Medicare reform

What it should look like

Ezra Klein's column in the print edition of today's Washington Post is headlined "Republicans missing central issue on Medicare." On the Post's website, the column is headed "A smarter Republican agenda on Medicare." I like the head on the print version better, though near as I can tell, the content in print and on the web is nearly identical.

I like the print head better because Klein's column makes the point that "raising the Medicare age [of eligibility] is a particularly dumb cut, and his elaboration of that point is simple and clear. The move wouldn't save anything. "It merely shifts costs to employers, consumers and other public entities, including Medicaid, the Affordable Care Act and the states." The move would not reduce the deficit or preserve the program.

Some Republicans and conservatives are pushing "beneficiary engagement," Klein writes, but nothing in his column makes the case that there is "a smarter Republican agenda" out there. It's just that some Republicans are not interested in pursuing the "trophy" win (as Nancy Pelosi calls it) that John Boehner and the House Republican caucus appear to be seeking.

In the meantime, a smarter agenda for Medicare reform, "A Systemic Approach to Containing Health Care Spending" is posted on the website of the New England Journal of Medicine. And in "The Senior
Protection Program," the Center for American Progress (CAP) proposes a series of reforms that should save hundreds of millions of dollars over the next 10 years. Despite all the fiscal cliff hoopla, the CAP proposal hasn't gotten much media attention. Other than a Republican interest in preserving profits for insurers, pharmaceutical companies and medical equipment manufacturers, it's hard to say why.