Healthcare experts, including former Obama advisers, say the White House appears to be considering ideas for Medicare, the popular health insurance program for the elderly and disabled, that could become models for the overall health landscape.If true, huzzah, though it will be difficult to achieve in the ongoing political climate where the austerity fetish demands punishment for people who would dare to get old or sick or lose their jobs without a trust fund as a backup. If it's true, though, we could perhaps start having a conversation once again about what will actually work to drive down costs for Medicare and for the health care system overall.
And in some good news for Obama, whose 2010 Affordable Care Act has been a lightning rod for Republican opposition, experts also see the political climate brightening for efforts to control the rise in healthcare costs generally.
"My expectation is that the president will offer a mix of ideas on the Medicare program that will not be about middle-income beneficiary cuts," said Neera Tanden, a former Obama healthcare adviser who heads the Center for American Progress, a think tank with strong Democratic Party ties.
That would include, has to include, forcing cost reductions on the provider side and on the health care industry, which has for the most part escaped major reforms. For example, allowing Medicare to negotiate for cheaper drug prices could save as much as $200 billion over the next decade. It should also include real consideration of expanding eligibility to Medicare, bringing the age down to 55 or even 50 to enroll a younger, healthier population injecting premium payments into the system.
If the White House truly does try to expand this conversation beyond Medicare reforms to the larger health care system and the critical reforms that still need to be done, then more progressive, and practical, proposals have to be on the table along with benefit cuts. And President Obama needs to be the one to put these options on the table. He's publicly argued for them before, but now it's time to make that rhetoric real in policy proposals.