For federal deficit reduction commission, Medicare changes may be easier said than done

Introduction

The salvo fired Wednesday by the co-chairs of a federal deficit reduction commission made clear that a host of budgetary sacred cows are in their sights — including Medicare, which is the subject of an ongoing Center for Public Integrity investigation.

The formal recommendations of the National Commission on Fiscal Responsibility and Reform aren’t due until Dec. 1, but the chairmen, former Clinton Administration official Erskine Bowles and former GOP Sen. Alan Simpson, opened the bidding by announcing their own proposal — an aggressive blueprint that slashes spending, eliminates tax breaks, and reduces deficits by $3.8 trillion over the next decade.

Not surprisingly, their proposal hit official Washington with a thud, because it prescribes harsh medicine on a host of fronts — including health care spending. Bowles and Simpson call for Medicare reform in part through changes in payment policies and cost-sharing procedures. Their plan says doctors and other health care providers will be asked to “take responsibility for slowing health care cost growth.”

But as the Center’s series, “Manipulating Medicare” has already demonstrated, that’s easier said then done — way easier. Our initial piece, “Medicare: An Entitlement Out of Control,” detailed how the federal health program is unsustainable on its current path, but has also been politically untouchable. Our second piece, “Little-Known AMA Group Has Outsized Influence on Medicare Payments,” revealed how rising Medicare payment rates are often being effectively determined by the very doctors who stand to benefit from them.

Subsequent stories in the series will describe how and why Medicare is paying millions of dollars for procedures and services that, based on available evidence, don’t really make sick people better.