GOP’s Rx for Medicare Is a Bitter Pill in O.C. : Health care: Republicans tell seniors that reform--and higher premiums--will sustain program, balance budget.

With a cool confidence, Orange County Rep. Christopher Cox says senior citizens are convinced the Medicare system is ailing, and the Republicans are the ones with the cure.

To prove his point, he tells of a brief discussion he had last week on Capitol Hill with constituents from Leisure World of Laguna Hills--the largest elderly community in California.

The seniors, he says, agreed with Republicans on the need to reform the federal health insurance program for the elderly, and--just like the Republicans--were critical of the Democratic leadership and “people who were saying ‘The sky is falling,’ and then not doing anything about it.”

But the very next day, back in Orange County, another group of Leisure World residents was telling a different story to the community newspaper: They posed for a photograph before a pile of 3,200 postcards to be delivered to Cox and held a banner with the message, “Congressman Cox. Stop the $270 billion Medicare cut.”

Even in staunchly conservative Orange County, where Republicans have the hearts and minds of voters, the question looms: Will the county’s 347,000 elderly citizens buy the Republican Medicare potion?

Local congressmen say they will.

With the angle that they are saving the 30-year-old Medicare program from bankruptcy and balancing the federal budget at the same time, the congressmen are touting the Republican prescription for Medicare: Cut the growth in the program’s costs or risk an insolvency that will cost even more seven years from now.

Rising health costs and an expanding elderly population are sacking Medicare, which serves 35 million elderly people nationwide.

Republicans want to cut the growth in the program’s costs, now rising at 10% a year, to 6.5%, generating savings of $270 billion. The plan has two goals: to rescue Medicare, which would go broke in 2002, and to balance the federal budget in seven years.

The House plan would raise monthly premiums from $46.10 to $90 by 2002. President Clinton has proposed raising the premium to $83 by 2002.

The plan also calls on seniors with incomes more than $75,000 and couples earning more than $125,000 to pay up to $146 month. There would also be tough new restrictions on payments to doctors and hospitals.

House Republicans released more information on their plan Thursday and the Senate on Friday released its version, which mirrors the House plan in raising premiums but differs in its proposal to raise the current $100 deductible immediately to $150 and $210 by 2002. The Senate plan also would raise the eligibility age from 65 to 67 between 2003 and 2027 and would allow seniors to pocket up to 75% of the savings in cash if they joined health maintenance organizations or other plans that cost Medicare less.

Critics have attacked the GOP, saying the House’s blueprint did not specify how the $270 billion in savings would be met and who would be expected to pick up additional costs and suggesting the motive behind the Republicans’ efforts is come up with more savings to finance a tax cut for the wealthy.

Republicans dismiss the charges, and have begun selling their program to seniors. They hope to minimize opposition from the elderly by emphasizing reform is needed to keep the program alive, and more subtly, suggesting seniors do not want to be accused of standing in the way of a balanced federal budget.

“We can’t afford to stand around bickering while the system goes broke,” warned Rep. Dana Rohrabacher (R-Huntington Beach) in a newsletter mailed last month to 170,000 voters in his district, including a smaller Leisure World community in Seal Beach.

So far, the Republicans’ campaign appears to be working. A recent Los Angeles Times Poll found that three-fifths of those surveyed nationwide favored paying higher premiums, but they did not support reducing payments to doctors and hospitals.

But local congressional offices report that so far the Medicare issue has barely registered among constituents, based on telephone calls and mail. Although the debate is just beginning, they say those who have let their feelings known want Medicare reformed.

“You have a Congress that has a reputation from the beginning of this year of acting in good faith, certainly in the eyes of the Republican voters of Orange County,” said Rohrabacher spokesman Dale Neugebauer. “It’s one of the few issues where we have actually gotten mail saying, ‘Please take care of this problem.’ ”

Not so fast, says Leisure World resident Patricia Green, who voted for Ross Perot in 1992 and is uneasy about proposed changes in something as basic as her health care. “I’m not ready to trust either of them,” Green said, referring to the Republicans and Democrats.

With cancer in her medical history, the 77-year-old voter and a member of an HMO wonders why the elderly have to pay more. “I think it’s the doctors who are charging too damn much.”

Ted Rosenbaum, 77, who helped organize the postcard campaign against Cox on behalf of People For a National Health Program, says that if seniors are asked to pay higher premiums, then the defense budget should also be stripped of costly bombers and other pet projects. Congress should also eliminate contracts and tax cuts that favor corporations, he says.

“We feel that all groups in our society . . . should pitch in and do their thing. But we want to be fair,” Rosenbaum said.

