What Context Should Reporters Have in Order to Assess Competing Medicare Reform Proposals?

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September 25, 2012

The Medicare NewsGroup asked its newly formed Medicare Leaders Advisory Board – a group of prominent former leaders of the federal program and political veterans – this question: “What context should journalists have in order to evaluate competing Medicare reform proposals?”

It's an important question to ask considering the number of Medicare-related stories being written every day, especially during this election cycle.

These were their answers:

Stuart H. Altman, Ph.D., an economist who served as chair of an advisory commission on Medicare payment under President Ronald Reagan and was a member of the U.S. Bipartisan Commission on the Future of Medicare under President Bill Clinton. Altman, a Democrat, is the Sol C. Chaikin Professor of National Health Policy in the Heller School for Social Policy and Management at Brandeis University.

“The most important issue facing Medicare is the growing gap between future expenditures and revenues. There are three methods for eliminating that gap: add more revenues through an increase in taxes or an infusion from general revenues, cutting expenditures by either paying providers less for services or reducing benefits to beneficiaries, or limiting the amount the program pays to beneficiaries through a voucher and requiring them to pay more for coverage.”

Robert A. Berenson, M.D., who was a member of the White House domestic policy staff under President Jimmy Carter, a senior official in the Medicare program under President Bill Clinton and former vice chair of a commission advising Congress on Medicare policy.  Berenson, a Democrat, is Institute Fellow at the Urban Institute and adjunct faculty at The George Washington University Schools of Medicine and Public Health and the Fuqua School of Business at Duke University.

“Over the next 25 years, one-half of increased Medicare spending will result from the Baby Boomers aging into Medicare. Per capita spending is not the primary issue; rather, there will be a near doubling in the number of “capitas” to be cared for. So journalists need to ask how the Medicare proposals will address the mismatch between the population to be served and the revenues to serve them.”

William L. Roper, M.D., M.P.H., who headed the Medicare program under President Ronald Reagan and served as a White House domestic policy advisor under presidents Reagan and George H. W. Bush. Roper, a Republican, is currently Dean of the School of Medicine, Vice Chancellor for Medical Affairs and Chief Executive Officer of the UNC Health Care System at the University of North Carolina at Chapel Hill. He also is Professor of Pediatrics in the School of Medicine and Professor of Health Policy and Administration in the School of Public Health.

“Journalists can play a critical role in helping people understand the competing proposals. To accomplish that goal, journalists should be sure to speak to as many third-party and independent sources, including academics, to gain a nonpartisan perspective and pass the facts on to their audience.”

Gail R. Wilensky, Ph.D., an economist who was a White House policy advisor to and headed the Medicare program under President George H. W. Bush. She later served as chair of a commission advising Congress on Medicare policy. Wilensky, a Republican, is currently a Senior Fellow at Project HOPE, an international health foundation.

“Medicare as we used to know it, has ended; that is, Medicare as an open-ended entitlement where spending is whatever results from the benefits available to seniors, the volume and mix of services they use and the reimbursement rates that Congress provides to institutions and clinicians providing services to seniors.  Both Republicans and Democrats realize this can't continue but they have chosen different strategies to enforce a fixed level of spending.”

 Read their complete answers here: Medicare Leaders Advisory Board Advice to Journalists