Robert Berenson

Robert A. Berenson, M.D., is an institute fellow at the Urban Institute and deputy chair of the Medicare Payment Advisory Commission, which advises Congress on Medicare policy. The views expressed here do not necessarily represent those of the commission.

Recent Articles

Unleashing Restraint

Health reform won't stop costs from rising in the short term, but it lays the groundwork for long-run control of spending.

Smewhere along its tortuous path to enactment, health-care reform turned into health-insurance reform. Providing coverage to 34 million Americans and eliminating the unsavory practices of the insurance industry are major achievements. To pass the Affordable Care Act, however, reformers had to give up their grander aspirations. As a result, the legislation won't do much to change the health care most Americans receive or to slow the overall growth in health costs in the short term. It does, however, create new opportunities for long-term cost containment, and the challenge will be to make the most of those opportunities. The Affordable Care Act is fully financed: The additional costs to the federal government are more than offset by a combination of new revenues and compensating cuts in expenditures. But overall health costs to society are still projected to go up. Without health reform, according to the chief actuary for Medicare and Medicaid, health expenditures would reach 20.8...

Doctoring Health Care, II

If you're a senior citizen or just happen to know one, you're probably familiar with the flaws in the Medicare Modernization Act (MMA) -- the legislative monstrosity that Congress enacted, after one very long night in 2003 when Tom DeLay held the vote open for three full hours to intimidate a majority of unwilling members into voting for the bill. It prohibits Medicare from bargaining with drug companies over the price of their medications. It fails to cover seniors' medications if their annual costs rise over a specified level, only to mysteriously resume coverage once costs rise over a higher specified level. It costs taxpayers trillions in order to make pharmaceutical companies billions. You've heard this all before. You know the drill. Or do you? On balance, even a poorly conceived drug benefit is -- though just barely -- a net plus for Medicare beneficiaries, if not for taxpayers. But tucked deep inside the act were a series of provisions aimed at realizing the long-running...