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Past Event

An Economic Studies Event

Reforming Medicare: Options, Tradeoffs, and Opportunities

Health Care, Medicare, Retirement, Aging


Event Summary

As baby-boomers begin to retire and health care spending continues to outpace income growth, Medicare faces a dire financial future. Critics from the left and right criticize the costly Medicare program variously for gaps in coverage or bureaucratic rigidity. All agree that Medicare requires reform—and soon.

Event Information

When

Wednesday, July 30, 2008
10:00 AM to 12:00 PM

Where

Falk Auditorium
The Brookings Institution
1775 Massachusetts Ave., NW
Washington, DC
Map

Event Materials

Contact: Brookings Office of Communications

E-mail: events@brookings.edu

Phone: 202.797.6105

To help guide the debate that will precede this reform, Henry J. Aaron and Jeanne M. Lambrew have written Reforming Medicare: Options, Tradeoffs, and Opportunities. Outlining three broad approaches to reform—strengthened social insurance, premium choice and consumer-directed health care—the authors present the strengths and weaknesses of each and recommend a blended approach.

On July 30, the authors were joined by advocates of each of the three reform strategies. Robert Berenson of the Urban Institute argued that the social insurance framework should be retained. Karen Ignagni, president of America’s Health Insurance Plans, suggested the desirability of allowing Medicare beneficiaries to choose among competing insurance plans. And Michael Tanner of the Cato Institute defended consumer-directed health insurance under which individuals are covered by high-deductible insurance and have health savings accounts. E.J. Dionne, Jr. of the Washington Post and Brookings chaired the event.

After the program, participants took audience questions.

Watch Full Video of Event »

Transcript

HENRY AARON: Right now, the election day is just a hundred days away. You all may have seen projections released this week by the administration that whoever is elected president is going to confront some pretty terrible deficits. Moreover, those deficits are projected to keep on growing, and among the health fraternity or sorority, it is well understood that the primary force driving those projected deficits are increases in Medicare spending.

Nonetheless, the health programs of both Senators Obama and McCain focus on reform of the overall health-care system, not focusing on Medicare. That reflects a core fact, and the fact is that as a practical matter, it's going to be impossible significantly to slow Medicare spending without undermining the nation's commitment to provide care, standard care, to the elderly and disabled unless it is part of a larger health care reform.

Now, Medicare has dramatically improved access to health care for the elderly and disabled, but, at the same time, I think everybody recognizes that the program has some serious flaws. Fixing them is going to take some combination of changes in the way the program is administered, more use of markets and consumer choice, and, not paradoxically, in my view, simultaneously more regulatory oversight by government, probably some combination of all three of those. But whatever the nature of the reform, implementing it is going to cost a lot more money than the share of government spending currently devoted to Medicare.

What Jeanne and I have tried to do in this book is provide a guide to the debate about Medicare reform, even if the candidates are currently shying away from it. And they shied away from it for the reason that E.J. mentioned: there’s some really nasty choices involved, and the job of people running for office is to get elected. Sooner or later, however, one of the three major options for reform that Jeanne is going to describe will have to be chosen.

Participants

Introduction and Moderator

E.J. Dionne, Jr.

Senior Fellow, Governance Studies

Featured Speakers

Henry J. Aaron

Senior Fellow, Economic Studies

Jeanne M. Lambrew

University of Texas

Robert Berenson

The Urban Institute

Karen Ignagni

America’s Health Insurance Plans

Michael Tanner

The Cato Institute


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