Overpayments to insurance companies selling private-fee-for-service plans to Medicare beneficiaries. Seniors can choose one of these plans instead of traditional Medicare benefits. But independent experts like the Medicare Payment Advisory Commission say the government pays these insurers 19 percent more than it costs to provide the same benefits under traditional Medicare. Medicare’s own actuaries predict that overpayments hasten the depletion of the system’s trust funds, resulting in benefit cuts unless new revenues flow in. When President Bush vowed to veto any legislation that cut the excess payments, Congress didn’t push for cuts during its end-of-the-year session. The media missed a golden opportunity to press the candidates. For the record: Both Obama and Clinton supported cutting the overpayments, important positions that have gotten no attention or traction so far.


How Medicare will cope with the rising cost of health care, and who will pay those costs. Medicare like other segments of the health care system has been unable to control the mounting costs of new technology and treatments. To continue benefits, tax increases might be necessary. Yet the snippets of Medicare policy we have heard come mostly from Republicans promoting market solutions—like shifting future costs to beneficiaries—instead of revenue solutions that will retain Medicare’s fundamental structure. Clinton said almost a year ago that the president’s attempt to make higher-income beneficiaries pay surcharges for their Medicare drug benefits was “exactly the wrong approach.” But as the year unfolded, squabbles over whose health care plan forced more people to buy insurance drowned out this crucial policy difference.


A recent retirement column posted on businessweek.com/investing questioned the silence about Medicare and other retirement issues. The writer, Ellen Hoffman, scanned position papers, statements, and tried, sometimes without success, to get more information from campaign staffs. It’s a hopeful sign that she tried. Maybe other reporters will start delving in to the effects of government overpayments and rising health care costs on Medicare, and whether Medicare will continue to cover all of the elderly. Here’s a case where the press needs to lead rather than wait for the spinmeisters to decide what gets covered.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.