By Senators Richard Burr and Tom Coburn
Across America, it's Medicare "open enrollment" -- the period when seniors can choose a plan that best suits their needs. While polls show that Medicare remains very popular, unless Congress makes some needed improvements, seniors will face reduced Medicare choices in the days ahead.
The program faces increasingly grave challenges in costs and benefits. With the right improvements, however, we can uphold our promise to save this program for millions of elderly and disabled who depend on it; and we can give them better benefits than they have today.
Unlike most commercial insurance, traditional Medicare still does not offer seniors maximum out-of-pocket protection. Too many seniors are exposed to unpredictably high costs when they get sick or feel forced to purchase costly supplemental plans.
Nor does basic Medicare spend dollars smartly to coordinate patient care. Despite the efforts of centralized Medicare technicians to cut costs, data from MedPAC and other experts reveal Medicare's often inexplicable variation in spending across the country.
On the cost front, the day of reckoning is hurtling toward us. Program insolvency could hit as soon as 2016, according to the Medicare actuary. The longer-range picture is even more dire. As the fiscal commission and budget experts warned, Medicare is the fastest-growing part of the budget. Federal health care represents the nation's single largest fiscal challenge over the long run.
But these serious challenges offer Congress an opportunity to improve the entire program. The way to save Medicare is to build on what is working. This means Congress should create competition in health care to create more affordable options for seniors by using private plans offering Medicare benefits.
Favoring competition using private plans is based less on ideology than on pragmatism. The traditional fee-for-service system is not affordable or efficient. Private plans, however, have been offered in Medicare since the 1980s and represent some of what works best.
Roughly nine in 10 seniors today receive prescription drug coverage through a private Medicare plan, and premiums for Medicare's drug benefit are expected to be even lower in 2012 than this year. Seniors benefit from a range of choices, and the competition between private plans has reduced costs for taxpayers -- roughly 40 percent under budget compared with original estimates. While Congress must make the financing of the drug benefit sustainable for the long term, the success here is indisputable.