How Medicare should and should not control expenditures "It is necessary to begin a serious discussion on many tough topics, including nearly unlimited access to high-technology procedures, reforming end-of-life care and finding effective policies to improve the population's health behaviors."

for doing so, it is essential to understand that Medicare does not have total control of its own spending. The same factors that drive national healthcare expenditures also drive Medicare expenditures. These include the highly techno­ logical and costly way in which care is delivered; the preponderance of specialists and relative lack of primary care physicians; the income levels of healthcare professionals in the country, which lead to prices that far exceed those in other coun­ tries; and costly health behaviors that result in costly health problems, such as obesity. How can Medicare save? One proposal that is currently popular among some political conser­ vatives is raising the age of Medicare eligibility from 65 to 67 years. This would mimic what was done many years ago for Social Security eligibility. The Congressional Budget Office estimates that it would save the federal govern­ ment approximately US$150 billion over a 10 ­ year period, or by approximately 5% of total Medicare spending [103].