This is topic CBO Assessment of giving broad authority to Executive Branch for saving in Medicair in forum Books, Films, Food and Culture at Hatrack River Forum.
"This letter focuses on proposals to give the President broad authority to make changes in the Medicare program, subject to Congressional disapproval. Such proposals could enhance the prospects for additional long-term cost control, but they would also entail shifting some power from the Congress to the executive branch."
I particularly like:
"reducing Medicare payments in areas of the country with higher spending"...don't live in a retirement community.