By David Pittman, Washington Correspondent, MedPage Today
Published: January 31, 2013
WASHINGTON -- Reducing overall healthcare costs -- and not cutting benefits -- is the way to address rising spending on entitlement programs, a senior White House adviser said Thursday.
Gene Sperling, director of the National Economic Council and assistant to the president for economic policy, slammed efforts to change Medicaid, addressing advocates at a conference here sponsored by Families USA, a liberal health policy group.
"The right answer and the best answer for reducing entitlement savings is to reduce the cost of healthcare in a way that does not compromise quality," Sperling said.
The economic adviser specifically mentioned Republican efforts to transform Medicaid into a block grant program -- a move the GOP says would cut Medicaid spending by about a third -- as one effort to attack Medicaid.
Instead, efforts currently under way through the Affordable Care Act and private sector have the ability to reduce costs, he said, citing accountable care organizations and bundled payments.
"The more that we win the battle of lowering overall healthcare costs, the less you will have to do in terms of more difficult budget choices," Sperling said.
But if the White House chooses to protect Medicaid, policymakers will make to make tough decisions elsewhere, Sterling admitted, noting the need for a balanced budget.
Sperling left the door open for Medicare changes, but didn't mention what those could be. A common call has been to increase the eligibility age to 67 or force more wealthy beneficiaries to pay higher premiums.
"But we're going to [make changes] in a sensible way, and when we do it, we are going to make sure we're not just shifting costs in ways that make no sense or put the burden on the most vulnerable," he said.
Making changes that simply shift costs to beneficiaries doesn't address the true problem in either Medicare or Medicaid because then money is still leaving the economy by forcing them to pay more, Sperling said.
He tried to reassure governors who might be struggling with the decision to expand Medicaid programs in their states. A common complaint has been that they would expand only to have federal support slashed and then be left to cover beneficiaries themselves.
"They will not make this step and then find later Medicaid is the first place or even the last place people are going for serious deficit reduction," Sperling said. "Medicaid savings and Medicaid cuts for this president are not on the table."
The Obama administration has made that very clear to the Republicans in Washington, he added.
Instead, making cuts to Medicare and Medicaid now -- just as the ACA is about to lift off the ground with health insurance exchanges and Medicaid expansion -- would be devastating to healthcare, he said.
"Every time somebody thinks it's a politically easy thing to do to cut and go after Medicaid because they think nobody will care," Sperling said. "It is incumbent on all of us to let them know that they are wrong."gn Up
David Pittman is MedPage Today’s Washington Correspondent, following the intersection of policy and healthcare. He covers Congress, FDA, and other health agencies in Washington, as well as major healthcare events. David holds bachelors’ degrees in journalism and chemistry from the University of Georgia and previously worked at the Amarillo Globe-News in Texas, Chemical & Engineering News and most recently FDAnews.
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