The political/intellectual ground may be shifting beneath our feet.
According to the New York Times, members of Congress from both parties told the so-called supercommittee 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. The Times points out that Republicans, including Mitt Romney and Newt Gingrich, have endorsed variations of a premium support plan, in which Medicare would subsidize premiums charged by private insurers that care for beneficiaries under contract with the government. But what is noteworthy is that “some Democrats say that —if carefully designed, with enough protections for beneficiaries — it might work.”
John C. Rother, president of the National Coalition on Health Care, which represents consumers, employers and providers, said, “The supercommittee may have laid the groundwork for future reductions in the growth of Medicare.” And Representative Jeb Hensarling of Texas, the ranking Republican on the committee, frequently quoted a statement by President Obama: “The major driver of our long-term liabilities, everybody here knows, is Medicare and Medicaid and our health care spending. Nothing comes close.”
The Times goes on to report, “Competition among private insurers has already driven down costs for prescription drug coverage under Medicare. Medicare’s drug benefit is delivered entirely by private insurers.”
To be sure, Democrats say the idea of restructuring Medicare as part of a large deficit reduction package must also include tax increases. Still, the case for major structural changes in Medicare is being made that would “limit the government’s open-ended financial commitment to the program.”
This is a world away from where we once were.
We’re still a long way from building a bi-partisan consensus on this issue. And some Democrats will undoubtedly try to use the Medicare issue to their advantage in the 2012 election. But my sense is that we’re in a different era, one in which “Mediscare” attacks will be much less potent than in the past. The math is incontestable and, unless significant changes are made to Medicare, a fiscal crisis is unavoidable. As a result, the political winds are shifting. And it looks as if those who argued that Republicans who voted in favor of structural reforms for Medicare (via the House GOP budget in April) were engaging in a political suicide mission were wrong. In fact, they were doing what needed to be done: putting forth arguments on behalf of a policy whose time has come. All honor is due them.