Buried among its articles about Black Friday shopping, the New York Times published an article headlined “Support Builds for a Plan to Rein In Medicare Costs.” In case readers should get the idea that a breakthrough has been reached which would actually reduce the cost of providing needed services, the article begins: “Though it reached no agreement, the special Congressional committee on deficit reduction built a case for major structural changes in Medicare that would limit the government’s open-ended financial commitment to the program … Members of both parties told the panel that Medicare should offer a fixed amount of money to each beneficiary to buy coverage from competing private plans, whose costs and benefits would be tightly regulated by the government.”
Sarah Kliff commented on the NYT story in the Washington Post: “In some ways, you can read this as a big shift: Democrats have long been skeptical of allotting seniors a fixed-level of spending for Medicare. It could leave some seniors short of covering medical expenses, they have worried. The Medicare market could suffer, as all the healthy seniors gravitated towards less costly options, leaving the sick with increasingly costly options.”
That’s right. A trial balloon is being floated here to test a new narrative on controlling health care costs. Should the government cap the amount of money allocated to each senior to buy Medicare (so-called “premium support”), which mostly ends up in the pockets of the insurance and drug companies, or should the high profits of these companies be brought under control by using the government’s buying power to stop them creaming off the money intended to go to health care providers?
It looks as though congressional Democrats have offered to accept the premium support method of reducing actual benefits in exchange for the minimum amount of tax increase on the rich to make it politically palatable. They are also reinforcing the false premise that competition among private-sector companies creates a more efficient system than government control.
The NYT article makes no mention of the successful Republican filibuster which ended Donald Berwick’s recess appointment as administrator of Medicare and Medicaid. According to Talking Points Memo, “The irony is that Berwick is best known, and widely respected, for his academic work on making the U.S. health care system more efficient — i.e. how to save people, businesses, and the government money, and simultaneously improve patient care. … Berwick, like most liberals and Democrats, is of the school of thought that the system can be made much more efficient before it becomes necessary to roll back increasingly expensive government programs like Medicare and Medicaid. … That’s why conservatives rejected Berwick’s nomination. He wanted to prove that the government does a better job financing health care — at least for the poor and elderly — than private insurance companies. The implication, if he’d succeeded, would have devastated the right’s campaign against the centerpiece of the Great Society. That’s why he had to go.”
But even more onerous than the Republican all-out attack on Medicare, is the congressional Democrats’ capitulation to the ideology of market capitalism that truly threatens the achievements of the Great Society. Is the NYT facilitating this capitulation?