Clinton Medicare Plan

Chris Burford cburford at gn.apc.org
Tue Mar 16 23:59:41 PST 1999


The following news item looks to me like a major political and class battle. Clinton, as with tobacco, is prepared to take on a small but powerful section of capital, for the better management of capitalist society as a whole.

He is progressive in this regard.

One of the battle lines is about control of the vast finance involved. Am I not right that Greenspan has unusually specifically criticised the idea that such large sums of money invested on the stock exchange should be managed by state functionaries rather than by being dispersed to private individuals and for- profit capitalist companies?

The other big class issue is the range of the working class to benefit by a more rational (and probably cheaper and more efficient health system). Unfortunately this article looks as if Medicare is about patronising hand-downs to a mere 39 million of the population. The robustness of the British NHS through all the Thatcher years was that the "middle classes" benefitted greatly from it. I would strongly suggest that campaigners in the US will be inescapably reformist if they put their limited energies into a minority health care system rather than centrally into a rational socialised health care system for the great majority of the working population.

Chris Burford

London

________________________________

Medicare rescue plan

By ALICE ANN LOVE

Associated Press Write

March 16, 1999

Web posted at: 7:29 p.m. EST (0029 GMT)

WASHINGTON (AP) -- President Clinton

criticized a plan endorsed by several members of a

Medicare advisory commission, saying Tuesday that

it falls short of what's needed to shore up the health

care program for the elderly. So he said he will draft

his own plan in hopes of getting an agreement with

Congress this year.

"Every independent expert agrees that Medicare

cannot provide for the baby boom generation without

substantial new revenues," Clinton told reporters on

the White House lawn. The president has proposed

using billions of dollars of coming budget surpluses

for Medicare.

A plan endorsed by 10 of the 17 members of the

Medicare advisory commission would, in contrast,

aim to reduce the program's costs by making it more

like private health plans. Its chairman, Sen. John

Breaux, D-La., has raised concerns that

recommending the use of surpluses might simply ease

pressure on lawmakers to make difficult but

necessary changes.

"It is not a modern, efficient and effective program,"

Breaux said of Medicare.

As the commission met for the final time Tuesday,

Breaux acknowledged he would fall short of the 11

votes needed to make a formal recommendation to

Congress and Clinton, but said he plans to introduce

the plan in Congress anyway.

Senate Majority Leader Trent Lott, R-Miss., took

issue with Clinton's comments, noting that the

comptroller of the General Accounting Office last

week said the president's plan could "undercut the

incentives to engage in meaningful and fundamental

reform."

Clinton, for his part, called Medicare "too important

to let partisan progress stand in the way of vital

progress." * Breaux's plan would inject competition

into Medicare by letting senior citizens choose from

among private and government-run insurance

options. The government would subsidize their

premiums. * Clinton has proposed spending a chunk

of the coming expected budget surpluses -- about

$700 billion -- to boost the program. But he also

praised elements of the Breaux plan, and said some

of its proposed changes may be needed even if the

overall plan falls short.

"Even if all the changes recommended by the

commission were adopted, because of the projected

inflation rates and health care costs, it would not be

sufficient to stabilize the fund," Clinton said.

Without changes, Medicare, which provides health

insurance for 39 million elderly and disabled

Americans, is expected to run short of cash in about

a decade -- just before the first of the baby boomers

retire and become eligible for benefits.

However, tampering with the program has proved a

political lightning rod in the past. Republican leaders

and Clinton had hoped the bipartisan commission of

key lawmakers, private experts and former

government officials could take off some of the heat.

Instead, the commission has largely highlighted,

rather than solve, the political disagreements

confronting lawmakers looking to overhaul

Medicare.

Aside from Breaux himself, the only other Democrat

on the panel to support his plan was Sen. Bob

Kerrey, D-Neb. The other eight supporting it are

Republicans.

Breaux's plan would begin to shift Medicare away

from paying people's individual medical bills and

make it more like the health benefits that many

companies offer to workers.

One of the biggest unresolved Medicare issues is

whether more money is needed for the program, in

addition to restructuring. Republican leaders have so

far declined to endorse Clinton's idea of using budget

surpluses.

Most Democrats on the commission insisted that

even with changes to control costs, Medicare can't

provide adequate health care for growing numbers of

elderly Americans without more money.

Commissioners likewise clashed over their desire to

make prescription drugs -- not covered by Medicare

now -- more accessible to the elderly and disabled.

In general, Democrats including Clinton want to

subsidize drug coverage for all Medicare

beneficiaries. But Republicans wonder if the program

can afford that and want to explore other

private-sector options.

Similarly, the idea of raising the Medicare eligibility

age from 65 to 67 was attractive to many

commissioners of both parties. * Clinton said he

could not accept that idea, and also said he worried

that Breaux's plan could increase premiums for those

remaining in the traditional Medicare system.



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