Experts all agree that controlling Medicare and Medicaid spending is crucial to slowing rising health care costs. However, under the current system, the most expensive subset of Medicare and Medicaid beneficiaries are lost in a complicated web of multiple payers and programs that lack both the incentive and the ability to curb risings costs. These beneficiaries are "dual eligibles"--people who are eligible for both Medicare and Medicaid at the same time--and they are among the poorest and sickest individuals in our society.

Providing care for these individuals under two entitlement programs proves that two is truly not always better than one. Instead of working together to coordinate care, Medicare and Medicaid split responsibility, dividing up who pays for what based on which service is provided and in which setting. This bifurcated payment structure leaves dual eligibles in a black hole between Medicare and Medicaid, resulting in poorer care and increased costs for taxpayers. 

Congress should do away with the dual eligible model and instead place responsibility for this population in one federal program that can ensure quality of care and cost control.

Read More: The Atlantic