If you were contracting for a kitchen remodeling, you’d probably solicit bids and select the lowest one that meets your quality standard. Many goods and services purchased by the government are bought in a similar way, including certain medical equipment like walkers and wheelchairs for Medicare patients.
But a big part of Medicare isn’t: private coverage through Medicare Advantage. And that accounts for about a quarter of Medicare’s budget anda third of its enrollees.
It’s odd, since such competitive bidding approaches are part of both Republican and Democratic efforts to expand health insurance. Competitive bidding is built into Medicare’s prescription drug program — passed by a Republican Congress and signed by President Bush in 2003. And it’s built into the insurance marketplaces established by the Affordable Care Act — passed by a Democratic Congress and signed by President Obama in 2010.
– The New York Times