Republicans will likely rely on support from voters such as June Hicks, who blames liberals in Congress and the news media for using “scare tactics” to stir up opposition to Medicare reform.

“It’s going to have to be torn down in order to save the entire program,” said Hicks, the leader of the Leisure World Republican Club. “I feel there’s a point at which all American citizens are going to say, ‘Hey, there are some of us who can afford to do a little bit more.’ . . . I was never raised to feel like anybody owed me anything.”

The GOP plan counts on a large number of seniors to voluntarily switch over to private health care. Competition in the marketplace should keep prices down and drive up quality, according to the GOP theory.

Only about 10% of the elderly across the nation belong to HMOs. But government studies show that in Los Angeles and Orange counties, the number is much higher--from 35% to 40%, though the higher enrollment in HMOs has produced little evidence of savings to the federal government.

Greater savings will be realized under the GOP plan, insists Rep. Ron Packard (R-Oceanside). He did his part to sell the proposal by organizing a telephone hook-up between reporters and Jake Hansen, a vice president of the Seniors Coalition, a group representing elderly citizens that has aligned with the GOP.

“We’ve found that older seniors, basically those seniors about 70 [years old] and up--the majority are inclined to stay with what they know,” Hansen said. “From 70 on down, there is a high likelihood that they will take a look at other options. They are used to higher quality health care and they don’t want to be shoved into Medicare.”

In questionnaires now landing in the mailboxes of his constituents, Rep. Jay C. Kim (R-Diamond Bar) asks voters: “Do you trust the new Republican Congress to do the right thing in reforming Medicare?”

He is one of the few to concede his mailbags contain letters from opponents, but is convinced that once voters read the GOP’s plan, their response will be “yes.”

“I told them we are not mean-spirited people and they trust me,” Kim said of voters who met with him recently in his district. “After I explained [the plan] and we had dialogue, they understood. They know we have a financial crisis. . . . I think people understand. I even got a standing ovation.”

Cox’s newsletter to his coastal Orange County district contains the dire warning: “Unless action is taken now, a retired couple will have to pay a 300% increase in their annual Medicare premium just seven years from now.” The newsletter does not mention the increase in “Part B” monthly premiums, which covers doctors’ bills.

Packard, meanwhile, defends against contentions that this is a ruse to fund a tax cut for wealthy Americans. “I think the senior citizens . . . realize it’s not the tax cut we are trying to protect. They know it’s the Medicare system we are trying to protect,” he said.

Rep. Robert K. Dornan (R-Garden Grove) joins the chorus that makes up the heart of the Republican message, and argues against raiding the defense budget to help finance Medicare. Those who call for defense budget cuts “just don’t understand how dangerous the world is,” said Dornan, who chairs a House subcommittee addressing national security issues.

If local congressmen have not yet heard much from their elderly constituents, it’s because they have been waiting for the details of the GOP plan, says Rosenbaum, who has joined forces with the 31-million-member American Assn. of American Retired Persons. At best, what they have heard so far sounds confusing, he adds.

“If these Republican congressmen want people to go with that [plan], let them put their mothers and fathers in it,” Rosenbaum said. “If they are really heroes, let them join the weakest HMOs in their districts to show their integrity; to show they really believe in the HMOs. And if it not good enough for them, it’s not good enough for these people.”

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Medicare Changes

Republicans want to cut growth in Medicare’s costs--now rising at 10% a year--to 6.5%, generating a savings of $270 billion. The plan has two purposes: to rescue the federal health insurance for the elderly, which is on a path to go broke in 2002, and to balance the federal budget in seven years. The House Republican plan calls for:

* Higher premiums for all enrollees, from $46.10 a month to more than $90 by 2002. President Clinton has proposed raising the monthly rate to $83 by 2002.

* Bigger payments for affluent seniors--up to $146 per month for individuals with annual incomes of more than $75,000 or couples with incomes exceeding $125,000.

* Tough new restrictions on payments to doctors and hospitals.

SENATE VERSION

Senate Republicans on Friday released their version. It incorporates much of the House plan, but there are key differences:

* Seniors would be required to pay the first $150 in doctor bills next year--up from the current $100 deductible--with annual increases of $10 that would raise the deductible to $210 by 2002.

* The eligibility age would increase in steps from 65 to 67 between 2003 and 2027, as full Social Security eligibility rises. Everyone born since 1938 would have to wait longer for Medicare; those born since 1960 would have to wait until age 67.

* Seniors would be able to pocket up to 75% of the savings in cash if they joined health maintenance organizations or other plans that cost Medicare less. This rebate provision is more generous than the House’s.

Source: Times and wire reports