There is a deepening crisis in America's hospital emergency rooms. More and more patients are showing up for care without the ability to pay for it. The burden on taxpayers and private insurance policy holders is increasing, and doctors and nurses are often overworked while operating in an environment of complex and confusing overregulation, increased litigation, and rising costs.
In 2003, the Medicare Modernization Act created the Medicare Advantage program, which allowed seniors to choose coverage from private health plans. Both recent research published in The American Journal of Managed Care by Niall Brennan and Mark Shepard and another analysis by America’s Health Insurance Plans use HEDIS measures and state-based data on hospital utilization, respectively, to compare the quality of care received by enrollees in Medicare Advantage and traditional Medicare fee-for-service. The studies found the new program performed better than traditional Medicare on a number of measures, including delivery of care car and hospital utilization.
Medicare Advantage is a success and can serve as the first stage ofreform, but Congress will have to change the existing paymentsystem and provide a system of premium support, properly adjusted,for each beneficiary. What is needed next is more robustcompetition for the entire program and parity in the payment tohealth care options that seniors choose.