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Can Medicare Spending Be Tamed?

So, if it were up to you, what would you do to fix Medicare?

The health program for the elderly already costs a lot, and it's going to cost so much more down the road that Medicare is becoming a key part of the debate about how to tame federal spending.

President Obama is expected to talk about Medicare when he weighs in today on the country's fiscal priorities in a speech that will be part of the administration's response to the Republicans' budget plan, as recently laid out by Rep. Paul Ryan (R-WI).

Ryan wants to change Medicare for people now younger than 55 by turning it, essentially, into a voucher program. He calls it a support of insurance premiums. The idea is that the federal government would subsidize people's purchase of Medicare coverage from private insurers.

That's not going to happen, Democrats say. So what could work?

The president's blue-ribbon deficit panel came up with some ideas, many a little bit technical. First off, the Simpson-Bowles report laid out a stark diagnosis: "Federal health care spending represents our single largest fiscal challenge over the long-run." Now, that spending includes Medicare, Medicaid and children's health programs. But the big money is in Medicare. So Simpson-Bowles, among other things, recommends changes to the way doctors are paid, reforms of payment for long-term care and rooting out fraud and abuse.

The New York Times rounds up some options, including a few advanced by the deficit commission, such as:

  • Raise Medicare's eligibility age to 67 from 65
  • Institute copayments for some services, such as lab tests and home care
  • Reduce Medicare payments for education of doctors
  • Cap payments for care and put them in one pot to cover "episodes of care"
  • What would you do?

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