I am surprised no one has mentioned this article. I think you will be extremely interested in it:
Wall Street Journal Editorial Page Column January 17, 2000
Seniors Won't Swallow Medicare Drug Benefits
By Dan Rostenkowski, a former chairman of the House Ways and Means Committee.
Last week, pharmaceutical industry executives signaled their support of a Clinton-administration plan that would have Medicare pay for prescription drugs. Despite this new willingness on the part of drug companies to move ahead with Medicare reform, I don't think action will come quickly or easily. Only when America's seniors show they are willing to pay for these new benefits will the current system change for the better.
Politicians have long thought that adding such a drug benefit would be both good policy and good politics. Yet neither Congress nor President Clinton made good on a pledge to expand drug benefits in 1999, and they aren't likely to this year. Recalling the short period when an expanded Medicare program did exist -- and why it was repealed -- may explain why these politicians won't push forward with an expanded Medicare proposal.
Given Ronald Reagan's conservative reputation, many people are surprised to hear that he enthusiastically signed the largest Medicare expansion in history. That 1988 legislation limited the cost of multiple hospitalizations and partially paid for prescription drugs. The plan, originally proposed by the Reagan administration, was wildly popular, winning overwhelming bipartisan support in the 328-72 House vote.
Today it's equally surprising to hear that the following year George Bush signed legislation repealing the expansion. This reversal was by far the largest cut in Medicare benefits in history. But the repeal legislation passed the House by a 360-66 vote -- the most sudden and drastic reversal during my 36 years in Congress. Worse, there was an understanding at the time that the repeal did not solve Medicare's biggest flaws. "The problem is bad and getting worse," said then-Senate Majority Leader George Mitchell .
The problem was, and still is, a lack of money -- the result of senior citizens' reticence to pay more. Debating the wisdom of the Reagan-era expansion plan, Sen. Alan Simpson said at the time, "It is a social experiment. It is called pay-for-what-you-get." He was right. The plan was financed by a premium increase for all Medicare beneficiaries, supplemented by extra payments from more affluent recipients. The latter group led the successful campaign for the legislation's repeal.
In hindsight, we made several mistakes. The first was to break precedent and ask that the group receiving the benefits actually pay for them. The second involved timing. We adopted a principle universally accepted in the private insurance industry: People pay premiums today for benefits they may receive tomorrow. Apparently the voters didn't agree with these market principles.
Sadly, I don't think attitudes have changed much since the repeal legislation. In the past decade, the climate for Medicare expansion has worsened for several reasons:
The arrival of the balanced budget, coupled with the commitment to use surplus funds to buttress Social Security, has made deficit spending for new programs nearly impossible.
The failed debate over the Clinton health plan has made the public more aware of the growing number of people who lack health coverage. It is difficult to expand coverage for some while an unprotected group continues to grow.
Medicare is closer to insolvency than it was a decade ago. The first priority now should be protecting the program rather than expanding it.
Television archives preserve the image of unhappy Chicago senior citizens surrounding my car when I visited a decade ago to explain why I thought Medicare expansion was a good deal. This tape will be shown in the future as a warning to any politician who makes a serious attempt to revive this issue.
This is a serious problem. But until America's seniors send a clear signal that they are willing to pay for new benefits, action is unlikely.
----
URL for this Article:
interactive.wsj.com
----
Copyright ¸ 2000 Dow Jones & Company, Inc. All Rights Reserved.
For information about subscribing, go to wsj.com |
