MEDICARE REFORM: Divided Panel Moving Toward Consensus?
The prospects for consensus on the national Medicare commission may be on the upswing with a formerly recalcitrant Democratic panel member reportedly "warming" to the premium support plan, and a positive budget scoring from HCFA. CongressDaily reports that Rep. John Dingell (D-MI) said yesterday after a closed committee meeting, "The (premium-support) idea has merit. We have to find out whether the merit is sufficient to be supported." He said that his decision depended on the resolution of key details such as a defined benefit package and a prescription drug benefit. Sen. John Breaux (D-LA) said, "I'm detecting a willingness (of Democratic commission memebers) to be supportive of a premium support package 'if, if, if.' And I think the if's are not unsolvable problems." He confirmed that the panel is considering including the drug benefit in all plans, including the traditional fee-for-service plan, which would likely require additional funding; or creating a drug benefit for Medicare beneficiaries up to 135% of the poverty line and requiring all Medigap plans to include prescription drug coverage for higher-income beneficiaries (Morrissey, 2/23). The Boston Globe reports that the HCFA scoring projected savings of at least $35 billion per year, or $347-$372 billion between 2000 and 2009. That would represent a 11.2% to 11.9% savings over current spending. The complete report will be released at today's meeting of the commission (Pham, 2/24).
L.A. Times Weighs In
A Los Angeles Times editorial today says that "[b]ringing more competition to the outdated fee-for-service Medicare system is a good idea, but the commission should add consumer protections and quality-monitoring systems." The Times suggests that while "applying managed care to Medicare is a good idea in principle, in practice [it] could be disastrous," with no safeguards to prevent HMOs from "increasing profits by denying patients medically necessary care" (2/24).