More MS news articles for March 1999

Medicare commission lacks votes for overhaul

http://www.nandotimes.com/healthscience/story/body/0,1079,28404-45696-340213-0,00.html

Copyright © 1999 Nando Media
Copyright © 1999 Associated Press
By LAURA MECKLER

WASHINGTON (March 16, 1999 2:19 p.m. EST http://www.nandotimes.com) - After a year of work, the commission charged with overhauling Medicare is about to adjourn without making any formal recommendation, though leaders say they'll pick up the fight for their ideas in Congress.

On the eve of Tuesday's final vote, the panel's leaders said they remained one vote shy of the votes needed to make a formal recommendation to Congress, and the White House said Tuesday that President Clinton also rejects the plan being considered.

That plan, which would inject competition into Medicare by letting seniors choose from a menu of options, falls short of what is needed to reform the ailing health program, said White House spokesman Joe Lockhart said.

"The president looks forward to putting forth an alternative proposal," Lockhart said. "It's something we believe we can improve."

Ten of the 17 members of the National Bipartisan Commission on the Future of Medicare support the plan, but 11 votes are needed. None of the four commissioners appointed by Clinton support it.

The panel, which includes Republicans, Democrats, members of Congress and private economists, hoped to rise above politics and offer Congress a blueprint for overhauling a program that has been a magnet for partisan warfare.

But in the end, the plan was largely supported by Republicans and backed by just two Democrats - Louisiana Sen. John Breaux, the commission's chairman, and Sen. Bob Kerrey of Nebraska.

Breaux and his co-chairman, Rep. Bill Thomas, R-Calif., promised to fight for it in Congress, saying they hoped to move legislation this year that would make their ideas law even without commission endorsement.

"What do you do? Do you just cry about it or do you introduce legislation based on this?" Breaux said Monday. "What we've got is very important. ... We've changed the debate in a major, major way."

He predicted the plan would attract at least 60 votes in the Senate, enough to overcome any filibuster. Thomas was less confident about its prospects in the House, though he said there was substantial support.

Thomas has accused Clinton's appointees of bowing to White House pressure, but Clinton spokesman Barry Toiv said Monday that the president did nothing to influence them.

"But the president wants very much to achieve bipartisan reform this year," Toiv said.

Senate Majority Leader Trent Lott was skeptical of Clinton's intentions.

"It's a sign to me that apparently he's going to try and politicize Medicare instead of introduce real reform," Lott said Monday on PBS' "NewsHour With Jim Lehrer" program.

Breaux defended his detractors, saying there was a "legitimate policy disagreement" with opponents. "There's always the fear of the unknown," he said.

Thomas was less charitable: "The proposal we will present is, in fact, the only reasonable way to go."

Their plan would make Medicare more like health benefits that many companies and the federal government offer to workers.

Retirees could choose from a menu of health-insurance policies and get a subsidy to help cover the cost. The more expensive plans would require participants to pay more out of their own pockets. Meanwhile, the government-run system that serves most retirees now would compete with the private health plans, which would have to offer similar coverage.

The plan also would gradually raise the eligibility age from 65 to 67.

One of the most contentious issues has been prescription drug coverage, which is not part of the 34-year-old, traditional Medicare plan. The plan would require private companies to offer at least one option that includes drug coverage. The popular private plans that supplement Medicare coverage, known as Medigap, would be required to offer drugs as well.

Drugs would be available through the traditional Medicare program too, but the elderly would have to pay for the extra cost.

Clinton has proposed using 15 percent of the budget surplus to shore up Medicare, and he has suggested that the program add drug payments, though the details of his program are not clear.

The Breaux-Thomas plan does not anticipate funneling extra money into Medicare from the budget surplus. But the commission staff estimates that their plan would save the program $100 billion between 2000 and 2009 and enough to keep the program solvent through 2017. The program is now expected to go broke in about a decade - just as the huge baby boom begins to retire.