Creating a Sustainable and Equitable Program
"Synthesis and roadmap for transforming Medicare into a sustainable and equitable health program for America’s elderly"
Len Nichols, Director, Health Policy Program at the New America Foundation and Robert Berenson, Senior Fellow at the Urban Institute
Although currently neither political party is willing to show leadership and propose reforms that would stabilize Medicare’s financing, it is evident that the program cannot continue on its current course. There are both programmatic and political reasons to modernize the traditional program, whether or not more beneficiaries eventually get their care in private plans, because it is becoming increasingly clear that neither Medicare beneficiaries nor taxpayers are getting their money’s worth for their considerable investment in Medicare’s funding. Consistent with the objectives of a social insurance program, traditional Medicare should become more efficient and improve the quality of care provided to those who rely on it.
This paper will synthesize the insights of the previous papers and the Advisory Council meetings into a cohesive set of recommendations for structural Medicare reform. The recommendations will range from governance and statutory changes to specific policy recommendations about financing as well as monitoring, measuring and rewarding high quality care. In addition, institutional changes, e.g., new entities or old with enhanced authority or input on technology and coverage decisions, will also be described in some detail. The point of this paper is to pull together in one place a blueprint for a transformed Medicare program that is both more equitable and more sustainable than our current one, and therefore more attractive to the majority of Americans who inhabit the real world between our current ideological extremes. We believe this synthesis paper, along with the other papers in our volume, will help lay down a catalytic and centrist marker in the upcoming Medicare reform debates of ’08-09.
