The Peru Gazette

By Matt Doheny

Our country has a long, proud history of taking care of its most vulnerable citizens. Medicare is an important part of that promise, giving seniors and disabled guaranteed access to care and the dignity they deserve.

Sadly, our Medicare system is at a crisis point as spending grows twice as fast as our economy. Most members of Congress treat the program like a political football, pointing fingers while ducking the tough challenges that lay ahead.

With 10,000 baby boomers turning 65 every day for the next 20 years, the challenge facing the Medicare system is a crisis that must be addressed now. It’s time to fix the program in a way that both keeps our promise to current recipients, like my mom, and preserves it for our children and grandchildren.

A few policy makers are working in a bipartisan way to address these serious challenges, including Democrat-turned-independent Sen. Joe Lieberman, Republican Sens. Tom Coburn and Richard Burr, Republican Rep. Paul Ryan and Democratic Rep. Ron Wyden, former Sen. Pete Domenici and former Congressional Budget Office and Office of Management and Budget chief Alice Rivlin.

This is not a plan. Instead, these are some ideas I’d like to see incorporated in any bipartisan effort put before Congress:

Patient choice: If the current fee for service system works for you, then you should be able to keep it – no questions asked. But Medicare should welcome competition, just like the program that members of Congress use for their benefits. Market forces have been proven to constrain costs. To participate, private plans would have meet or exceed benefits offered through traditional Medicare – and plans should not be able to deny coverage based on pre-existing conditions. In all instances, the federal government should pay insurers directly. This is not a voucher program.

Align incentives: Medicare Parts A (inpatient) and B (outpatient) should be combined into a single deductible to reduce the perverse incentive for providers to push beneficiaries toward expensive hospitalizations.

Increase retirement age: When Medicare was first enacted, the average person lived about 70 years. Now we live closer to 78 years. It was thought Medicare would cover about the last five years of a person’s life. Now, that’s closer to 13.

Americans are adding one year to their life expectancy for every eight years that pass. To reflect that, we should raise the eligibility age to 67 incrementally over a 10-year period and increase periodically to reflect changes in life expectancy.

Means testing:There are about 60,000 retirees earning $1 million or more that receive subsidized coverage. We should increase caps on out-of-pocket costs of those with the ability to pay more. It makes no sense to consider raising taxes to pay for a continued subsidy for this group.

Consumer protections:Private plans competing against traditional Medicare will have a strong incentive to root out waste, fraud & abuse to reduce their costs. But we should have a consumer protection agency to ensure that both private and government-run plans are not cheating customers by offering one thing and delivering something inferior.

Drug benefit:The Part D program should continue much as it does today – and would still be voluntary. The “donut hole” should remain closed.

To further reduce our debt, we should consider the following health care initiatives:

·      Repeal and replace ObamaCare, but keep insurance up to age 26

·      Increase competition by allowing purchasing across state lines

·      Help doctors reduce the cost of practicing medicine

·      Make plans more flexible

·      Improve doctor recruitment in rural areas

·      Give hospitals flexibility

Concluding thoughts

The status quo both threaten our country’s ability to keep its Medicare promise and remain fiscally solvent. Reform is necessary.

There are three options to reduce the Medicare deficit. The first is requiring an immediate 47-percent increase in the payroll tax rate, which both employees and employers pay. This would be devastating to our economy.

The second is to cut benefits and payments to providers, which my opponent supported through ObamaCare. I do not support this.

The third is to create market-driven reforms. By introducing competition to the existing Medicare program, I believe that the private sector can provide better services at a more reasonable cost than the current Medicare bureaucracy.

Further savings can be injected into the system through the ideas I’ve offered above, including raising the retirement age and means testing.

I offer the above as ideas for addressing the challenge of the current Medicare crisis, and look forward to a rational and spirited discussion as we work to save and protect this program so important to those that depend on it.