To save Medicare, change the model
Drug benefit serves as a prototype for Paul Ryan's reforms.

Reuters

U.S. Rep. Paul Ryan (R-WI) is escorted into the White House by a staffer to attend a luncheon with U.S. President Barack Obama in the Private Dining Room next to the Oval Office in Washington, March 7, 2013.

Article Highlights

  • Paul Ryan is proposing important Medicare reforms as part of a 10-year balanced budget plan.

    Tweet This

  • Medicare is not sustainable in its current form.

    Tweet This

  • Medicare costs too much even as the quality of care it provides falls short of what seniors deserve.

    Tweet This

  • Without reform, the Medicare Hospital Insurance trust fund will be depleted of reserves in 2024.

    Tweet This

Editor's note: this piece was published opposite the USA Today Editorial Board's article found here

House Budget Committee Chairman Paul Ryan is proposing important Medicare reforms as part of a 10-year balanced budget plan. He's absolutely right to do so.

Medicare is not sustainable in its current form. It costs too much even as the quality of care it provides falls well short of what seniors deserve. The Congressional Budget Office estimates that Medicare's costs will reach $1.09 trillion in 2023, up from $551 billion in 2012.

Without reform, the Medicare Hospital Insurance trust fund will be depleted of reserves in 2024. An insolvent Medicare is unfair to younger Americans who will need the program just as much as their parents and grandparents.

The solution can be found within Medicare itself. The drug benefit, enacted in 2003, is built on consumer choice and competition among private drug plans. This approach has worked well to provide access to drugs at an affordable price.

Surveys show that seniors are more than satisfied with the options available to them, and costs are under control. From 2006 to 2011, per capita costs rose an average of just 1.8% annually.

This is the model for Ryan's Medicare reforms, which would be phased in for those under age 55 today. Seniors would get the guaranteed package of Medicare services from the health plan of their choice, and one of their options would be the traditional Medicare program.

The government's contribution toward coverage would be based on the premiums charged by the competing plans. Every Medicare beneficiary could get coverage at no cost above the current-law premium requirement, and they could reduce their premiums by choosing less expensive options.

The alternative to this model is heavy government regulation of prices. That's the approach taken in the Patient Protection and Affordable Care Act. The result will be impaired access to care for seniors.

As the law stands, the cuts in what Medicare will pay for services are so deep that by 2030, about 25% of hospitals will be operating in the red.

Today's seniors rely on Medicare for access to needed medical care. Congressman Ryan's plan honors that commitment even as it also secures Medicare for future generations.

James C. Capretta, a senior fellow at the Ethics and Public Policy Center, worked on health care issues during the George W. Bush administration as associate director of the Office of Management and Budget.

 

Also Visit
AEIdeas Blog The American Magazine
About the Author

 

James C.
Capretta

What's new on AEI

Love people, not pleasure
image Oval Office lacks resolve on Ukraine
image Middle East Morass: A public opinion rundown of Iraq, Iran, and more
image Verizon's Inspire Her Mind ad and the facts they didn't tell you
AEI on Facebook
Events Calendar
  • 21
    MON
  • 22
    TUE
  • 23
    WED
  • 24
    THU
  • 25
    FRI
Monday, July 21, 2014 | 9:15 a.m. – 11:30 a.m.
Closing the gaps in health outcomes: Alternative paths forward

Please join us for a broader exploration of targeted interventions that provide real promise for reducing health disparities, limiting or delaying the onset of chronic health conditions, and improving the performance of the US health care system.

Monday, July 21, 2014 | 4:00 p.m. – 5:30 p.m.
Comprehending comprehensive universities

Join us for a panel discussion that seeks to comprehend the comprehensives and to determine the role these schools play in the nation’s college completion agenda.

Event Registration is Closed
Tuesday, July 22, 2014 | 8:50 a.m. – 12:00 p.m.
Who governs the Internet? A conversation on securing the multistakeholder process

Please join AEI’s Center for Internet, Communications, and Technology Policy for a conference to address key steps we can take, as members of the global community, to maintain a free Internet.

Event Registration is Closed
Thursday, July 24, 2014 | 9:00 a.m. – 10:00 a.m.
Expanding opportunity in America: A conversation with House Budget Committee Chairman Paul Ryan

Please join us as House Budget Committee Chairman Paul Ryan (R-WI) unveils a new set of policy reforms aimed at reducing poverty and increasing upward mobility throughout America.

Thursday, July 24, 2014 | 6:00 p.m. – 7:15 p.m.
Is it time to end the Export-Import Bank?

We welcome you to join us at AEI as POLITICO’s Ben White moderates a lively debate between Tim Carney, one of the bank’s fiercest critics, and Tony Fratto, one of the agency’s staunchest defenders.

No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.