Parties agree on need to curb health-care spending but deadlock over Medicare

Amid a bitter debate over taming the federal deficit, the political parties are in rare agreement on a need to curb the nation’s spending on health care — and on Medicare most of all.

But with Democrats on the Hill vilifying a plan by House Republicans to privatize Medicare, lawmakers are stalemated over how to curb costs in the program, which is forecast to be the biggest contributor to future federal deficits.

Loading...

Comments

• Weigh In
• Corrections?

Personal Post

More on this Story

• Parties agree on need to curb health-care spending but deadlock over Medicare
• Obama, GOP lawmakers meet at White House on debt reduction
• House rejects plan to raise debt ceiling
• Motion Graphic: How did we get here?

View all Items in this Story

• 2chambers: Economists pen letter to Boehner, backing spending cuts
• In effort to reduce deficit, panel votes to cut subsidies
• Fact Checker: Will GOP Medicare plan ‘throw you to the wolves?’
• GLOSSARY: Guide to understanding the debates

Despite the lack of political momentum, a few Democratic health-policy experts contend that changes are needed quickly, and on Friday, Sen. Joseph I. Lieberman of Connecticut, an independent, put forth his own plan, lamenting the “partisan pugilism.” For the most part, Democratic health-policy analysts support a patchwork of older ideas, such as raising retirement ages, making moderate use of private subsidies or setting higher prices for wealthy participants.

The most optimistic liberal health-policy experts contend that Medicare costs will slow because of changes embedded in last year’s law to overhaul the health-care system. Those are forecast to save about $550 billion by the end of the decade, in part by reducing payments to some private health plans or by delivering care more efficiently.

“In many ways, the Democrats sort of shot their wad on the Affordable Care Act,” said Marilyn Moon, senior vice president and director of the health program at the American Institutes for Research. “We have to see how far it takes us before we start a lot of other stuff.”

The top official overseeing Medicare for the Obama administration, Donald M. Berwick, is a cheerleader for the notion that coordinating care saves money. But even he acknowledges that the “tempo” of improvements under the law may not be fast enough.

There are political obstacles to almost all the other ideas under discussion among Democrats, some of which have been promoted — unsuccessfully — in the past. “The reason why they aren’t law now is they have a constituency and at least semi-credible arguments that makes adding them to the pot quite challenging,” said Chris Jennings, who was the Clinton administration’s top health-care adviser.

Nonetheless, financial pressures on the program, which is a lifeline to health care for 48 million Americans 65 and older, are intensifying. Medicare’s cost per person is the lowest in years, but its finances are being upturned by the aging baby boomers, increasing life spans and the ballooning cost of care. The program’s spending is likely to increase from $519 billion last year to $929 billion by the end of the decade, according to congressional budget analysts. And the trust fund that pays for Medicare patients’ hospital bills is predicted to run short of money by 2024, five years earlier than predicted a year ago, according to trustees.

Among the few Democrats who talk openly about an immediate need to address this fiscally treacherous future is Alice M. Rivlin, a senior fellow at the Brookings Institution and former director of the Congressional Budget Office. She argues that waiting until after the 2012 presidential election — as many Democrats would prefer — “is too late. I don’t think we have two years to play around with this.”