Policymakers on both sides of the Medicare finance reform debate have more in common than they may realize, according to Joseph Antos.
Antos, a health care and retirement policy specialist at the American Enterprise Institute, Washington, talked about the possibility of Democrats and Republicans coming together today at a Medicare reform hearing organized by the Senate Special Committee on Aging.
Some observers have argued that the climate in Washington is so toxic right now that Congress cannot hope to accomplish anything of significance until the 2012 general elections, if then.
Antos, who was assistant director for health and human resources at the Congressional Budget Office from 1995 to 2001, testified that, despite all the controversy, there are also important areas of agreement.
Congress still needs to grapple with the more controversial arguments about structural reforms, but “immediate action can be taken on those areas of agreement, which would allow policymakers more time to focus on more fundamental disagreements,” Antos said in written testimony posted on the committee website.
Most of the arguments about Medicare reform reflect different views about whether reform should focus more on government-driven reform efforts or consumer-driven efforts, Antos said.
“As stark as those discussions often are, there are common elements that run through the arguments on both sides,” Antos said. The basic question is not all or nothing. The argument is over where we draw the line between government and market incentives.”
Someone will impose regulations, whether that someone is the government or a private insurer, and consumer and employer responses to any new rules will be unpredictable, no matter how the rules are written, Antos said.
“Consensus will develop around a Medicare reform that sets a reasonable balance between regulation and incetives,” Antos said.
Eventually, in the face of rising fiscal pressure, policymakers could probably come to agreement on making Medicare more progressive and doing more to focus limited resources on those who need help the most, Antos said.