Congressman Paul Ryan (R–WI) and Senator Ron Wyden (D–OR) have proposed a new bipartisan framework for structural Medicare reform. It continues the conversation with the American people on a solution to save the popular but financially troubled entitlement program. While there are differences between the proposal and the Heritage plan outlined in Saving the American Dream, and while their proposal does not go as far or as fast as it should in changing the massive entitlement program, it would establish a premium-support system of financing for Medicare, a variant of …
Congress rarely considers a bill that would change the way Washington works. But this is exactly what the Regulations from the Executive In Need of Scrutiny (REINS) Act would do. The REINS Act (H.R.10) would require Congress to approve all “major” regulations—those costing $100 million or more annually—before they take effect. On December 7, it passed the House of Representatives by an impressive vote of 241–184. It is now headed for consideration in the Senate. The Current Process Currently, Congress passes laws with overly broad or intentionally vague statutory language. …
Reports have surfaced that conservatives in Congress may propose further increasing income adjustment in Medicare to lessen the program’s insolvency. This is a great idea. While the left continues to argue for higher taxes for the likes of Warren Buffett to maintain the status quo of a costly, failing Medicare program, it makes more sense that Congress should simply stop subsidizing them. As Congress continues to pursue solutions to the entitlement spending crisis, one question that must be answered is whether the United States should even have universal federal entitlements …
In January 2012, Medicare physicians face a 27.4 percent cut in their payment for treating senior and disabled citizens. Congress, as it has routinely since 2003, is feverishly preparing legislation to stop its own goofy Medicare payment formula from going into effect. If they don’t succeed this year, seniors can be assured of severe problems accessing physician care. The reason Congress goes through this silly routine almost every year is that it is unable or unwilling to make serious changes in the Medicare program. Today, Medicare payment for doctors is …
When it comes to the super-committee’s duty to reform Medicare, you’ll likely to hear the same tired and unsuccessful methods for lowering Medicare’s soaring costs: raising taxes, manipulating payment formulas, or making even deeper payment cuts to doctors and hospitals. The best way to reform Medicare is transform it into a premium-support program, which provides a defined contribution to seniors’ chosen health plans, which include a variety of private plans as well as traditional Medicare fee-for-service. This approach — based on injecting consumer choice and competition into Medicare — has …
The congressional enactment of the Budget Control Act to increase the national debt limit was mostly a triumph of process, not substance. But substance cannot be avoided. The looming question is how this process will deal with the biggest entitlement challenge: Medicare. On Medicare, Congress has only two options: (1) serious but careful structural reform, or (2) blunt across-the-board cuts that will make matters even worse. After almost 30 years of tiresome debate on this issue, studiously ignoring the findings of independent analysts and presidential commissions alike, Congress has yet …
Red Alert! Conservatives in Congress and elsewhere should be warned: The Administration’s latest signal for “compromise” may end up as little more than an expansion of existing bad policy, rather than a serious effort to enact substantive reforms. And only substantive reforms can change the perverse incentives that plague giant entitlement programs and have worsened America’s deepening financial crisis. Consider some of the latest ideas that have surfaced in the media for finding “savings” in health policy: Importing Medicaid drug policy into Medicare. In Medicaid, patients do not have the …
Senator Jim DeMint (R–SC) and 12 of his Senate Republican colleagues recently introduced the Retirement Freedom Act. The bill would allow senior citizens to buy a better health plan than traditional Medicare, if they wish to do so, without having to give up their Social Security benefits. Today, if a person who is retiring does not wish to enroll in traditional Medicare’s hospitalization program and instead wants to buy his or her own health care coverage, the federal bureaucracy forces that person to give up Social Security benefits as well. …
Senators Tom Coburn (R–OK) and Joseph Lieberman (I–CT) unveiled a major Medicare proposal. Based on preliminary estimates provided by the Congressional Budget Office (CBO), the proposal would reduce total Medicare spending by more than $600 billion in the next 10 years and cut the program’s long-term (75-year) unfunded liability by approximately $10 trillion. This is a serious start. Without remedial action, Medicare faces a long-term unfunded liability of almost $37 trillion. The Medicare hospitalization trust fund is running a deficit of $34.1 billion this year alone. While the program has …
The hot Washington Medicare debate centers on whether congressional Republicans will, in the language of the left, “End Medicare As We Know It.” But the dirty little secret on Capitol Hill is that Obamacare already ended the program as we know it. They don’t tell you that in those clever “Mediscare” ads. Here’s what Obamacare has already done: Replaced Medicare’s traditional financing. Obamacare replaces Medicare’s fee-for-service structure—the very heart of traditional Medicare financing—with capitated payments and salaried physicians. Whether this is a good or bad idea, it’s not your grandpa’s …
