By Thomas Saving and John Goodman
healthaffairs.org—As Congress faces mounting pressure to rein in Medicare spending, two sides seem to be squaring off. The don’t-touch-a-thing-other-than-squeezing-provider-fees position seems to appeal to mainly Democrats, while eat-your-spinach reforms, including more cost sharing and higher premiums, seem to appeal mainly to Republicans. Neither position is very appealing to voters — nor should they be.
Is there a third way? Is there a way to get the job done and appeal to voters – young and old – at the same time? We think there is. To see how it might work, we first have to understand that what Medicare is currently trying to do is virtually impossible.
Consider that Medicare has a list of about 7,500 separate tasks that it pays physicians to perform. For each task there is a price that varies by location and other factors. Of the 800,000 practicing physicians in this country, not all are in Medicare and no doctor will be a candidate to perform every task on Medicare’s list.
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