Reforming Medicare: Options, Tradeoffs, and Opportunities

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.

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.

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