A joint NPR/Kaiser Health News report looks at one approach to reigning in health care costs that is gaining momentum in Congress and with the White House. With a rapidly growing older population, more and more attention is being directed at controlling entitlement costs:
Amid growing signs that health care overhaul legislation will do little to "bend the cost curve" in the coming decade, lawmakers and administration officials are considering tougher steps to rein in costly entitlement programs and address mounting concerns about soaring deficits.
One approach attracting widespread attention calls for the creation of a bipartisan commission to draft proposals to control the long-term costs of Medicare, Medicaid and Social Security. Together, the three programs account for 40 percent of all federal spending, other than interest on the debt.
The recommendations of the proposed commission would command a swift up or down vote by Congress. Senate Budget Committee Chairman Kent Conrad, D-N.D., and Republican Sen. Judd Gregg of New Hampshire, the chief authors of the proposal, say they may attempt to attach it to must-pass legislation raising the government's debt ceiling in the coming weeks.
"My concern is the trajectory of our deficits and debt are completely unsustainable and that [while] health care reform helps, it is not sufficient" to control runaway entitlement spending, Conrad said in an interview. "We've got to do much more, and I don't believe it will happen in the regular order. I think it requires a special process."
The process being proposed would create a commission that would operate in a manner similar to the successful Defense Base Closure and Realignment Commission (BRAC) since their recommendations would not be subject to congressional amendment. And because a three-fifths supermajority would be required in both chambers to adopt the recommendations, the two political parties would have to work together to address entitlement reform.
[E]xperts agree that real long-term health care and Social Security cost savings would necessitate highly unpopular measures, such as reducing health care benefits and cost-of-living adjustments, boosting taxes and fees, or, in the case of Social Security, raising the eligibility age even higher or increasing payroll taxes.
"Everybody knows what the options are, that's not the problem," said William A. Galston, a senior fellow in governance studies at the Brookings Institution. "People have known for 10 years what the options are. The question is a political question, not an analytical question."
Read the full story here.
