The Medicare Commission is off and running in several different directions at once. The 17-member, bipartisan panel set up three task forces, with mandates ranging from coming up with suggestions for tinkering with Medicare to overhauling it in its entirety.
The most important task force will consider a complete rebooting of Medicare. The commission's co-chairmen, California House Republican Bill Thomas and Democratic Rep. John Breaux of Louisiana, said at the panel's first meeting on March 6 that sweeping structural reform is needed. Thomas suggested merging Parts A and B, and examining the program in relation to Social Security.
Breaux said he was sick of the "same old, same old" attempts to change Medicare incrementally. He favors home-health care reform and experimenting with new delivery systems. Look for this group to explore replacing the $200 billion-a-year program with a system requiring workers to start mandatory savings plans to pay for future medical needs.
The second task force will focus on the benefits package and Medicare's role in paying for physician training programs. The third will examine ways to cut fraud and waste, and consider whether wealthier retirees should pay higher premiums.
The commission will report by March 1, 1999.