Jewish World Review July 11, 2003 / 11 Tamuz, 5763
Drs. Michael A. Glueck & Robert J. Cihak
Costly Medicare Changes, Without Real Reform
In The Medicare Mess: Will President Bush call Congress' Bluff?, we described some of
the problems with the Medicare "reform" bills passed by the US House and
Senate last month. We also need to review how the bills shorten the fuse on
the demographic time bomb facing Medicare and other entitlements.
Since President Franklin D. Roosevelt established the first Social Security
entitlement in 1935, Americans are living longer, healthier lives. At the
same time, Americans are having fewer children on average than previous
generations. This has resulted in a demographic time bomb, with fewer than
four workers currently paying taxes into Social Security and Medicare for
every recipient. In 1950, 16 workers were putting money into the system for
In the latest temperature spike of this "entitlement fever," the U.S. Senate
and House passed separate bills late last month calling for a new Medicare
prescription drug entitlement. Will President Bush stick by his original
call to link such a benefit to reforms that provide more choice, including
private health plans, for Medicare recipients, and for competition among
Medicare insurance providers?
The bills that the House and Senate passed last month open up another huge
sinkhole in Americans' lives. They create another open-ended entitlement
which purportedly would cost "only" $400 billion over the next 10 years.
Similarly optimistic past predictions of the cost of other new federal
entitlements proved grossly low.
And rather than helping Americans, Congress' proposals will cause more pain
and suffering for Medicare recipients, doctors, taxpayers and their
children. Instead of reforming Medicare, lawmakers may bankrupt it. Andrew
J. Rettenmaier and Thomas R. Saving of Texas A&M, writing in the Wall Street
Journal, estimate the bills could create an additional unfunded liability of
$7.5 trillion, or $25,000 for every American alive today, adjusted for
For all their cost, the measures don't include President Bush's proposal for
Medicare reform modeled after the Federal Employees Health Benefits Program
(FEHBP) provided to congressmen and other federal employees, as we noted in
the previous column. Bush would include a "Medicare Advantage" system which
would allow Medicare recipients to have health plan choices and insurance
companies to compete and offer innovative plans.
Even though a June 21 Zogby poll showed 82 percent of voters favor a private
health plan option for Medicare recipients, Congress is intent on precluding
Given Congress' record, it's no wonder the legislation its branches passed
is inconsistent with the health-care choices that Congress gives itself and
the health-care choices the president says he wants for Medicare recipients.
Members of the House and the Senate will meet as a Conference Committee to
try to iron out the differences between the two bills. We hope President
Bush has the courage to defuse this entitlement booby trap while continuing
to seek genuine reform. More specifically, we hope he can convince the
Conference Committee to make some real reforms. If the Conference Committee
fails to significantly improve the legislation and Congress passes the
resulting bill, the President should veto the current mess and tell us why.
No wonder author Philip Gold calls the result of such political pressures on
American medical care a "Disaster by Design."
Michael Arnold Glueck, M.D., is a multiple award winning writer who
comments on medical- legal issues. Robert J. Cihak, M.D., is past
president of the Association of American Physicians and Surgeons.
JWR contributors are Harvard trained diagnostic radiologists.
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