HHS Secretary Leavitt Urges Lawmakers, Public to
'Start Now' To Make Changes to Medicare
Congress has only three methods -- raising taxes,
reducing benefits or lowering payments to providers
April 30, 2008 - Health and Human Services
Secretary Mike Leavitt said Tuesday that it is "simply unreasonable" to
think Medicare can maintain its solvency without changes to the program
and that if "we start now, the change can be made over time and with
genuine fairness,"
CQ HealthBeat reports.
Leavitt, speaking at a Medicare forum hosted by the
American Enterprise Institute, the
Heritage Foundation and the
Galen Institute, urged lawmakers and the public to join together to
make changes to Medicare to ensure the program's solvency as millions of
baby boomers begin to enter the program in 2011. He said that changing
Medicare will be difficult because Congress has only three methods --
raising taxes, reducing benefits or lowering payments to providers --
for revising the program.
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Leavitt suggested that a commission handle policy
changes because the legislative process "won't ever produce enough
bipartisanship" to revise the program. Leavitt said that such a
commission could resemble the military base closure commission, which
must accept or reject a whole set of recommendations.
Leavitt also said that Medicare legislation should
include "trigger points" so that lawmakers could prepare "contingent
plans if things go beyond a predetermined point" instead of voting on
specific measures. He added that Congress should change how it "scores"
Medicare policy initiatives to account for savings in addition to their
initial cost.
Leavitt recommended putting more emphasis on
coordination of medical care in Medicare and paying providers based on
quality. He also advocated changing Medicare to resemble the program's
prescription drug benefit because it "provides a good example of how
better transparency and competition can drive change." In addition,
Leavitt supported "rebalancing the generational obligation" to shift
more costs to current beneficiaries instead of relying on payroll taxes
from current workers.
Members of a health care panel who also spoke at
the forum "generally agreed" that Medicare requires modifications but
did not come to a consensus on how to alter the program, according to CQ
HealthBeat. Stuart Butler of the Heritage Foundation said that
higher-income beneficiaries should pay more in premiums and that a
commission should handle changes to Medicare.
Robert Berenson of the
Urban Institute said that the Bush administration's support of
higher Medicare Advantage payments limits its credibility to warn about
Medicare spending concerns. "We don't have a Medicare crisis," Berenson
said, adding, "I think there's plenty of opportunity if we had the
political will to get Medicare spending under control" (Carey, CQ
HealthBeat, 4/29).
>> A Webcast of the forum is available
online at
kaisernetwork.org.
Presidential Candidates
Leavitt on Tuesday before speaking at the forum said that the health
care proposals of Democratic presidential candidates Sens.
Hillary Rodham Clinton (N.Y.) and
Barack Obama (Ill.) would increase the rate at which the entitlement
program moves toward insolvency.
Leavitt said, "One of the plans is to give
everybody access" to the
Federal Employees Health Benefits Program, adding, "What is it they
like about that? Is it the subsidized portion or the price-fixing
portion?" He said, "Medicare covers a relatively small percentage of the
total population, but you add everybody else to that and it just
accelerates the nature of the (fiscal) problem." In addition, Leavitt
said, "Successfully changing Medicare will change health care. Now
that'd be better news if changing Medicare was not politically or
bureaucratically complicated."
Before the speech, Leavitt told reporters, "I don't
see anyone (in the Democratic party) talking about the bigger problem. I
see people talking about how we can make it worse, but I don't see
anybody talking about how we could make it better" (Young,
The Hill, 4/29).
>>
HHS
