Reihan Salam wonders,
The conditions Austin outlines for the kind of Medicare voucher system he would endorse are worth reading. I am, as regular readers know, a great believer in experimentation. I wonder, however, if Austin is proposing a true level playing field behind Medicare Advantage and Medicare FFS.
It matters a great deal what this “true level playing field” is. If Reihan points me to something specific, I’ll look. In the meantime, it is worth remembering that the key is to reduce Medicare costs below trend (well below). If a level playing field achieves that and all the other conditions I outlined are satisfied, I’d be very happy.
Also, note that I wanted an IPAB-like entity to govern how plan bidding would work. To the extent the playing field is leveled and remains so, it would be done by them. Finally, the whole arrangement has to be proven effective in a pilot. It’s about results, not theory.
As I recall, getting past that first step–a bidding demo or pilot–has been a pretty tough sell. Why don’t we work on that? A Medicare Competitive Pricing Demonstration anyone?