By Margot Sanger-Katz and Alicia Parlapiano | New York Times For decades, runaway Medicare spending was the story of the federal budget. Now, flat Medicare spending might be a bigger one. Something…
For decades, runaway Medicare spending was the story of the federal budget.Something strange has been happening in this giant federal program. Instead of growing and growing, as it always had before, spending per Medicare beneficiary has nearly leveled off over more than a decade.
The reason for the per-person slowdown is a bit of a mystery. Scholars have been arguing about it for years, but no one seems sure enough to confidently predict whether it is likely to stick around for much longer. Older Americans appear to be having fewer heart attacks and strokes, the likely result of effective cholesterol and blood pressure medicines that became cheap and widely used in recent years, according to research from Cutler and colleagues. And drugmakers and surgeons haven’t developed as many new blockbuster treatments recently there has been no new Prozac or angioplasty to drive up spending.
That budgetary good news isn’t all good news for people with Medicare. Reductions in heart attacks and strokes have had big benefits for public health, but the paucity of major medical breakthroughs has been accompanied by slowing improvements in life expectancy for seniors. The cost containment strategies in hospitals may mean patients have been denied the treatments of their choice.
It’s so much money that almost no major legislation passed during this period comes close in scale. Even some major deficit reduction proposals, like the one known as Simpson-Bowles, aren’t much bigger. The Trump tax cuts cost an estimated $2 trillion over 10 years. The recent deficit reduction deal passed by Congress will save a relatively modest $1 trillion in comparison.
The fact that spending has remained so much lower than expected “has allowed us to put these decisions off for a while,” said Sherry Glied, the dean of the Wagner School of public service at New York University, who has evaluated several proposed long-term options for managing Medicare’s finances.
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