Insurers’ government-backed health plans for the elderly have increased taxpayer costs with no evidence of improved care, according to research backing President-elect Barack Obama’s call to lower U.S. subsidies.

Many of the Medicare Advantage plans, as they are called, don’t coordinate care to avoid duplication and ensure the best results, authors said in articles posted today on the Web site of Health Affairs. The plans were devised to offer more benefits than conventional Medicare paid directly by the U.S. government.

About a fourth of the 44 million people on Medicare are covered by the Advantage plans, with the U.S. expected to pay $100 billion this year for the coverage. Congress had increased payments in 2003, helping private insurers led by UnitedHealth Group Inc. and Humana Inc. Obama has called payments to insurers excessive and pledged to reduce funding by $15 billion annually.

Congress and the new president should set clear goals for Medicare, authors of a separate Health Affairs article said. That means facing down ideologues who want Medicare to wither and those who want it to be the foundation of the U.S. health-care system.

Will this be as important on Jan.21 as it was during the run up to the election?  Will the economy trump all other promises or will it be a priority?