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Save the Medicare Commission!

The independent Medicare Commission is one of the most promising cost-control measures in the Senate bill. But as Joshua Gordon explains, it's been seriously weakened in recent weeks. The big problem is that the commission is now barred from submitting reform proposals when Medicare's five-year spending growth average is lower than the health-care system's more generally.

But Medicare's five-year average is almost always lower than the health-care system's. Medicare is better at containing costs. But better, in this case, is not good enough. Medicare will go bankrupt, and so too will the federal government -- and it will be no consolation that cost growth is even worse in the rest of the health-care system.

It's particularly important that the Senate fix this because the House, quite simply, won't. If anything, members of the House are likely to try and weaken the Medicare Commission in conference, as they've never much liked the idea. The administration will weigh in firmly on its behalf, but if the Senate has neutered it and the House opposes it, they won't be coming to the table with a very strong hand.

By Ezra Klein  |  December 3, 2009; 10:35 AM ET
Categories:  Health Reform  
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Comments

Here is what I do not understand politics of President Obama - why does he not come swinging his 'veto pen' and say that these things are non-negotiable in the final HCR? It is surprising because precisely that would get back the constituency of Independents he cherishes rightly and more importantly insisting these things is better for America.

President Obama is already slowly moving away from HCR business and essentially making it look like as Congressional mess (which it is). For about a year now Congress has been debating this bill and they may have nothing to show if President Obama insists on getting these 'iron clad' cost control measures in the final bill. Let those snakes in Congressional well jump on each other, let them make whatever mess they want to do; but if President intends to hold them responsible for a tight bill; these Congressional folks have nowhere to go but must submit what he wants.

In other words, Budget Commission, fiscal prudence, Afghan War, Economy and Alternative Energy; these can be very well the legacies President Obama can live with if Democratic Congress wants to sink with their disastrous HCR. There will be damage to President if HCR does not go through. But he can recover whereas sitting Congressional members will sink for sure.

Standing to foolishness of Congress is where America's future lies and indeed there is a political 'bundle' to be made in placing these recalcitrant, spend-spend Democrats where they belong.

Posted by: umesh409 | December 3, 2009 11:40 AM | Report abuse

Can we stop with the "going bankrupt" hysteria? Medicare isn't going bankrupt. At worst in a few decades its revenues will exceed its outlays. In which case, the government will either cover the difference from general revenues, make changes to the program to lower spending, modestly increase the payroll tax to bring things back into balance, or some combination of the above.

Posted by: redwards95 | December 3, 2009 12:02 PM | Report abuse

I'm shocked... Shocked! this was watered down.

When you chose to deal from a weak hand, the only direction to negotiation is even further down.

Time for some of this stuff to be split off into reconcilliation with the most progressive policies that can get 50+1 votes.

John

Posted by: toshiaki | December 3, 2009 12:12 PM | Report abuse

This is hardly surprising. Congress hasn't showed any political will to cut Medicare in the past. Why would they change now? What's more surprising is if anyone didn't see this coming.

Posted by: MBP2 | December 3, 2009 12:39 PM | Report abuse

Does this now have to be rescored by the CBO? If so, where are they going to find the funds to make it deficit-neutral again? My guess = subsidies.

Posted by: NS12345 | December 3, 2009 2:52 PM | Report abuse

I gather it is inconceivable to tax people who have money to make up a short fall. Oh, I forgot, this country doesn't do taxes, except maybe blunderbuss regressive ones like sales and VAT.

Posted by: janinsanfran | December 3, 2009 4:19 PM | Report abuse

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