Social Security and Medicare

In response to your editorial “No Time To Tinker,” Dec. 13:

As a member of Congress who voted against the Medicare Catastrophic Coverage Act, I strongly disagree with your recent editorial endorsing this new law.

The name of this law is a misnomer, because it implies protection from the financial devastation that a major, long-term illness can cause. The only true catastrophic benefit provided by the new law is for long-term hospitalization; it provides no coverage whatsoever for lengthy nursing home or home health care, the types of care that are much more frequently needed for people with long-term disabilities or illnesses.

The other principal benefits provided by the law are help with physicians’ fees and prescription drug expenses. Large bills in both of these areas can cause hardship, but rarely are the costs “catastrophic.” Yet, $2,000 worth of doctors’ bills in a year is a modest expense compared to $30,000 for a yearlong stay in a typical nursing home, which really is catastrophic for all but the most affluent elderly.


To pay for these minor additional benefits, Medicare recipients are going to pay large fees. All recipients (except the very poor) will pay a premium of about $10.20 a month five years from now, when the new benefits are fully phased in, in addition to their basic Medicare premium. The 40% of the elderly who pay income taxes will also pay a surtax, with the wealthiest paying as much as $1,050 by 1993. Most of the higher-income elderly who have complained to me about the surtax say that they wouldn’t object if it was for benefits they really wanted, but they feel (justifiably so) that it’s too much for anyone to pay for the relatively unimportant coverage the new law provides.

The biggest problem with the new law is that it will make it much more difficult for Congress to address the need for help with the costs of long-term nursing home and home health care. Because of the great expenses involved in these two types of care, it will be nearly impossible to create a federal program to pay for them without asking beneficiaries to bear part of the cost.

This dilemma could freeze action in Congress on long-term care for years to come, which is why your conclusion that this “is not the time to tinker with” the new law is absolutely wrong. Congress needs to scrap it as soon as possible and start over. If we provide, instead, long-term care benefits--the catastrophic coverage that the elderly need and want the most (and probably thought they were getting with this bill)--we’re certain to see a much greater willingness on their part to pay for them.



D-Los Angeles