• Medicare Limit Instead of Debt Limit?

    Noah Millman thinks that we should get rid of the debt limit in favor of a limit on Medicare spending.

    We’re all agreed that the big driver of future deficits is the growth in Medicare, which in turn is driven primarily by the growth in the cost of medical services (secondarily by demographic factors).

    Both parties agree with this, but there is stark disagreement about how to restrain the growth of Medicare: whether by greater government control of the medical system or by less (or by a combination thereof – Obamacare plus the voucherization of Medicare would be such a combination).

    He goes on to state the obvious about the debt ceiling:

    We’re also all agreed (everyone who’s actually paying attention, anyway), that the debt ceiling serves no rational purpose. Congress approves both taxes and spending; if Congress refuses to approve borrowing the difference, then Congress isn’t making a policy statement – it’s simply refusing to do its job.

    In its place, he proposes a cap on Medicare spending and if that cap is to be violated in a given year, then Congress would have to pass a supplemental spending bill, a supplemental bill to reduce spending, or raise the Medicare ceiling and say the extra amount will be deficit financed. His point is that in the long run, the major driver of budget deficits is health care, and health care has its primary impact on the federal budget in the Medicare program. A policy such as the one Millman suggests would help to focus our attention on health care costs….and then we would have to decide whether we wanted to pay more than planned or to take steps to reduce planned spending.

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    • A cap on Medicare makes no sense. It would just be an annual political battle for no good reason.

      We need to get healthcare costs under control. That means lowering the cost of care, not imposing arbitrary limits that shift costs to a vulnerable population while likely raising overall costs (seeking private replacements for gaps in Medicare coverage would be more expensive).

      We’re about twice as expensive as the next most expensive country, with middle of the pack quality. We have to do better.

    • The politicians who put a cap on Medicare will feel the wrath of the AARP so it will not happen before a real crisis hits.

    • @Don’s offering:

      Noah Millman’s conservative blogs offers misinformation to bandwagon the assault on Medicare.

      It is not a “cap” on Medicare spending that’s needed but an end to Medicare Advantage, the privatized Medicare giveaway to the big insurers by the Bush II administration in the 2003 Medicare Prescription Drug Improvement and Modernization Act (Medicare Part D), that was started ineffectually in the 1997 Balanced Budget Act as Medicare+Choice).

      In exchange for more “benefits” (eroded away by the giant commercial Medicare managed-care companies, such as United HealthCare’s multibillion dollar deal with AARP) the elderly and disabled have less Medicare and fewer real benefits than they had with “original” Medicare. demanding changes to privatization is clearly what the present administration means when it agrees that there must be “spending limits to Medicare.” And this is the entire reason that managed Medicare and managed Medicaid “costs” are going through the roof. It’s all due to privatization.

      The Affordable Care Act “levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies while protecting guaranteed Medicare benefits. Instead of overpayments similar to the last several years to insurance companies, the new law will base payments on the local cost of providing guaranteed Medicare services.” See White House Press Release June 8, 2010: The Affordable Care Act: Strengthening Medicare, Combating Misinformation and Protecting America’s Senior

      http://web.archive.org/web/20161110070708/https://www.whitehouse.gov/the-press-office/affordable-care-act-strengthening-medicare-combating-misinformation-and-protecting-

      Taking aim at the conservative misinformationists, the Press Release concluded with: “The Centers for Medicare & Medicaid Services, in conjunction with the Administration on Aging, will be launching an educational media campaign this summer to educate Medicare beneficiaries about the importance of staying vigilant with their personal Medicare information and getting the facts about the new law to seniors so that scam artists are not able to prey on them.”