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By Modern Healthcare
Posted: April 27, 2013 - 12:01 am ET

The war between the generations

“During the big healthcare fight, conservatives told older Americans that Obamacare was grabbing money from their Medicare and giving it to young people. Now they tell young workers that Medicare and Social Security are draining their take-home pay to support retirees sitting around the pool.

The story … moves from the young taking from the old to the old taking from the young. The one constant here is the motive: To weaken public support for government programs offering Americans a modicum of economic and healthcare security.

We can all agree that entitlement spending must be contained. The 'how' of it is a big question. But the answer cannot be intergenerational warfare. And it need not be. …

President Barack Obama's budget would begin to correct the imbalance reflected in an Urban Institute computation that Washington spends seven times as much per older American as it does per child. It would increase spending on education, on infrastructure, on research, on jobs—programs aimed at boosting an economy that has not been kind to younger workers. …

But the origin of this phony war between the generations isn't so much how the budget pie is being cut by age group. It is the size of the pie. …

Obama's budget offers a clever means of giving conservatives some of what they want, but it also names a price for them: $700 billion in new tax revenue. The main idea, limiting itemized deductions for the richest households, is well-chosen. Rather than engage in hand-to-hand combat over ending this tax break or that one, lawmakers could simply put a cap on the total taken.”

Froma Harrop in the Providence (R.I.) Journal

Healthcare cost spiral hasn't been cured

“With every new report about the recent slowdown in healthcare spending, there is speculation in the media that the problem of rising health costs has somehow been solved or cut down to size.

We have seen this movie before. On a number of occasions in the past several decades, we have been led to believe that the challenge of containing the growth in healthcare costs has been met. In the mid-1990s, it was the managed-care revolution. That was followed by the managed-care backlash, when the trend line for healthcare costs headed back up.

The idea that we have licked the problem of healthcare cost increases is no more probable today than it was in the past. Our nation has made no fundamental change in how healthcare is paid for or delivered. …

Our main conclusion is that most of this slowdown … has been due to years of a weak economy, which causes people to put off health services when they can and prompts employers and states to reduce health spending. …

We need to be realistic about the fact that health spending will start going up more rapidly again as the economy improves. But how much costs escalate is at least in part within our control, and that matters a lot for federal and state budgets, employers and families. The place to start is by recognizing that the problem of healthcare costs is far from solved.”

Drew Altman and Larry Levitt of the Kaiser Family Foundation in the Washington Post



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