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With Medicare facing a bleak fiscal future, and because the program is a major factor in the enormous federal deficit and long-term debt, there needs to be structural reform. The way forward is to (1) require the program to operate under a real, long-term budget based on “premium support”; (2) add catastrophic protection; (3) convert fee-for-service Medicare into a premium-based program; and (4) systematically link premiums to income.
Under preferred pharmacy networks, unsubsidized Part D beneficiaries faced substantial incentives and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated and demonstrated little switching.
Medicare's hospital insurance trust fund is projected to run out in 2031, three years later than forecasted in last year's boards of trustees report, according to the 2023 report
Government negotiation of drug prices would substitute regulationand access restrictions for market competition and consumer choicein Medicare.
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