Los Angeles Times
November 17, 2003
Deal Would Alter Medicare’s Core
If a compromise bill on prescription drugs passes, the government program
will become a massive subsidized insurance market.
By Vicki Kemper
As Congress prepares to vote on a final $400-billion Medicare prescription drug bill, there is one thing on which most lawmakers agree: The legislation would, over time, change the essence of the 38-year-old health insurance program for the elderly and disabled.
Now, the government sets the prices for thousands of medical services and pays the bills. But under the Medicare reform legislation, some details of which were released Sunday, the government would pay private insurance companies and managed-care plans billions of dollars in incentives to compete with traditional Medicare for the prescription drug business and general health-care needs of more than 40 million Americans.
It is that fundamental difference – Medicare as a government program versus Medicare as a huge government-subsidized health insurance market – that underlies the deep divisions between Democratic opponents of the bill and its Republican supporters.
With Republicans in control of both Congress and the House-Senate committee
that shaped the compromise legislation, it is not surprising that the GOP goal of containing Medicare costs by turning much of the program over to the private sector prevailed over Democrats’ desire to maintain Medicare as a social insurance program.
For Rep. Bill Thomas (R-Bakersfield), chairman of the House-Senate negotiating committee, the legislation is all about reducing the government’s financial burden for seniors’ health care while making Medicare sustainable over the long term and adding a major benefit.
“Over the next decade, [the bill] will also change the relationship between taxpayers and an ever more expensive program,” he said.
http://www.latimes.com/news/printedition/asection/la-na-medicare17nov17,1,5618060.story?coll=la-news-a_section
The New York Times
November 18, 2003
Medicare Plan Covering Drugs Backed by AARP
By Robert Pear and Robin Toner
AARP, the largest and most influential organization of older Americans, threw its weight behind a bill on Monday that offers drug benefits to the elderly as part of the biggest transformation of Medicare in its 38-year history.
The group will support the bill with $7 million worth of newspaper and author of the premium support proposal along with Rep. Bill Thomas and Sen. Bill Frist.
Thus the only representation that the Democrats really had was “TheGreat
Compromiser” Sen. Max Baucus. Sen. Baucus’ negotiating style is to enter
negotiations by playing all of his cards immediately, and then negotiate the
proposals that originate from the right. Since he is no match for Bill Thomas, the process ended with the approval of the agenda of the far right. With this process no outcome other than privatization of Medicare was remotely possible.
The prescription benefit alone is totally unsatisfactory because it fails to place prescription drugs under the same type of cost controls that the rest of the health care delivery system has. Affordability must be a prime consideration. Also, the bill grants private plans the control of prescription benefits. And the actual benefit provided is significantly deficient. As stand-alone legislation, it should be rejected so that Congress can move forward with a legitimate prescription program.
But, far worse, the innumerable measures included to meet Thomas’ goal of “reducing the government’s financial burden for seniors’ health care” are deliberately designed to destroy Medicare as a program of social insurance.
It reduces the government’s financial burden by shifting more of the funding
of health care back to the patient. Once fragmented by private options, the
traditional Medicare program will be severely underfunded, like Medicaid.
But the traditional program will have only about half of the benefits of Medicaid, unless they are successful in further reducing the “unaffordable” Medicare benefit package. An underfunded, stripped-down, welfare-type program for the sick and poor is not the Medicare transformation that we need or want.
AARP is deservedly the most influential organization representing the interests of the seniors of this nation. William Novelli has firmly staked his position in support of private interests at the cost of AARP’s members. There are only two choices for us. Either William Novelli must resign, or he must witness the greatest exit of an organization’s membership in the history of mankind. But we really need AARP to continue its role as the credible voice of seniors. The only real option is that Novelli must go.
Destroying Medicare for a crummy prescription benefit is not a compromise.
It’s a sell-out!