Controlling Medicare costs is a political minefield for Congress. So, with everybody talking about the costs of health-care reform , some key Washington figures are arguing that another body should make some of the hard decisions about Medicare. Peter Orszag, who runs the Office of Management and Budget, today sent Nancy Pelosi a piece of legislation that would create a new council to make recommendations on Medicare payment rates and other issues. Members of the council would be appointed by the president, confirmed by the Senate and serve five-year terms. The group would make recommendations, which the president could then accept or reject as a package. If the president accepted the package, Congress would have

30 days to block it by joint resolution. In the absence of such a resolution, the secretary of HHS would be authorized to implement the recommendations. In a blog post on the proposed bill, Orszag notes that mechanism for blocking (or not blocking) the group’s recommendations would resemble that used for the military base-closing commissions — another body convened to make politically difficult decisions. The letter also reiterated the White House’s support for a similar measure, backed by Sen. Rockefeller, that would give more decision-making power to MedPAC, a group that currently advises Congress on Medicare.

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Is Closing Military Bases a Model for Controlling Medicare Costs?