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Politics : Bill Clinton Scandal - SANITY CHECK -- Ignore unavailable to you. Want to Upgrade?

To: jlallen who wrote (19449)	12/14/1998 6:01:00 PM
From: Les H	Respond to of 67261

Medicare Could Be Fixed, But Politics Intrudes By Morton M. Kondracke rollcall.com Just maybe, President Clinton and the Republican Congress could agree on a plan to save Medicare. A good one's been proposed, but don't bet on its adoption before the 2000 elections. The plan, tagged "premium support," would give the nation's seniors the same kind of choice among private health insurance plans that federal employees currently enjoy and a subsidy to pay all or part of the premium. Premium support would replace the current Medicare system -- due to go broke in 2008 -- under which a government agency determines which medical services will be covered and how much the government will pay for them. Conceptually, premium support has the backing of at least 10 of the 17 members of the bipartisan national Medicare commission, which is charged with recommending how to keep the system solvent in the 21st century. These include the panel's eight Republicans, led by Rep. Bill Thomas (Calif.), co-chairman of the commission, and two "New Democrats" -- Sens. John Breaux (La.), commission chairman, and Bob Kerrey (Neb.). Adamantly opposed are two liberal Democrats -- Rep. Jim McDermott (Wash.) and Sen. Jay Rockefeller (W.Va.) -- and Bruce Vladek, President Clinton's first head of the Health Care Finance Administration, the agency that runs Medicare. Commission rules require 11 votes to make a majority recommendation when the panel reports in March, and the balance of power lies with four Democrats: Rep. John Dingell (Mich.) and three commissioners appointed by Clinton. Dingell leans against premium support. White House aides say that Clinton will decide what his position on Medicare reform is based partly on what the commission recommends. At the same time, though, Clinton has the power to influence that decision through his appointees, former White House economic policy chief Laura Tyson, Brandeis University professor Stuart Altman and Anthony Watson, CEO of HIP Healthcare in New York. Clinton is in the same position on Medicare as on Social Security: He's pledged to make the system survive past the retirement of the Baby Boom generation, yet he has no plan of his own for doing so. White House aides say Clinton's next budget will contain important short-term Medicare fixes -- a fraud-control program and "carrot and stick" ideas for preventing private HMOs from abandoning Medicare -- but not long-term ones. As with Social Security, Clinton is cross-pressured both ideologically and politically. The New Democrats -- a group Clinton claims to be part of -- favor giving seniors insurance choices in Medicare and the opportunity to invest some of their Social Security money in private markets. Liberals want to save both Social Security and Medicare by raising taxes and they contend that government control of both programs is safer and more equitable than privatization. Politically, Clinton has to decide which is more likely to help Vice President Al Gore become President -- a record of having helped secure the big retirement programs or one last use of them as a club to beat Republicans. In the case of Medicare, a Senate aide close to Kerrey predicted that Clinton and Gore would work to block 11 votes for going with premium support in order to use Medicare as a 2000 campaign issue. The aide envisioned ads saying, "Republicans won't let Grandma see her favorite doctor." Other ads could say, "Republicans want to throw your Mom to the HMOs." If Kerrey runs, the ads could also be directed against him in Democratic primaries, though Kerrey favors protections within a premium support program to protect the poor and residents of rural areas unlikely to be served by managed care. Even supporters of the current Medicare system acknowledge that it needs modernizing, making it more possible for seniors to opt for HMOs and other managed care plans. Current Medicare is based on traditional (and expensive) fee-for-service medicine familiar to most current retirees. The Medicare commission's staff estimates that various reforms suggested for the current system -- including raising the Medicare eligibility age to 67 -- would barely reduce the system's shortfall of about $1 trillion over the next 30 years. Premium support would cut the deficit approximately in half. In an estimate disputed by liberals, having all seniors opt for HMOs might lower the deficit to $30 billion. Chances are that politics, including Clinton's deteriorated moral authority, will prevent the government from solving the Medicare crisis in 1999. That means that how to save it will be up to the voters in 2000. >>>How does one support such a corrupt party like the Democrats? >>>Blocking solutions to a program the party's own constituents >>>support in order for political gain.