Viewpoints: Suggestions for modifying proposals on Medicare

The Wall Street Journal: The Right Way To Reform Medicare
In recent weeks, our country has continued an important conversation about our fiscal future. Washington doesn't agree on much, but we all agree that we need to reduce our deficit and debt. Reforming Medicare and reducing health-care spending is crucial to meeting that goal. But there's a right way to reform Medicare and a wrong way (Donald Berwick, 4/29).

The New England Journal of Medicine: Consensus and Conflict in Health System Reform — The Republican Budget Plan And The ACA
The "Roadmap for America's Future," put forward by Representative Paul Ryan (R-WI) and adopted in principle as the Republican budget proposal for 2012, offers a vision of the role of government and the nature of a good society that contrasts sharply with the vision inherent in the Affordable Care Act (ACA). Nevertheless, the Roadmap and the ACA have much in common, suggesting that there is a growing consensus regarding the way in which the U.S. health care system should be structured (Timothy Stoltzfus Jost, 4/27).

The New England Journal of Medicine: Reforming Medicare — Toward a Modified Ryan Plan
There has been no lack of criticism of Ryan's proposal. I agree with some concerns that have been raised about it, but rather than dismiss it in its entirety, I would relax some of the harsher provisions, recognizing that by doing so, I would diminish some of the savings it would create. ... the subsidy must be sufficient for purchasing at least one available health plan in each geographic area at whatever percentage of premium coverage is assumed to be appropriate at the outset. ... consideration should be given to making traditional Medicare available on a premium basis, so that the subsidy could be used to buy it as well as private plans. Since traditional Medicare will be available anyway as long as Americans who are currently 55 years old are alive, continuing Medicare as a choice, as a defined-contribution plan, might be a politically important compromise (Gail R. Wilensky, 4/27).

Burlington Free Press: My Turn: Vermonters Should Share Risks Of Health Care Reform
Gov. Peter Shumlin is right. Health care reform is needed -- the sooner the better. One big reason: Health care is busting the state budget. But proposed reforms are not likely to produce real budget savings until 2015 at the earliest. And health care costs will continue to balloon until these reforms are in place. What happens to state budgets in the meantime? Which Vermonters bear the burden now? And who bears the risk if the needed reforms fail to materialize (Paul A. Cillo, 4/29)? 

The Wall Street Journal: Union Busting, Massachusetts Style
Pop quiz: What political party, in what state, this week passed a bill in the dead of night stripping public-sector unions of their collective- bargaining powers? Republicans in Wisconsin? The GOP in Ohio or Indiana? Try Democrats in Massachusetts. Maybe the debate over public-sector benefits isn't all that ideological after all (Kimberley A. Strassel, 4/29).