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During the course of negotiations to raise the debt ceiling, proposals to reduce Medicare costs had an on-again, off-again presence at the table. We asked Bruce Vladeck and Gail Wilensky which of these ideas could have a positive or negative impact on the program.

A ‘Pernicioius’ Idea: Proposals To Forbid First-Dollar Coverage For Medicare Beneficiaries Ìý

Bruce Vladeck, who oversaw Medicare and Medicaid from 1993 to 1997,ÌýwritesÌýabout “one especially pernicious proposal” to rein in Medicare savings —Ìýthe prohibition of first-dollar coverage in Medicare supplemental insurance.

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An Unreasonable Expectation…ÌýÌýÌý

Gail Wilensky, who ran Medicare ane Medicaid during the George H.W. Bush administration, writes that, althoughÌýthere has been anÌýexpectations that the current fiscal crisisÌý“would produce the ‘right environment’ to finally reform entitlements — particularly Medicare,”Ìýit won’t be easy to get lawmaker and public to seriously engage in Medicare reform.