Boldness on Entitlement Reform Will Benefit Republicans
6:00 AM, Mar 29, 2011 • By JEFFREY H. ANDERSON
On Medicare, an even more substantial problem, Republicans should propose more substantial solutions, along the lines of the Ryan-Rivlin model — only phased in more quickly (while grandfathering in current beneficiaries). Medicare’s broken system — which is a major reason why the costs of Medicare and Medicaid have risen 33 percent more, per patient, than the costs of all other health care in America — should be transformed into a sustainable system in which the government (meaning, the taxpayer) continues to be the payer, but future Medicare beneficiaries (and whichever current ones freely decide they'd like to switch) get to take the money they are given and use it to buy a private plan of their choice. This will give seniors more control, will give everyone involved the incentive and opportunity to pursue, or provide, good value, and will therefore lower health costs without reducing the quality of care. In many cases, these reforms would actually lead to higher quality care, as providers are now often rewarded financially for not getting the diagnosis right the first time and instead putting patients through unnecessary tests or procedures.
These Medicare reforms should be phased in almost immediately — grandfathering in only those who are currently enrolled (while allowing them to switch if they'd like) and those who are within one year of enrollment. Here are several reasons: Doing so would enable Republicans to show real and substantial budgetary savings over ten years. It would help avoid giving the (false) impression that those who would be grandfathered in, rather than enrolled into the newly reformed program, would somehow be getting a better deal. And it would be the right thing for the country. We cannot afford to wait.
In short, Republicans should force President Obama to make the case against needed entitlement reforms that the CBO scores as — finally! — making a real dent in our federal deficits and debt, rather than letting him make the case against entitlement reforms that the CBO scores as not doing much good at all over ten years. If Republicans are to go down the road of entitlement reform — as they must — they must go boldly.