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Published: 5/26/2011

Medicare pushback

The extreme Republican proposal to turn Medicare into a private voucher program is attracting broad public resistance, in Ohio and across the country. GOP lawmakers can continue to peddle a prescription that most Americans reject. Or they can work with the Obama Administration and congressional Democrats on real solutions to strengthen the solvency of the government health insurance plan that serves 47.5 million elderly and disabled citizens.

According to a poll of Ohio voters sponsored by four liberal interest groups and released this week, three-fourths of respondents said they oppose efforts to cut the national debt by reducing Medicare spending. Separately, a new nationwide poll reported that most Americans think Washington can balance the budget without cutting Medicare.

Republicans say such surveys misrepresent their plan, which they claim would allow Medicare spending to continue to rise for 10 years while they convert the program to one based on helping elderly Americans buy private insurance. But if voters appreciate that distinction, they evidently aren't buying it.

On Tuesday, a Democrat won a special election in a heavily Republican congressional district in New York. She based her successful campaign largely on her opposition to the GOP proposal, which she argued would "decimate" Medicare.

Her victory could prove as significant as the special-election upset win last year by Sen. Scott Brown (R., Mass.), who campaigned against ObamaCare. Other GOP candidates adopted that strategy successfully last November.

No one would responsibly argue that Medicare costs do not need to be contained, and quickly. A new report by the program's trustees concludes that the Medicare trust fund for hospital insurance will run out of money in 2024.

It projects the program's unfunded liabilities through 2085 at $24.6 trillion. Left unchecked, such spending will leave no money for other national priorities, such as education, public infrastructure, and programs to fight poverty.

The budget approved by the GOP-majority House, which Republicans such as Newt Gingrich now disavow, would merely shift Medicare's funding burdens to its recipients. The "premium support" the government would offer in the form of subsidies for private coverage, replacing Medicare's guaranteed payments, would not keep up with the expected growth of medical costs. That would force recipients to pay more out of pocket for their health care -- if they can afford it.

A better approach would be for Republicans and Democrats to find ways to make the nation's health-care system more efficient and less costly. The new health-care reform law offers promising ideas for doing that, but Republicans are determined to repeal it, even though Medicare trustees say it has helped maintain the program's solvency.

There can be a greater role for private competition to Medicare as part of a comprehensive reform proposal. Consumers' ability to pay should be taken into account as well. But dismantling Medicare while cutting taxes for the wealthiest Americans and corporations, as the GOP plan would do, isn't that proposal.

President Obama and Democratic lawmakers now can press their advantage over Republicans by pursuing genuine reform. For example, they can defend from GOP attacks the Independent Payment Advisory Board created by the health-care reform law. That 15-member panel, appointed by the President, is charged with making medical -- not political -- decisions about the fees Medicare pays providers.

The broader challenge remains to improve the delivery of health care in America in a way that cuts costs without harming quality or access. That includes such things as using information technology better, reducing medical errors, and curbing wasteful duplication of services.

That is where both parties should place their emphasis, if the long-term solvency of Medicare is a higher priority than their performance in next year's election.



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