Medicare is dying. That’s the inconvenient truth that most politicians don’t want to talk about for fear they will be accused of “killing Medicare.”  But the Medicare board of trustees say that Medicare will be insolvent in six years if changes aren’t made soon. In other words, doing nothing will kill Medicare.

I did a series on this subject a couple months ago called Solving Medicare/Medicaid Insolvency – Part I – III. For more on this subject, you can read those posts by typing the name of the post into the search engine to the left of this page on my website.

I bring the subject up again for several reasons. First, it continues to be a political third rail that no one wants to talk about. Even Republican presidential candidate and former President Trump is bashing Governor Ron DeSantis with ads in Florida that accuse DeSantis of wanting to kill Medicare. Trump seems to have stolen a line from the Democratic playbook in his desperate attempt to diffuse the momentum of the governor even before he announces his candidacy. Yet neither Trump nor the Democrats are offering any ideas on how to save Medicare.

Second, Grace-Marie Turner, writing for Galen.org and Forbes, tells us there is a new book just published which directly confronts the issue. It’s called Modernizing Medicare: Harnessing the power of consumer choice and market competition, edited by Robert Emmet Moffit and Marie Fishpaw. The book features a dozen top health policy experts who have come together with detailed prescriptions for Medicare’s looming bankruptcy – solutions with decades of demonstrated success.

Turner says the key is competition and consumer choice in a sensibly regulated system that provides extra support for the poor and most vulnerable.

Edited by Heritage Foundation’s Bob Moffit and policy consultant Marie Fishpaw, the prestigious authors each conclude that the answer lies in the premium support model upon which Medicare Advantage and the Part D Prescription Drug Benefit are based.

Doug Badger, a key architect of the Medicare Modernization Act that created these two programs in 2003, explains premium support: “The government makes a per capita, income-related contribution to competing health plans on behalf of beneficiaries, and the beneficiaries choose the health plans they determine best meet their personal needs.”

“Medicare beneficiaries and federal taxpayers are benefitting from the efficiencies achieved through the competitive process in Medicare Advantage,” former Medicare Trustee Charles Blahous writes, explaining that “competing health insurers. . . have responded by finding ways to lower their costs while reducing premiums and out-of-pocket expenses facing program beneficiaries.”

Nearly half of Medicare beneficiaries have voluntarily enrolled in private Medicare Advantage plans, and American Enterprise Institute’s Brian Miller and former Medicare chief Gail Wilensky recommend that the program should be the default option for new enrollees to better harness MA’s market efficiencies. Otherwise, Medicare’s outdated fee-for-service segment will continue to be a “blank check” with unlimited draws on taxpayer dollars.

Former Congressional Budget Office (CBO) Director Doug Holtz-Eakin, now president of American Action Forum, says not acting is not an option: “Medicare alone was responsible for 34 percent of all federal debt outstanding at the end of 2019.” Since that’s over three years ago, that percent is likely much higher now. “For policymakers, the primary goal of Medicare reform should be the achievement of better value for this major expenditures of America’s healthcare dollars.”

He goes on to say, “On the basis of evidence to date, there is every reason to expect that a Medicare premium support program can reduce outlays by both beneficiaries and taxpayers. Over the 2022-2032 budget window, for example, Medicare outlays could decline by at least $2.2 trillion, or 11.5 percent. Even more important, however, is that the introduction of consumer choice allows beneficiaries to reveal their values on the crucial issues of medical care and coverage. A values-driven Medicare system will be a better social safety net, regardless of its cost.”

(Note: For more information on this exciting new book, stay tuned for Part II.)