White House Stymied on Medicare?

By James R. Hood
Caregivers USA News

February 3, 2003
President Bush's plan to reform Medicare and add a prescription drug benefit appears to be disintegrating prior to lift-off.

It was hardly surprising that Democrats in Congress were quick to object to Bush's sketchy proposal to provide prescription coverage to seniors who join private health care plans. What was surprising -- and significant -- was that, after a few days of anxious waiting, Republicans felt they had little choice but to express their own reservations.

Sen. Charles Grassley (R-Iowa), said flatly that prescription drug coverage must be available to "all seniors, not just those who switch into managed care." And Sen. Olympia Snowe (R-Maine) said she feared the President's Medicare plan could "hamper our effort to pass comprehensive prescription coverage."

Even as fierce a partisan as Rep. Tom Delay (R-Texas), the House majority leader, found himself lacking ammunition. He said critics were wrong to say that seniors would have to join managed care to get drug coverage. Such claims were "absolutely false," he said.

But Delay could not go much farther than that, saying he was "not even close to understanding" what the details of the Bush proposal might be. Nor was anyone else. The day after his State of the Union address, the President went to Michigan where he was expected to reveal more about his vision.

But in a 40-minute speech Bush spent just a few minutes recapping his Medicare comments of the night before, devoting the rest of his remarks to Iraq and his tax cut proposals. By week's end, the plan seemed to be vaporizing. The loss of the Columbia on Saturday pushed it completely off the news pages.

While Republicans tip-toed around the subject, Democrats were less circumspect. Senate Minority Leader Tom Daschle (D-S.D.) called Bush's plan a "back-door approach to privitization."

"I will say flatly it just won't work in South Dakota," he told the South Dakota Plainsman.

Daschle noted that, as in most rural areas, there are no Medicare HMOs in South Dakota. But even if there were, Daschle said drug coverage should be part of Medicare and should be available to every Medicare beneficiary, regardless of where they live.

The Alliance for Retired Americans, which claims 3 million retired union workers as members, said it was "deeply disappointed" with Bush's proposal.

"What Medicare needs is a prescription drug benefit that is comprehensive, universal and affordable. There is no need to dismantle the entire Medicare program to get a prescription drug program," said ARA Executive Director Edward F. Coyle.

The Committee to Preserve Social Security and Medicare was also critical of the White House plan.

“Choice is not worth much if none of the options are good. The president's Medicare reform plan could force seniors to choose between a private health insurance plan with prescription drug coverage or traditional Medicare with none,” said Barbara B. Kennelly, president and CEO.

“The president wants it all - the tax plan, the war and the privatization of Medicare. Seniors just want to see progress on a prescription drug plan,” she said.

The federal government has been promoting HMO-type Medicare plans for nearly ten years, with a notable lack of success. More than 85 percent of the 40 million Medicare beneficiaries remain in the traditional fee-for-service program. Many of those who did join HMOs have had to scramble when their carriers pulled out of the program, claiming they weren't being paid enough to cover costs.