Healthy, well-to-do elderly people would be more likely to join private plans, leaving traditional Medicare with "high-cost, high-risk beneficiaries," Mr. Dingell said.
Medicare is fundamentally expensive, since it is aimed at the elderly, who are high-cost, high-use beneficiaries, while private insurance plans prosper by covering younger, low-cost, low-use members.
Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%), while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%).
Further means testing would distance middle class and higher income beneficiaries from that value.
The proportion of malnourished children treated exclusively in outpatient facilities was higher among beneficiaries of the preventive distribution (84.2%, p<0.0001) than among children from Guidam Roumdji not registered for distribution (80.5%).
The cost varied significantly among four treatment groups and was considerably higher for beneficiaries using insulin.
Other fixes could involve reducing the benefits of high-income beneficiaries.
"High-income beneficiaries can afford to pay a larger share of Medicare's costs," said Senator Dianne Feinstein, Democrat of California.
One of the more high-profile beneficiaries of the easier rules is José Contreras, a pitcher in America's Major League Baseball.
Saddled with more and more costs, he said, high-income beneficiaries may eventually want to leave the program.
