In Blog

New Series: Building a Health System with Better Care at Lower Costs, Part 1

Why We Don’t  Need to Gut Medicare and Medicaid to Curb Spending – Take Note           

I  watched Congressman Paul Ryan on “Meet the Press” the other day, insisting that the only salvation from our national deficit crisis is to essentially gut (“reform,” in his words) Medicaid and Medicare per his recent proposal — ending Medicare as we know it by changing it into a “defined” or limited benefit and block granting Medicaid. Under both programs, people with higher health needs – such as older adults and others with chronic conditions and disabilities – spend until broke, get uncompensated care from providers, or go without. (For more on the Ryan plan, check out the comprehensive analysis by the Center for Budget and Policy priorities ( As Dickensian as it sounds, the Ryan plan and variations are getting a second look from both parties for want of a credible alternative for curbing health care spending.

But the alternative – real transformation of U.S. health care – is actually under construction and we had better all join the work crews. Please read on – and send questions.

Both the Affordable Care Act and the Kasich administration’s Office of Health Transformation contain blueprints for dramatically slowing spending growth, without cutting eligibility or vital services. Forward-thinking providers and payers in Ohio and across the U.S. are hard at work changing how they deliver care to improve patient safety, quality, and outcomes. By doing so, they will curb spending.

Just look at the numbers. Many experts agree that at least 30% of U.S. health spending produces no value or “negative” value (i.e. harm). Example: a member of Ohio Campaign for Better Care shared that his wife had surgery last year, came home, then was re-hospitalized for 14 days with an infection. The Medicare bill for the first stay was $30,000, and for the second stay was $60,000. One out of five hospitalized people on Medicare are readmitted within 30 days of discharge and many, if not most, are preventable (such as hospital-acquired infections, poor discharge planning). We’re talking big money here. Billions nationally.

It’s time for organized consumers to demand real transformation that improves patient care and patient health, while cutting costs – instead of gutting Medicare and Medicaid.