Pre­mium sup­port of­fers best chance to bend cost curve, a reader says

Modern Healthcare - - FRONT PAGE - Patrick Booth Pres­i­dent and CEO Fre­mont (Neb.) Area Med­i­cal Cen­ter

Re­gard­ing “Ryan: Plan is bi­par­ti­san” (Aug. 20, p. 8), Medi­care was en­acted 47 years ago to pro­vide a med­i­cal safety net for those who were lucky enough to live longer than av­er­age. It has be­come a wel­fare pro­gram, even for the rich, and even for to­day’s young se­niors who will live, on av­er­age, an­other 1012 years af­ter el­i­gi­bil­ity. Medi­care ben­e­fi­cia­ries cur­rently pay a rather small por­tion of their ex­penses, which has fu­eled overuti­liza­tion. Medi­care has been pay­ing providers fees for their ser­vices with­out hold­ing them ac­count­able for qual­ity and the health of the pa­tient. Fi­nally, when all of the baby boomers be­come el­i­gi­ble, the pyra­mid scheme of tax­ing younger work­ers for Medi­care is go­ing to bust.

Most rea­son­able peo­ple agree that Oba­macare does lit­tle to fun­da­men­tally re­form the sys­tem, in­stead re­ly­ing on new taxes and penal­ties, price con­trols and ra­tioning. Re­gard­less of the out­come of the pres­i­den­tial elec­tion, I be­lieve the Rivlin-Ryan-Wy­den plan of­fers a bi­par­ti­san ap­proach to real and last­ing re­form. Many peo­ple worry whether the pre­mium sup­port pay­ments will keep up with cur­rent med­i­cal in­fla­tion. Isn’t that the point? More com­pe­ti­tion among in­sur­ers and providers, lower uti­liza­tion, more pa­tient choice, health­ier pa­tients—isn’t that the best hope we have for bend­ing the cost curve?

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