What Will Health Care Reform Do To Medicare?

Is the $460 billion reduction a cut in care or just cost control?

Senate Democrats secured a controversial health care reform provision on Thursday: changes to Medicare that would reduce the program's price tag by $460 billion. Republican critics of the provision, as well as two Democrats (Ben Nelson and Jim Webb), warn that it will reduce benefits in Medicare, an enormously popular government-run health care program. Democrats insist that the measure is about cost control and will help pay for expanding public health care to tens of millions of Americans.

• Disaster for Democrats  Commentary's Jennifer Rubin gleefully projects that this vote will be an albatross about the necks of Senate Democrats. "Remember December 3. It’s a date that will pop up in many campaign ads [...] And those who are up for re-election next year will hear about it over and over again." Rubin also suspects that Nelson and Webb, the two Democrats to vote against, may not support the final legislation as a result.

• The 'Grand Bargain'  The New York Times's Paul Krugman endorses. "Think of it as a grand bargain: coverage for (almost) everyone, tied to an effort to ensure that health care dollars are well spent," he writes. "[T]he health care economists I respect are seriously impressed by the cost-control measures in the Senate bill, which include efforts to improve incentives for cost-effective care, the use of medical research to guide doctors toward treatments that actually work, and more."

• Medicare Too Important  The New Republic's John Judis writes, "Medicare is the most penurious and least wasteful of health insurance programs.  If anything, a dispassionate policy-maker concerned about healthcare costs might have insisted that the private sector insurance emulate, or perhaps be folded into, Medicare." He adds, "How a society cares for those too young, too old, or too sick to work is a test of its maturity, and level of civilization. Social security and Medicare are among the foremost achievements of American government in the twentieth century."

• Bad For Seniors  The Wall Street Journal's Tom Scully blasts a related cut in Medicare Part D. "It sounds smart—except that nobody asked how many employers will drop retiree drug coverage. Clearly, many will. The result is that, instead of saving money, the proposed revenue raiser will force Medicare Part D costs to skyrocket as employers drop retirees into the program."

• Not The Medicare You Think  The Washington Independent's Mike Lillis points out, "Lost in the argument is AARP's nuanced reasoning that the Democrats’ bill would preserve benefits under the traditional Medicare program, even if it scaled back some services under Medicare Advantage, the confusingly named program in which the government pays private insurance companies to cover Medicare patients." AARP has endorsed health care reform.