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Using Medicare as Part of Coverage Expansion?

Friday, June 06, 2008

Medicare as a Building Block for Health Reform:

Should Americans Buy In?

A new proposal by The Commonwealth Fund suggests, as a major component of moving toward coverage for all, a Medicare-like program that uninsured adults below the age of 65 could purchase voluntarily. Reform proposals offered by Senators Clinton and Obama as part of their presidential campaigns feature similar options, as do some state reform plans.

Is Medicare a good model for expanding coverage? What features of the program are worth emulating? Which features ought to be avoided? Can we afford to build on Medicare given current concerns over the adequacy of financing for current and future obligations under Medicare? What impact, if any, would using Medicare as a foundation for coverage expansion have on health care costs in general?

To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored a June 6 briefing. Panelists were: Cathy Schoen, Commonwealth; Steve Lieberman of Lieberman Consulting, former senior official at the Congressional Budget Office; Representative Tom Price; Gail Wilensky, Project HOPE; and Cybele Bjorklund, Democratic staff director for theHouse Ways and Means Health Subcommittee. Dr. Wilensky is a former administrator of the agency in charge of Medicare. Karen Davis of Commonwealth and Ed Howard of the Alliance moderated.


 Ed Howard, Alliance for Health Reform, Moderator
 Karen Davis, The Commonwealth Fund, Moderator
 Cathy Schoen, The Commonwealth Fund, Speaker
 Rep. Tom Price, U.S. House of Representatives, Speaker
 Steve Lieberman, Lieberman Consulting, LLC, Speaker
 Cybele Bjorklund, House Ways and Means Health Subcommittee, Speaker
 Gail Wilensky, Project HOPE, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Medicare as a Building Block for Health Reform (Adobe Acrobat PDF), 6/6/2008
Event Summary: Using Medicare as Part of Coverage Expansion? (Word Document), 6/6/2008
Full Webcast/Podcast: Medicare as a Building Block for Health Reform

The transcript, full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Rep. Tom Price Presentation (PowerPoint), 6/6/2008
Cathy Schoen Presentation (PowerPoint), 6/6/2008
Steve Lieberman Presentation (PowerPoint), 6/6/2008

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Medicare’s Challenges in Paying Providers (Adobe Acrobat PDF), Health Care Financing Review, 1/1/2006
Speaker Biographies (Adobe Acrobat PDF), Adobe Acrobat PDF, 6/6/2008
Using Medicare as Part of Coverage Expansion? (Word Document), Word Document, 6/6/2008
Sourcelist (Word Document), , 6/6/2008

Offsite Materials (briefing documents saved on other websites)

Medicare: Starting Now on the Path to Higher Value, The Commonwealth Fund, 2/28/2008
Enhancing Value in Medicare: Demonstrations and other initiatives to improve the program, The Commonwealth Fund, 2/1/2007
Medicare Not the Model for Reform,, 4/15/2008
Democratic Hopefuls Agree on Medicare as Healthcare Model, LA Times, 1/21/2008
Clinton, Obama & Edwards Agree on Medicare-style Option, Wall Street Journal Blog, 1/22/2008
The Republican Health-Care Surrender, Wall Street Journal, 5/15/2008
We Seek Bipartisan Health Care, Wall Street Journal, 5/22/2008
MEDICARE: A model of special interest legislation, Health Affairs Blog, 3/22/2008
The President’s Medicare Budget: A First Step Toward Entitlement Reform, WebMemo: The Heritage Foundation, 2/5/2008
Ending the Physician Payment Crisis: Another Reason for Major Medicare Reform, WebMemo: The Heritage Foundation, 5/20/2008
Saving Medicare, American Enterprise Institute, 5/15/2008
Medicare’s Bad News: Is Anyone Listening?, American Enterprise Institute, 4/16/2008
Insuring the Near Elderly: The Potential Role for Medicare Buy-in Plans, Urban Institute, 1/2/2002
What happens to health benefits after retirement?, Center for Retirement Research at Boston College, 2/1/2007
Rising Health Care Costs Lead Workers to Delay Retirement, Urban Institute, 5/14/2008
The Burden of Out-of-Pocket Health Spending among older adults versus younger adults, Kaiser Family Foundation, 9/7/2007
The Building Blocks of Health Reform: Achieving Universal Coverage and Health System Savings, The Commonwealth Fund, 5/13/2008
Summary of the 2008 Annual Medicare Reports, Social Security Administration, 4/3/2008


U.S. Rep. Tom Price of Georgia's 6th District describes his vision of national health reform, which he terms "patient centered health care." (9 minutes)

Karen Davis, president of The Common-wealth Fund, describes the Fund's approach to national health reform, with an emphasis on a high-performance health system as well as coverage for all. (7 min.)

Cathy Schoen, senior vice president at The Commonwealth Fund, details the Fund's Building Blocks approach to national health reform, which would offer a Medicare Extra option for those under age 65. From the June 6 briefing cosponsored by the Fund. (11 min.)

Steve Lieberman, president of Lieberman Consulting, urges a go-slow approach before offering a Medicare-like insurance option to those under 65. (11 min.) From the June 6 briefing cosponsored by The Commonwealth Fund.

Cybele Bjorklund, Democratic staff director for the House Ways and Means Health Subcommittee, discusses ways to expand health coverage to the uninsured under age 65, including a Medicare-like option. (12 min.) From the June 6 briefing cosponsored by The Commonwealth Fund.

Gail Wilensky, senior fellow at Project HOPE, discusses whether CMS could administer a Medicare-like insurance option for the uninsured under age 65. (8 min.) From the June 6 briefing cosponsored by The Commonwealth Fund.


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