Bush Takes Courageous Step Toward Medicare Reform

Gov. George W. Bush has proposed a Medicare reform plan that is based on sound policy. It would modernize Medicare, in particular by providing drug coverage for those who need it. Bush has taken a politically courageous stance and challenges those who insist on maintaining the creaky status quo.

Here’s what is best about the Bush Medicare plan:

It acknowledges reality: Bush acknowledges that there is a real problem with the antiquated Medicare program, and it must be updated and improved. It would be easy to shove this fundamental truth under the rug again, but every year that passes, Baby Boomers are a year closer to eligibility, and the job gets more difficult. Bush has promised to take on the reactionary forces who struggle to retain the status quo, and has offered real reform.

It offers Medicare beneficiaries choice. Gov. Bush’s plan would ensure that seniors have a choice of different plans rather than being forced into the narrow confines of the current Medicare structure. When people retire today, they lose the insurance plan they had and are forced to accept Medicare’s rules. Under Gov. Bush’s proposal, it may be possible, retirees may be able to keep that coverage even under Medicare.

It’s bi-partisan: Medicare reform must have broad bi-partisan support if it is going to move forward, and Gov. Bush bases his initiative on a reform plan that was developed by the majority of a bipartisan commission led by Louisiana Democratic Senator John Breaux and Republican Congressman Bill Thomas. The work of the commission’s majority was stymied by the Clinton-Gore administration. Gov. Bush offers a chance to re-start the bipartisan process and to build on the solid foundation the majority of the commission laid.

It’s on a fast track: Gov. Bush said that Medicare reform is a priority, second only to his education initiative. He would create a bipartisan White House Medicare Reform Task Force and send legislation to Congress by September 1, 2001. Gov. Bush urges that the Medicare reform bill be given “fast track” status so that Congress could vote on it before the end of 2001. That’s what it will take for change to happen: Presidential level leadership with an electoral mandate for change.

It provides immediate drug benefit. Recognizing the pressing need to provide drug coverage for those who need it, Gov. Bush proposes an immediate program to finance drug coverage independent of overall reform.

Bush’s prescription drug benefit deserves high marks:

It’s targeted to those who need help the most. One third of seniors have no drug coverage, but the ones who need help the most are lower-income seniors, especially those with high drug costs. The plan would target money to them immediately.

It builds on existing programs: At least 23 states already have programs to provide a benefit to seniors who need help in obtaining medicines. Gov. Bush would provide money immediately to build on these existing programs and encourage states that don’t have them to quickly create them. The money would go to help seniors who have incomes up to 175 of poverty obtain coverage.

It provides coverage for big drug bills: Gov. Bush would provide coverage for all prescription drug costs in excess of $6000 in a year for all seniors. This provides coverage where it is most needed-large, unmanageable costs.

It protects medical research: It would have been easy to bash the drug companies, as Gore demagogically has done, but Bush took the courageous stance of speaking the truth. He recognizes said the pharmaceutical industry is the source of life-saving medicines, and they must have the freedom to conduct research without constraints of price controls and restrictive government formularies.

So what are the weaknesses of the Bush plan?

Bush has taken a bold stance in proposing major change to a popular program serving one of the nation’s most vulnerable constituencies. At the same time, he has guaranteed Medicare beneficiaries that they can continue to receive current benefits if they choose. Nevertheless, he exposes himself to the Medi-Scare tactics that liberals have used so effectively in the past. But he has done the right thing in proposing reform, as many of those same liberals will acknowledge in private conversations. Gore is trying to win by persuading people to fear change. Gov. Bush recognizes the need for change, and is willing to present a concrete proposal of reform.

And ultimately, that is the bottom line difference between the Gore and Bush plans. Gore would pour more money into a rusty and rickety program. Gov. Bush sets out a vision for a new Medicare system, with expanded benefits and expanded choice that returns power and control to seniors. The voters do have a real choice.

Grace-Marie Arnett is president of the Galen Institute, a health policy research organization based in Alexandria, VA. Readers may write her at galen@galen.org, or P.O. Box 19080, Alexandria, VA, 22320.

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