The Orange County Register
February 22, 2002
By Bernard J. Wolfson
Serious political and financial obstacles stand in the way of congressional action this year to fix any of the myriad problems afflicting the Medicare program, according to analysts and legislative aides who spoke Thursday at a health policy conference hosted by UC Irvine’s graduate school of management.
Norman J. Ornstein, a political commentator and fellow at the American Enterprise Institute, raised the sobering possibility of yet another brake on Medicare action: a large-scale U.S. military attack against Iraq, which he said is in the planning stages and could happen this summer or early fall. At that point, all bets on domestic legislation would be off.
John E. McManus, Republican staff director on the House Ways and Means health subcommittee… said the interest of taxpayers must be respected in any Medicare legislation, and that costs can be held down more effectively if health-care consumers are required to shoulder a bigger share of the financial responsibility for their choices.
John McManus:
“Imagine if you had grocery insurance, and every time you went to the market your insurance paid 80 percent of it. You’d eat a whole lot differently -and so would your dog.”
Comment: This oft-repeated analogy of food insurance and health care coverage belittles the serious problems of hunger and health care access. The silliness of this argument is apparent when considering that none of those nations providing universal health care coverage also provide “grocery insurance,” but most of them have better programs to assure that hunger is eliminated.
McManus’ suggestion that Medicare beneficiaries should bear more costs (when they already bear half the costs of Medicare) will only result in greater financial barriers to health care access for the very large segment with only modest incomes. How can such an important public official support such cruel health policies and then glibly pass it off with a joke about dog food insurance? Ways and Means Chairman Bill Thomas should seriously consider replacing his staff director with someone who has at least a modicum of sensitivity for the needs of Medicare beneficiaries.
And please forgive me for being off topic by including the comment on the planning of the large scale U.S. military attack against Iraq. Personally, I’m in mourning for the soul of our nation. (I know that I will receive several requests to be removed from this list, but I had to speak up anyway.)
Don McCanne
Prof. Donald W. Light, on CalPERS and the Wennberg paper:
“This CalPERS announcement about its inability to hold down skyrocketing costs and the Wennberg paper on continued large disparities in funding reflect a systemic problem that the comments on Wennberg’s article do not address. Every other industrialized nation has been able and is largely able to manage overall expenditures and to reduce the large disparities that most of them inherited because they have one or another kind of universal health coverage and management system. Some of them have competition, or contestability, within their overall frameworks; but a voluntary, market-based system is unable to address issues of inequality, overpricing, or overutilization.”