Most of the attention over the proposed changes in Medicare has focused either on the overall size of the spending reductions or on what will happen to the Part B premium. These issues can be translated into dollar differences among various proposals for Medicare, leading to the suggestion that all that is needed for compromise is to "split the difference" in the numbers. But the proposals of the Congress and the Administration differ on much more than the dollar magnitude of the changes. Key structural differences between the proposals need to be understood as well.
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