Medicare Debate: Circus, Circus : Will political posturing on vital issue never end?

Thirty years after its creation, Medicare is in need of an intelligent national debate on how the government’s troubled health care system for the elderly should be reformed. What we have instead is ugly politicization of the issue. Congressional Republicans are resorting to secret negotiations to come up with $270 billion in Medicare savings over seven years. Democrats, led by the President, are mounting an offensive to raise worry in the heartland about the GOP plans.

Lost in all the rhetoric and pandering to fears is the need for a major overhaul of Medicare, whose hospital trust fund could go broke by 2002. The problems are not unsolvable, but the solutions are politically unpalatable.

Take the experience of the Bipartisan Commission on Entitlement and Tax Reform. Amid the shift to a Republican Congress last fall, both Democrats and Republicans on the panel refused to stick their necks out for any changes in the benefit programs. After 10 months of work, the 32-member federal advisory commission could not agree last December on any specific proposals to slow the growth of Social Security, Medicare or other government entitlement programs.

The simple truth is that without new revenues, i.e. taxes, Medicare users will have to pay a greater share of their government-sponsored health care. Neither solution is easy. But unless and until Congress can come up with ways to moderate growing Medicare costs--such as raising co-payments or the age of eligibility or encouraging greater use of health maintenance organizations, Medicare’s solvency is in question.

The GOP has seized the Medicare high ground by making reform part of its deficit-cutting budget plan. But the congressional Republicans and their staffs are working on their proposal behind closed doors with key special interests. The secrecy is reminiscent of First Lady Hillary Rodham Clinton’s closed health care proceedings that led to the White House’s ill-fated attempt at massive health care reform. The GOP strategy is to wait until after Labor Day to unveil its detailed proposals so that the Democrats will not have enough time to mount adequate opposition against the legislation.

But Democrats began a preemptive tactical strike on Tuesday. President Clinton joined a partisan Medicare rally in Washington and said that, regardless of cost problems, he will not allow Republican budget cutters to take away important medical benefits in order to fund a tax cut for the wealthy. The President’s best weapon to undercut the GOP would be to put out his own detailed plan for creating $124 billion in Medicare savings over 10 years while cutting taxes. Until then, we’re all hostages to political posturing.