Weekly Column:   –  “A government report last week accelerated the timetable for when the Medicare trust fund will become insolvent, unsettling millions of working Americans who anticipate future retirement.  Under the trustees’ new projections, Medicare will be bankrupt in 2017, two years sooner than previously thought.

Americans are right to wonder if the federal solutions to Medicare’s impending shortfall will involve cuts in benefits, higher age limits for new enrollment, an increase in payroll taxes, or all three.  Several proposals now in Congress anticipate this problem, however, and would not threaten the size or availability of benefits.  Better, they already have bipartisan support because they can generate real cost savings for Americans as taxpayers and as consumers of health care at any age.

Some proposals focus on the Medicare Part D drug program, which is inherently inefficient because it rewards prescription drug manufacturers by buying its patients’ prescriptions one at a time.  Unlike the Veterans Administration, which negotiates bulk purchase prices for frequently-prescribed drugs, Medicare pays full price for each one.  It’s an embarrassingly wasteful procurement practice, and there is no place for it in the government of a nation in the best of times, let alone one in recession.

Medicare Part D would also benefit from higher utilization of generic drugs.  In the past ten years, generics have saved Americans an estimated $734 billion.  We must find ways to speed these low-cost alternatives to market, and break down barriers to their competition with chemically- and biologically-identical name-brand counterparts.  Part D has exceeded expectations by achieving monthly premium levels in 2009 which are 37 percent less than what was expected in 2003 when the program began.  Still, the New America Foundation expects the overall cost of Medicare Part D to increase 11.1 percent each year between now and 2018.  Cost saving measures are still in order.
Congress should also take up new incentives for wellness and preventative medicine to prevent costly late-stage treatments that occur when a disease is not identified until it has advanced.  Healthier people require less costly health care, and the savings to Medicare would be immense.  The idea has a place in the general population as well.

Even better billing practices and updated identification for Medicare could save providers, beneficiaries and taxpayers billions; so can making sure Medicare does not pay for procedures which are already covered by private insurers.

Finally, the federal government could save money on Medicare simply by allowing researchers to examine when and why certain treatments are most effective for certain patients.  Armed with evidence-based information for doctors, instead of a series of tests against placebos meant to satisfy bureaucrats, significant improvements in health care and reductions in cost are possible.

Not one of these solutions cuts a benefit to a Medicare patient today or in the future.  None of them infringe on the right of American patients and their doctors to pursue the best course of treatment without government intrusion.  All of them will keep Americans, and Medicare, alive longer.”