Posted on 01/03/2003 5:09:01 AM PST by RobFromGa
Bush targets Medicare
Proposal would increase competition, include drug benefits for aging population.
Robert Pear - New York Times
Friday, January 3, 2003
Washington --- President Bush, with the new Senate majority leader as a powerful ally, will propose sweeping, long-term changes in Medicare when he urges Congress to provide prescription drug benefits for the elderly later in January, administration officials say.
In the last three weeks, the president has told his advisers and congressional leaders that he wants to promote competition in Medicare to shore up the program for 76 million baby boomers and to establish his credentials on an issue likely to figure prominently in the 2004 election.
Administration officials said Bush's vision for Medicare closely resembles proposals advanced in the last three years by Bill Frist, the Tennessee Republican who is to become Senate majority leader when Congress convenes Tuesday. While Bush had been drafting his own proposals, administration officials and congressional aides said Frist's elevation enhanced the prospect that they would be taken seriously on Capitol Hill.
Though White House officials are still working out details, Bush, like Frist, has said he wants to foster competition between the original fee-for-service Medicare program and private health plans. Such changes could eventually make Medicare look more like private insurance. Because of his long interest in the issue, Frist can explain and defend the Medicare proposals in a way that the previous Senate Republican leader, Trent Lott of Mississippi, never could.
Still, persuading Congress to enact major changes in the structure of Medicare beyond the addition of drug benefits will be an uphill struggle for Bush, even with help from Frist, because the program is immensely popular with older voters.
Under one idea favored by many of the president's advisers, the government would give Medicare beneficiaries a powerful incentive to enroll in more efficient, less costly health plans. If private health plans did a better job of holding down costs, their members would reap the benefits, getting cash rebates or lower premiums. Conversely, if the traditional program cost less, the government would pass on most of the savings to people who use it.
An administration official said Bush agreed with Frist's view that ''drug coverage must be part of comprehensive Medicare reform.''
That view complicates the task facing Congress and virtually ensures a huge political battle. Almost every member of Congress has promised drug benefits to the elderly, and the two parties could conceivably strike a compromise on that issue, but they are nowhere near agreement on long-term changes in the structure of Medicare.
''If the price of a prescription drug benefit is the end of Medicare as we know it, that's not a price worth paying,'' said Debbie Curtis, chief of staff to Rep. Pete Stark (D-Calif.).
The White House is working with an influential Democratic senator, John Breaux of Louisiana.
''Just adding prescription drugs to an outdated Medicare program is like throwing lead weights onto a sinking ship,'' said Breaux, who has drafted legislation with Frist to inject market forces into Medicare.
In June, the House passed a Republican bill to offer drug benefits to all 40 million elderly and disabled people on Medicare. It included a little-noticed provision for an experiment under which the fee-for-service Medicare program would compete with private insurance plans, including health maintenance organizations, in four metropolitan areas.
Administration officials said this was the type of competition they wanted to encourage, because it would make Medicare beneficiaries more conscious of costs. But, the officials said, House Republicans were too timid in limiting their experiment to four areas and should have tried it on a larger scale.
Congressional Republicans welcomed the prospect that Bush would lead a high-profile campaign for prescription drug benefits, but they said they were apprehensive about White House ideas for fundamental changes in the structure of Medicare. Elderly voters want drug benefits as soon as possible, but are not clamoring for ''Medicare reform,'' said several Republicans who personally favor such changes.
Bush said last year that ''seniors who are happy with the current system should be able to keep the coverage that they have now, with no changes, if they prefer.''
Administration officials said this commitment applied to people already in Medicare and perhaps to those who become eligible in the next five to 10 years. Whether it applies to people who enter Medicare after that is ''open to discussion,'' an administration official said.
Under several proposals being considered by the administration, Medicare beneficiaries would be encouraged to enroll in an HMO or in a new version of the fee-for-service program to obtain prescription drug benefits.
Oh ouch! Politically incorrect capitalism!
If these folks don't end up needing Universal Heath Care, the Facist left is doomed! Oh, the horror, the horror!
Heh heh heh. Strategery.
Oh sure. Cut out all social funding tomarrow (not that I'd mind, personally) and the democrats would rule for life!
Incramentalism is how the social programs got here, and incramentalism is how we'll get rid of them.
People fear drastic change, which is why libetarians aren't presidents.
I agree that the other headlines all seem reasonable. Thanks to all for your contributions. Some of the better ones may even come tomorrow. But for today, it looks like the AJC is today's "Liberal Slant Award Winner" for
The only problem is that it should be oriented around major topics of the day and the most biased headlines. So it might be difficult to organize. How does something like this happen on FR?
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