A Vision for Medicare Sustainability

Medicare Rights Center continues to push for common sense modifications in coverage, considering, and apply to make sure that Medicare meets its full potential for present and future beneficiaries.

Medicare Still Matters

In a latest Health Affairs column, Dr. Marilyn Moon, a distinguished Medicare expert, former Public Trustee of the Medicare and Social Security Trust Funds, and member of the Medicare Rights Center’s Board of Directors, highlights a few of the challenges this system and policymakers face.

Medicare Financing is Complex

Dr. Moon discusses a few of the problematic myths and misconceptions that may underlie calls to “save” Medicare and explains why complete, beneficiary-centered reforms are vital.

Medicare Rights agrees. Medicare’s present financing construction is complicated. In our expertise, alternatives to enhance it are sometimes narrowly targeted on Part A’s Hospital Insurance belief fund. But this method ignores different price development components, reminiscent of shifts in doctor and outpatient protection, which have made Part B a bigger driver of spending than Part A.

Funding Needs Change Over Time

As Dr. Moon notes, Congress didn’t count on to set and neglect Medicare financing: “Instead, the earliest Medicare analysts argued that new funding sources would be needed over time.” The historical past of the payroll tax exhibits that adjusting the numbers to fulfill the demand was an everyday characteristic of congressional motion.

Reining In Spending on Medicare Advantage

Dr. Moon additionally flags the necessity to deal with Medicare Advantage (MA) overpayment. Congress and others have touted the potential for these non-public plans to avoid wasting Medicare {dollars}, however the reverse has confirmed true. In a report to Congress, the impartial Medicare Payment Advisory Commission put it merely: “[P]rivate plans have never yielded aggregate savings for the Medicare program. Throughout the history of Medicare managed care, the program has paid more—sometimes much more—than it would have paid for beneficiaries to have remained in fee-for-service (FFS) [Original] Medicare.”

Driven by overpayment and advertising and marketing benefits, MA plans have multiplied, making it tougher for folks to judge and select between their protection choices. Lack of information about supplemental benefits plans might supply compounds this downside. At the identical time, structural and price boundaries make it tough for folks to undo their selections or swap from MA to Original Medicare, successfully locking them right into a plan or pathway that doesn’t greatest meet their wants.

Smarter Investments, Not Cuts

Dr. Moon factors as nicely to the paradox of driving up Medicare spending by program cuts, together with reductions to Medicaid. Eroding techniques and companies that assist Medicare beneficiaries keep wholesome and impartial will undermine these targets in ways in which result in worse outcomes and better prices.

Medicare Rights helps good investments to assist folks construct well being and financial safety. This contains restoring what was minimize by the reconciliation invoice in addition to filling longstanding gaps in Medicare protection for companies reminiscent of dental, listening to, and imaginative and prescient care.

A Vision for Medicare Sustainability

At Medicare Rights, we agree wholeheartedly with Dr. Moon’s evaluation. A dynamic Medicare financing system that facilities beneficiary wants is important to make sure this system stays sturdy and efficient. Medicare issues for the thousands and thousands of people that depend on it, for the taxpayers who assist fund it, and for the well being system as an entire.

Further Reading

Read Dr. Moon’s column.

Read extra about Medicare sustainability.

Read concerning the checkered historical past of MA.