Medicare will run out of money in about 14 years without reform, and a transformation is needed to make the U.S. health care system sustainable, Senate Majority Leader Bill Frist (R-Tenn.) said at the Detroit Economic Club on Monday, the Detroit Free Press reports (Merx, Detroit Free Press, 2/28). In order to control government spending, Frist said, "The place to begin is Medicare. Political figures in Washington aren't talking about it. But let me tell you -- if they really care about the country's future -- they should be" (Carey, CQ HealthBeat, 2/27). To help get a handle on Medicare costs, Frist proposed implementing chronic-disease management programs, encouraging U.S. residents to participate in their health care decisions and improving medical information technology. Frist said, "More than 90% of Medicare dollars are spent treating people with chronic disease." If the government helped such beneficiaries manage their conditions and take preventive measures, health costs could be reduced by 30% for those patients, according to Frist. He said, "Prevention lowers the disease burden. Prevention lowers cost" (Detroit Free Press, 2/28). According to CQ HealthBeat, Frist said that Medicare needs to become a "consumer-driven, patient-centered program" that is "provider friendly" and rewards providers based on performance rather than "blindly reimbursing" them for treatments. Frist added that improving health care IT will help save money and improve the quality of care. He also said that "income relating" -- which ties the level of benefit provided to beneficiaries' income levels -- is "inevitable to avoid the intergenerational inequities that would otherwise stem from the demographic aging revolution around us" as baby boomers hit retirement age (CQ HealthBeat, 2/27).

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