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It's hard to see why America would be considering such an increase, given that under its current structure Medicare will be bankrupt by 2018.
LEON STEIN Mundelein, Ill., Aug. 21, 2012 To the Editor: David Brooks suggests that the revised G.O.P. plan for Medicare would unleash a process of discovery, one that would reveal which structure, Medicare or private insurance, would prove the more efficient.
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As now structured, Medicare pays specialists extravagant fees to perform tests and procedures, which drives up costs.
Gail E. Shearer, a health policy expert at Consumers Union, said the proposed changes in the structure of Medicare were "too high a price to pay" for the new drug benefits.
The new estimates will also reduce the political pressure for cutbacks or radical changes in the structure of Medicare or Social Security.
Mr. Obama would preserve the structure of Medicare but try to rein in costs, in part by trimming payments to health care providers.
But they have been unable to agree on sweeping changes in the overall structure of Medicare, which would require the traditional government-run program to compete directly with private health plans.
Samuel D. Turner, a lawyer coordinating support for the legislation, predicted that lawmakers would struggle over complex proposals for fundamental change in the structure of Medicare until Congress adjourns for the year.
Monica S. Tencate, the health policy director for the Finance Committee, said Mr. Grassley and the panel were not planning to make "fundamental changes in the structure of Medicare," as proposed by Mr. Bush.
Still, persuading Congress to enact major changes in the structure of Medicare, beyond the addition of drug benefits, will be an uphill struggle for Mr. Bush, even with help from Dr. Frist, because the program is immensely popular with older voters.
Almost every member of Congress has promised drug benefits to the elderly, and the two parties could conceivably strike a compromise on that issue, but they are nowhere near agreement on long-term changes in the structure of Medicare.
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