One claim I find especially annoying is when people say conservatives don’t have ideas for health reform. That absolutely, positively is not true! It’s lazy to cite one thumbs-down vote by a particular senator in 2017 as the final say on the matter.
We and our colleagues in the Health Policy Consensus Group offer a plethora of ideas and proposals—which are conveniently ignored by the mainstream media and others who believe a government takeover is the only answer.
The latest offering to prove them wrong is a book by a dozen colleagues, all top health policy experts presenting positive policy initiatives that can provide a foundation to revitalize Medicare—and our health sector.
This peer-reviewed volume, Modernizing Medicare: Harnessing the power of consumer choice and market competition, was just published by Johns Hopkins University Press and is the guidebook for policymakers who, like it or not, will be forced to tackle this issue.
It offers detailed prescriptions for Medicare’s looming bankruptcy—solutions building on decades of demonstrated success. The key: Competition and consumer choice in a sensibly regulated system that provides extra support for the poor and most vulnerable.
Edited by Heritage’s Bob Moffit and policy consultant Marie Fishpaw, the prestigious chapter authors each conclude that the answer lies in the premium support model upon which Medicare Advantage and the Part D Prescription Drug benefit are based.
Doug Badger, a key architect of the Medicare Modernization Act that created these two programs in 2003, explains premium support this way: “the government makes a per capita, income-related contribution to competing health plans on behalf of beneficiaries, and the beneficiaries choose the health plans they determine best meet their personal needs.”
Premium support musters the power of consumer choice and competition to deliver a variety of coverage and care options as competing health insurers find ways to lower costs while reducing premiums and out-of-pocket expenses for beneficiaries.
The book’s authors are a Who’s Who of the top free-market health policy experts in the country who have come together to offer a positive path forward for Medicare.
It’s vital that their ideas prevail. We already know what those who believe in government control rather than markets are offering—and their record is poor.
For example, the Affordable Care Act that passed in 2010 opted for sharp cuts in Medicare payments to hospitals, physicians, and other providers—cuts that grow over time, “eventually endangering the financial stability of providers,” AEI’s Joe Antos writes.
The ACA also promoted alternative payment models, Antos writes, “including accountable care organizations (ACOs), value-based purchasing arrangements, and bundled payments for specific services within traditional Medicare.”
“The results have been disappointing,” Antos reports. The largest ACO initiative “resulted in higher program spending at first and only began to show savings in the last few years. In 2018, savings averaged $73 per participating beneficiary.” Other programs had similarly poor performance.
Former Congressional Budget Office Director Doug Holtz-Eakin, now president of American Action Forum, says not acting is not an option: “Medicare alone was responsible for 34 percent of all federal debt outstanding at the end of 2019.”
“On the basis of evidence to date, there is every reason to expect that a Medicare premium support program can reduce outlays by both beneficiaries and taxpayers,” Holtz-Eakin writes. “Over the 2022-2031 budget window, for example, Medicare outlays could decline by at least $2.2 trillion, or 11.5 percent.”
“For policymakers, the primary goal of Medicare reform should be the achievement of better value for this major expenditures of America’s health care dollars,” he writes.
Medicare can be saved without demonic cuts. Modernizing Medicare is the guidebook for policymakers to forge a brighter future.
I reviewed the book in more detail for Forbes. Please take a moment to click through to see the ideas, reasons, and data behind these proven proposals.
And next time someone says conservatives have no ideas, offer to send them this book.