For those of us who are committed to passing health care system reform legislation, the new year and new Congress will bring many changes and challenges. One problem we will confront is a proposal to redirect Medicare and Medicaid spending to help pay down the federal deficit, rather than to pay for health care system reform.
Most of the comprehensive health care system reform bills of the last 2 years relied on reductions in projected spending of these two federal health programs. Savings from Medicare were to be used to finance additional Medicare benefits, such as prescription drugs, a home care program for disabled people of all ages, low-income subsidies, and, in some cases, even deficit reduction. Medicaid savings were generally to be used to pay for health care coverage for low-income families.
The basic idea was that we could responsibly limit Medicare and Medicaid spending if we also expanded
Rockefeller JD. Moving Ahead With Health Care System Reform. JAMA. 1995;273(3):250-251. doi:10.1001/jama.1995.03520270086044