Joe Lieberman has a few ideas about how to fix Medicare, as expressed in a Washington Post op-ed yesterday. They are, in brief:
- Raising the Medicare eligibility age,
- Increasing Medicare cost-sharing,
- Increasing Medicare premiums,
- Reforming Medigap to reduce “moral hazard” care, and
- Increasing taxes on the wealthy.
Lieberman claims these reforms will save $200 billion over a decade. I don’t know if he’s right about that. I do know what the Kaiser Family Foundation has said about increasing the Medicare eligibility age. There’s not a lot of savings there. What there is is a lot of cost shifting. Same goes for increasing cost-sharing and premiums: some savings, much shifting of costs to beneficiaries.
Don’t get me wrong, asking those who can pay more to do so is one part of a solution. But there is something missing from Lieberman’s ideas, something huge. Have you noticed?
There’s not a single word about provider reforms, about improving the quality and efficiency of care, about eliminating treatments that don’t work. That’s where the big money is. Moreover, it’s money we don’t need to spend. It’s not cost shifting. It’s real savings.
Remember, even a great price on bloodletting is not a price we should pay.
LATER: See also Ezra Klein’s reaction, which is similar to mine.
LATER STILL: Want more? See Igor Volsky.