Partisanship Over Medicare Elbows Congeniality Aside : Politics: The gloves come off day after President, Speaker debate politely. Administration official calls GOP position too extreme for negotiation. Gingrich lashes out.

A day after the congenial meeting between President Clinton and House Speaker Newt Gingrich (R-Ga.), the debate over Medicare turned bitter on Monday, with the Administration’s Medicare chief accusing Republicans of staking out so extreme a position on the health care program for the elderly that negotiations are virtually impossible.

Bruce Vladeck, head of the Health Care Finance Administration, said “there is no point in having a conversation” with Republicans because they are calling for unacceptable cuts in the future growth of both Medicare and Medicaid spending.

Meanwhile, Gingrich, still touring New Hampshire, said that the Democrats “have no ideas about welfare, they have no ideas about health care, they have no ideas about crime and they don’t have any ideas about balancing the budget. The only thing they can do is smear.”

The strongly partisan remarks previewed a long hot summer of political fighting over the giant federal health programs, Medicare for persons over 65 and the disabled, and Medicaid for the poor.

Appearing before a senior citizens picnic on Sunday, the President and Gingrich agreed in general terms that Medicare spending was growing too fast, and should be restrained.

But they are poles apart on determining the severity of the problem, and the best way to deal with it.

Congressional Republicans want to trim about $470 billion from the total growth of Medicare and Medicaid over the next seven years. This would still permit growth in the actual dollars spent and in the number of persons served, the Republicans emphasize. But the President and his fellow Democrats in Congress insist the ambitious Republican fiscal targets would cripple the health programs, cutting deeply into services and, in the case of Medicare, forcing beneficiaries to pay more for the doctor and hospital services they receive.

In fiscal 1995, Medicare is expected to spend $178 billion, or 11% of the federal budget, while federal spending on Medicaid will be $89 billion, or 5.5% of the budget.

The Republicans are not serious about health care issues, Vladeck said in a lunch meeting with reporters.

“They are the ones who staked out the extreme, extreme position,” he said. “You don’t negotiate when the other guy has staked out an extreme position.”

If the final Medicare and Medicaid plans adopted by Congress use the current Republican numbers, they would be unacceptable and would draw a presidential veto, Vladeck indicated.

Embittered by their experiences last year in promoting an ill-fated health reform program, Clinton Administration officials have steadfastly rejected any GOP suggestions that the Administration offer its own plan for Medicare. The trust fund that pays hospital bills under Medicare will run out of money in the year 2002.

Last year, in dealing with the Republicans, Vladeck said, the Administration learned, “every time you moved toward them, they moved back.”

If the Administration tries to offer a plan now, “everything we put on the table will cause them to move further away,” he said.

“I can’t have an intelligent discussion” about a cut in the spending growth rate of the magnitude proposed by the congressional Republicans, he added.

For Medicaid, a joint-federal state program, congressional Republicans want to slow the spending growth rate of 10% to about 4%. For Medicare, a federal program, the growth rate of 10% annually would be trimmed to 7% a year under the Senate GOP budget plan and 5.4% under the House version.

Committees in the House and Senate are working on detailed legislation to reach specific dollar targets, but the final clash between the GOP and Democrats over how much to spend will come late in the fiscal year, which ends Sept. 30, when the funding bills must be approved to avoid shutting down the government.

Gingrich emphasized the deep divide between Democrats and Republicans Monday, speaking in various locations during the final day of a four-day trip to New Hampshire, the site of the first presidential primary next year.

“For the last two generations liberals have taken America for granted,” promoting class warfare, income redistribution and “whatever this year’s fantasies are,” he said.