President Bush boldly stepped up to the plate last month by calling for Medicare modernization as part of his prescription drug benefit plan, initiating an historic debate that White House officials knew would either help or hurt his presidency in a big way.
But the White House team didn’t back up their star hitter by providing details of the plan, and it was attacked from all sides for daring to suggest changes to Medicare. Now the administration is backing down, with Health and Human Services Secretary Tommy Thompson saying Wednesday that the White House will likely offer principles but not a detailed plan for reform.
This means that the contentious debate over a drug benefit will be dominated by the closely-divided and politically-motivated Congress rather than by a clear vision for much-needed change from the White House.
The final strike came when House Speaker Dennis Hastert, a Republican, bluntly told his home-state newspaper on Monday, the Chicago Tribune, that he thought the president’s plan was unworkable.
A leaked January 10 memo from the White House provided outlines of the president’s plan. It would allow Medicare beneficiaries either to stay with the current Medicare program or choose from among private health plans.
These plans would be competing for seniors’ business and offering drug coverage as an integral part of their health benefit – plans just like members of Congress and the president’s staff have today.
The president favors using the drug benefit as a lure to encourage Congress to give seniors a new form of coverage would mirror the best health care plan in the country – the Federal Employees Health Benefits Program.
To prove that he was serious about providing generous and comprehensive coverage to seniors, Mr. Bush put an additional $400 billion in his budget to fund his program.
But the criticism started almost immediately. “The president’s proposal is an effort to say if seniors want to have help with their prescription drug costs, they would have to lose their choice of doctor and go into a private-sector HMO,” Sen. Debbie Stabenow (D-Mich.) complained recently.
That’s not true – seniors could get drug coverage, keep the doctor of their choice, and not be forced into an HMO – but that didn’t stop the politically charged criticism.
But Hastert’s quote hit hardest: “I don’t think you can pass a piece of legislation that takes an 80-year-old grandmother and says you have to give up your fee-for-service [Medicare benefit] as you know it in order to get a drug piece on it.”
Hastert said he told the president: “I don’t think you can do it humanely. I don’t think you can do it politically. I don’t think it’s practical.”
A day later, Hastert “clarified” his statement, saying he realizes now it “does not force seniors into an HMO in order to get lifesaving prescription drugs.” But the damage was done.
Despite the political talk, action still is imperative. Medicare is gobbling up a bigger and bigger share of taxpayer dollars. Without changes, future generations of taxpayers will have to shoulder a crushing financial burden. And for all that spending, Medicare patients will find their access to health services severely limited.
The public is increasingly aware of these problems. A recent Wall Street Journal – Harris poll found that 64 percent of Americans believe Medicare needs major reform.
Those most worried are those under age 64: 71 percent of them don’t believe that Medicare will be able to meet their health care needs.
Many of those on the left favor simply adding a drug benefit to the existing Medicare program – a benefit that would quickly be encumbered by price controls that would limit access to new drugs and with government officials making choices about which drugs are available.
Unlike his predecessors, Mr. Bush has shown he’s ready to provide leadership on the crucial need to bring Medicare into the era of modern medicine. His idea for modernization of the program has the potential to offer Americans real choices, not false promises.
The president’s new challenge will be to convince Congress to include some modernization of the program and not go down the tired and beaten path of more of the heavy-handed regulation that burdens the program today.
As the fierce debate unfolds, he must stick to his key principle to put patients and doctors back in charge of American medicine and reform Medicare in way that preserves a free and competitive market for health care.
Grace-Marie Turner is president of the Galen Institute. Joseph Antos is the Wilson H. Taylor Scholar at the American Enterprise Institute. Ms. Turner can be reached at firstname.lastname@example.org and Dr. Antos can be reached at email@example.com.