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Tuesday, February 25, 2003Mr. Bush's proposals for Medicare and Medicaid, taking shape in recent weeks, would transform these pillars of the Great Society and their guarantee of health benefits to the elderly, disabled and poor. States would have far more power to determine who receives what benefits in the Medicaid program, which covers 45 million low-income Americans. The elderly would rely more on private health plans, and less on the government, for their health benefits under Medicare, which covers 40 million elderly and disabled people. The administration's vision for Medicare and Social Security moves away from the notion that everyone should be in the same government-managed system with the same benefits. It promises individuals more choices, including the option of picking a private health plan or investing some of their Social Security taxes in the stock market. I’m not sure about that investment of Social Security taxes in the stock market, but for Medicare to remain solvent as the baby boomers age, some sort of reform needs to happen. Today, the government program covers all seniors, regardless of how wealthy they are. Many of those could afford their own healthcare plan: Mr. Bush's Medicare proposal, being revised after an earlier draft drew fire on Capitol Hill, would encourage many beneficiaries to leave traditional Medicare and get their benefits through private health plans associated with the program. Administration officials assert such plans can manage care, tailor benefits and control costs better than traditional Medicare, one of the last bastions of fee-for-service medicine. The officials also argue that Medicare must be overhauled before Congress adds prescription drug benefits, a priority for each party. ...."When it comes to cars, and when it comes to health care, 1965 is not the state of the art," Mr. Bush has said. At least they see the need to put in some limits before offering drug benefits to everyone. Reform will be difficult, though. Elderly people of all backgrounds have come to see it as an entitlement. And people don’t like it when someone messes with their entitlement. For Medicaid, the Administration plans to give the states more power to determine who they would cover: The administration's proposal would offer states vast new power to reduce, eliminate or expand health benefits for low-income people, including many who are elderly or disabled. In return for the flexibility, and a temporary increase in federal assistance, states would eventually have to accept a limit on the federal contribution to the program's cost. The choice would be up to the states; they could stay with the existing program. Administration officials say the plan would allow states to stretch scarce resources during fiscal crises. Critics assert it would replace the poor's entitlement to health care with a block grant to the states, just when the number of uninsured is rising. It should be noted that the “number of uninsured” has no correlation with the number of people covered by Medicaid. Most of the uninsured make too much money to qualify for Medicaid, and those receiving Medicaid aren’t counted among the ranks of the uninsured. It’s actually fairly difficult, at least in my state, to qualify for Medicaid. Most recipients are either very poor, severely disabled, or single mothers. Most of the fat lies within Medicare, but reform of that will be extremely difficult. Not only have the elderly of all persuasions come to see it as an entitlement, but they have a very strong lobby in the AARP. I wouldn’t hold my breath for reform in our lifetime. posted by Sydney on 2/25/2003 05:52:00 AM 0 comments 0 Comments: |
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