By Tom Curry National affairs writer
msnbc.com
updated 12/28/2009 10:18:32 AM ET 2009-12-28T15:18:32

Claim: A new Medicare board will have the power to cut national medical care spending.

There is bipartisan agreement that the growth in health care spending is straining federal finances. President Obama said last September, "Our health care problem is our deficit problem. Nothing else even comes close." He recently added: "The federal government will go bankrupt" if Medicare and Medicaid spending aren't brought under control. Many Republicans agree with him. But it has proven difficult for members of Congress to agree on how Medicare benefits ought to be cut, or which medical procedures the federal government should not pay for. The Democrats' bill would curb the growth in Medicare costs not by cutting benefits, but mostly by assuming that the health care sector will become more productive. Can Congress find a neutral arbiter who can cut Medicare costs?

Fact or fiction?
A little of both. The Senate bill would create a 15-member board to find ways to reduce Medicare spending. For the past 30 years, per capita Medicare spending has grown every year at an average of 2.3 percentage points faster than per capita gross domestic product. The board could recommend changes in payment rates to medical providers. Its proposals would take effect unless Congress voted to override them. But the board would be forbidden from proposing changes that would ration care, restrict benefits, raise taxes or premiums, increase deductibles and copayments, or change Medicare eligibility. Fiscal hawks said the board is a start, but doesn't go nearly far enough. A bipartisan group of former federal budget officials want the board to have the power to propose changes in "all aspects of Medicare -- including its dominant, fee-for-service design."

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