Medicare silver bullets
What's the best way to control costs?

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Article Highlights

  • If we expect to bend the Medicare cost curve, we must change the financial incentives that promote the use of services.

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  • The federal subsidy can’t grow without the limit, and Medicare’s payment arrangements must make that clear.

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  • Giving Medicare beneficiaries a choice of competing health plans will promote efforts to contain cost.

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Editor's note: Kaiser Health News asked a range of health policy experts the following question:  If you could make only one change to Medicare to control costs, what would it be and why? Joseph Antos' answer to their question follows. 

If we expect to bend the Medicare cost curve, we must change the financial incentives that promote the use of services. The federal subsidy cannot grow without limit, and Medicare’s payment arrangements must make that clear to both consumers and providers. Giving beneficiaries a choice of competing health plans, providing a defined contribution subsidy, and maintaining an appropriate oversight role for the government will promote more vigorous efforts by the health sector to contain costs without sacrificing access to care. The goal should be to get the incentives right to promote system improvement rather than a good budget score created by politically unsustainable spending limits. 

Other experts' answers to the question can be found here

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About the Author

 

Joseph
Antos
  • Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute (AEI), where his research focuses on the economics of health policy — including the Affordable Care Act, Medicare, the uninsured, and the overall reform of the health care system and its financing. He also studies the impact of health care expenditures on federal budget policy.

    Before joining AEI, Antos was assistant director for health and human resources at the Congressional Budget Office (CBO). He has also held senior positions in the US Department of Health and Human Services, the Office of Management and Budget, and the President’s Council of Economic Advisers. He recently completed a seven-year term as health adviser to CBO, and two terms as a commissioner of the Maryland Health Services Cost Review Commission. In 2013, he was also named adjunct associate professor of emergency medicine at George Washington University.

    Antos has a Ph.D. and an M.A. in economics from the University of Rochester and a B.A. in mathematics from Cornell University.



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  • Phone: 202-862-5938
    Email: jantos@aei.org
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