitments we've made -- seriously, but fairly," such as by reducing Medicare Parts B and D premium subsidies for upper-income beneficiaries;
  
  
• "Look for savings in Medicare payments," for example, by reducing Medicare Advantage payments; and
  
  
• "Finally, put Medicare (and Social Security and Medicaid) on a budget, with automatic 'triggers' to make sure spending stays within budgeted amounts" (Bixby et al., Washington Times, 11/18).