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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Joseph
Antos

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