Proposals to increase the eligibility age for Medicare drew fire from across the political spectrum during a Washington meeting of some debt negotiation leaders.
Sen. Max Baucus (D-Mont.), chairman of the powerful Finance Committee, said during the Fix the Debt Conference that he favored targeting the growth in healthcare costs instead of “shifting costs to seniors.”
Neera Tanden, president of the liberal Center for American Progress, agreed with Edmund Haislmaier, a senior research fellow at the conservative Heritage Foundation, that increasing the Medicare eligibility age would just shift the cost of their care to other systems. Tanden said employers would cover much of the shifted cost, while Haislmaier expected a cost shift to younger and healthier buyers in coming health insurance exchanges.
Other healthcare cuts drew more support from conference attendees as part of either a short-term deal to avoid looming healthcare cuts at the end of the year or as part of a major debt-reduction agreement.
Vic Fazio, a former Democratic congressman, urged using an overhaul of Medicare's sustainable growth-rate system to sharply change how the program pays physicians to reward quality over quantity.
The policy and business leaders generally were split over whether to pursue larger federal health policy changes or wait for possible savings from coming changes instituted through the Patient Protection and Affordable Care Act. For instance, Mark Zandi, chief economist for Moody's Analytics, urged avoiding large health policy changes until results are known from the “experiments” authorized by the healthcare overhaul, including the controversial Independent Payment Advisory Board. In the meantime, he supported the implementation of some Republican-backed healthcare cuts that could provide “fixes around the edges,” but opposed Medicaid block grants
The policy leaders also were split over the size of the healthcare savings that were needed as part of any deficit reduction deal. While they all agreed that healthcare spending is a primary driver of the federal government's historic debt, the policy leaders split over whether the Obama administration's proposal for about $340 billion in 10-year healthcare savings is sufficient or whether twice as much is needed.
Baucus urged an overall debt deal that is “closer to $4 trillion” in reductions of additional federal debt over the next 10 years. Toward this total he counted $1 trillion in savings already approved under the Budget Control Act, $800 billion from ending the wars in Iraq and Afghanistan and $600 billion in “interest savings.”
But no deal on adding federal healthcare savings to that total is likely if political leaders are subject to the types of campaign attacks that occurred during the 2012 election season.
“Both parties are certainly guilty, but no one will be able to come together on these tough decisions if, when we do, they're used as a red-hot iron to brand each other,” he said.