Medicare Re-engineering Raises Tough Questions - NYTimes.com

President Obama has deep disagreements with House Republicans about how to address Medicare's long-term problems. But in deciding to wade into the fight over entitlements, which he may address in a speech Wednesday afternoon, the president is signaling that he too believes Medicare must change to avert a potentially crippling fiscal crunch.

So the real issue now is not so much whether to re-engineer Medicare to deal with an aging population and rising medical costs, but how.

Even before they debate specific proposals, lawmakers across the ideological spectrum face several fundamental questions:

Will the federal government retain its dominant role in prescribing benefits and other details of the program, like how much doctors and hospitals are paid and which new treatments are covered? Will beneficiaries still have legally enforceable rights to all those services?

Will Medicare spending still increase automatically with health costs, the number of beneficiaries and the amount of care they receive? Or will the government try to limit the costs to taxpayers by paying a fixed amount each year to private health plans to subsidize coverage for older Americans and those who are disabled?

More ...

http://www.nytimes.com/2011/04/13/us/politics/13medicare.html?