http://thenation.com/doc.mhtml?i=20031215&s=lieberman comment | Posted November 26, 2003
Killing Medicare
by Trudy Lieberman
The Medicare "reform" legislation just passed by Congress sends the program on a path to destruction. Crafted in the heady days of the Great Society, Medicare has worked reasonably well for almost four decades for seniors and disabled Americans, many of whom are unable to buy health coverage in the private market. But the nation's financial commitment to Medicare--$224 billion in 2000--got in the way of the right's ideological goals of reducing the cost of government and making people fend for themselves. So nearly a decade ago right-wing politicians and their allies at the Heritage Foundation embarked on a campaign to transform Medicare into a private insurance program and ultimately to remove the government from the business of guaranteeing healthcare for the oldest and sickest citizens.
The modest drug coverage authorized in the bill is hardly worth the price of privatization. Those with chronic illnesses and ongoing drug expenses will see little benefit because of the convoluted benefit structure. The average Medicare beneficiary, who is currently without drug coverage and who spends about $2,300 on prescriptions, will actually spend $2,900 in 2007 even with the new benefit, assuming drug costs continue to rise at the same rate. That's likely, since Congress has placed no cost controls on pharmaceuticals and indeed expressly forbids the government from using its muscle to bargain for lower drug prices, as it does in the Veterans Administration health system. Also, the bill makes it virtually impossible to reimport cheaper drugs from Canada. And although the bill authorizes subsidies for very-low-income seniors to help pay increasing premiums, co-payments and deductibles, some 3 million people will lose out because of eligibility limits placed on income and assets. Those just over the line will struggle mightily.
The bill does, however, represent brilliant political strategy on the part of its proponents, who began seeking allies as far back as 1995. AARP's support was not surprising, given that right-wing interests attacked its tax exemption that year and that then-Senator Alan Simpson of Wyoming, who had opened an investigation, told AARP officials, "I want you to know that the intensity of my investigation will be directly related to your fight on Medicare." AARP got the message. The financial goodies for special interests--eliminating the planned payment cuts to doctors, the $25 billion to rural hospitals and doctors, the $12 billion in special payments to entice private insurers to offer benefits--insured the support of powerful lobbyists and gave wavering lawmakers a reason to support the measure. Arkansas Senator Blanche Lincoln said she voted for the bill because the extra money was helpful to rural health providers.
The repercussions from this legislation will be felt years from now when seniors and the disabled realize that they can't pay for their healthcare. Couple that with the prospect of less retirement income as employers shed their pension plans and the right begins to push hard for privatizing Social Security, and a picture emerges of impoverished elderly people like those seen before Medicare was phased in, in 1965. Two years before, President Kennedy, quoting historian Arnold Toynbee, noted in a special message to Congress that "a society's quality and durability can best be measured 'by the respect and care given its elderly citizens.'" The Medicare bill tells us how much has changed since Kennedy's time.
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