Call off the apocalypse?

What if Medicare costs aren't going to grow unsustainably after all? That's what Chapin White and Paul Ginsberg ask. I have mentioned here that the Affordable Care Act contains several provisions that promise to contain Medicare spending (while simultaneously improving outcomes, by the way) including the Patient-Centered Outcomes Research Institute, the Center for Medicare and Medicaid Innovation, and pilot projects to reconfigure the payment structure and reorganize health care. There was also some earlier legislative action that constrains costs.

Well, it turns out that for the past couple of years, Medicare spending per beneficiary has pretty much tracked inflation. That's partly because of the bad economy -- even Medicare beneficiaries have to pay something out of pocket -- and partly because of the retiring baby boomers who, for a period, will mean there is a higher percentage of "young old" in the mix. But White and Ginsberg think there's more to it, that we really are starting to get a handle on costs.

I think they're calling the game too early, but I also do think there is promise in the reforms that have been made so far and that if we can stuff a sock in the Death Panel wingnuttery and equally deranged "free market" fundamentalists, we can do this thing. But we need a much, much better press corps and a Democratic party that's willing to stand up and fight.