Obama Spikes Reform in SOTU Speech. Where Now for Medicare?
I hope you enjoyed the State of the Union (SOTU) address as much as I did — it’s the Super Bowl of policy geeks. I saw it as an effective rallying tool around a number of the President’s goals that will deeply challenge the GOP opposition, like an increase in the minimum wage and immigration reform. But it was the utter lack of any new ideas for Medicare that struck me — and definitely no olive branch to House Budget Committee Chairman US Rep. Paul Ryan (R-WI) on premium support. So where now for Medicare?
Medicare status quo advocates are turning cartwheels this week. Since the election Democrats have walked back every significant program reform that was on the table since the debt ceiling mess last summer — eligibility age increase, means testing, and the like. On the eve of across-the-board spending cuts on March 1 and a possible government shutdown on March 27, both driven in part by Medicare deficit politics, the President slammed the door on Medicare reform in both his Inaugural Address and then again in SOTU. And that’s tragic: Obama has no better opportunity to save Medicare for the long term than right now. Instead, we’re sticking to the path of incremental fixes and accounting gimmicks.
As a nation we have our heads in the sand on the viability of this pillar of American life. Medicare will run out of money no later than 2024. The program is unsustainable in its current form. Everybody in Washington who knows anything about Medicare knows this. What they also know — but nobody’s saying — is that premium support or something like it is inevitable as the only structural reform that can set Medicare on solvent footing for the long-term.
Former HCFA/CMS Administrators Drs. Gail Wilensky, Mark McClellan, Bruce Vladeck and I all comment on the future of Medicare in First Report Managed Care’s latest edition here.
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John Gorman comments on the future of Medicare in the First Report Managed Care’s latest edition.