Resignation of McClellan offers him 'golden opportunity' for Medicare reform

The resignation of CMS Administrator Mark McClellan will provide him with "a golden opportunity" to "tell us what to do about Medicare," the "monster of our future," columnist Robert Samuelson writes in a Washington Post opinion piece.

According to Samuelson, "Federal spending on the elderly is plausibly projected to double from 2000 to 2030 as a share of national income," and about "three-quarters of that increase will be health spending -- mostly Medicare."

Samuelson writes, "Now, uncontrolled health spending will dominate the federal budget and pose ugly choices: (a) raise taxes sharply, (b) gut other programs and (c) run ever-larger -- and more dangerous -- deficits."

He adds that "the present health-spending explosion ... may ultimately lower economic growth -- a side effect of the high taxes needed to pay for Medicare and Medicaid -- and already depresses take-home pay, squeezes other public services and redistributes income from the young to the old."

Samuelson writes, "We should overhaul Medicare, but just how is unclear.

To know, we need to answer three questions: (1) How much health spending can the economy absorb without having higher taxes or depressed wages reduce economic growth? (2) Who should pay for Medicare -- that is, should older people pay more (lessening the burden on the young)? (3) How can we pay physicians and hospitals for better outcomes and not just for more tests, hospitalizations and visits?"

He adds, "Carrying out President Bush's agenda ... McClellan couldn't pose these basic questions," but he will have the ability to ask them after his resignation (Samuelson, Washington Post, 9/14).