Which means it’s a bit of a Band-Aid. And perhaps that’s all right, at least as a stopgap measure. I’m against raising the retirement age — I prefer the position Lieberman held in 2009, when he wanted to lower it to 55 — but Medicare probably should include more in the way of deductibles and co-pays, at least for beneficiaries who can afford them. That said, unless we’re going to keep ratcheting deductibles and taxes up while yanking benefits back, you need more in the way of reforms. Otherwise, cost growth will chew up your tweaks pretty much as fast as you can make them.
Which is why I’m sorry to see Lieberman made no mention of the Rockefeller-Lieberman-Whitehouse proposal to strengthen the Independent Payment Advisory Board . They would’ve eliminated the exemption hospitals enjoy until 2019, clarified that the board could change payments for all providers and suppliers, accelerated the schedule for recommendations and tightened the ultimate spending targets. It’d also have allowed the board to make recommendations for the private plans in the exchanges. Another plan worst dusting off would’ve been the package of delivery-system reforms that some of the Senate’s then-freshmen legislators proposed.
Both proposals were an attempt at more cost control, as opposed to merely more cost cutting/shifting. But first with Ryan and now with Lieberman, the focus seems to be moving away from the hard and complicated work of cost control and toward easier-to-explain, but harder-to-sustain, efforts at cost cutting/shifting.