MEDICARE REFORM: Blizzard, Lack of Votes Delay Panel
Medicare reform commission co-chair Sen. John Breaux (D-LA), unable to marshal the last, elusive vote for his premium support proposal, announced yesterday that the commission would likely not meet this week. The decision was also spurred by a late-winter snow storm that disabled the Washington area yesterday. Breaux said the panel wouldn't meet "because of the weather and the snow, and the inability to get people here -- and the inability to get 11 votes" (Rovner/Serafini, CongressDaily, 3/9). "There are a lot of moving pieces right now," he added (Pham, Boston Globe, 3/10).
Stalling for Time?
Critics of premium support charged that Breaux was drawing out the process in a futile effort to gain support for his program. Mark Hannay of the National Campaign to Protect, Improve and Expand Medicare said, "Sen. Breaux is stalling Congress and leaning on the presidential appointee Laura Tyson to support his voucher program." The campaign announced today an e-petition drive at its Web site, www.Medicare4All.org. Health Access' Bruce Livingston said Breaux is "stalling, while consumers, persons with disabilities and senior citizens are organizing on the Web" (campaign release, 3/10). The campaign's Dr. Thomas Bodenheimer told CBS "Evening News" Monday that premium support "is a very radical change in Medicare, and it's hard to imagine a worse idea. As each year goes by, the vouchers are going to go up slower than the costs of health care, so that ... elderly Americans will have to pay more and more out of their own pockets" (3/8).
Drugs, Not Vouchers
In a Los Angeles Times op-ed, three prominent scholars conclude that premium support is a "bad idea" -- even if it provides the prescription drug coverage they argue seniors desperately need. The Yale School of Management's Theodore Marmor and Mark Goldberg, and the University of North Carolina-Chapel Hill's Jonathan Oberlander write that commission holdouts Tyson and Stuart Altman are "right and wrong" to insist on drug coverage as the price of their votes, as the "conversion of Medicare from a social insurance program to a voucher scheme doesn't make sense, with or without" the benefit. They blast the premium support plan's "wishful thinking ... that the combination of financial incentives and intensified competition among managed care plans will cut costs." They conclude that commission members should "separate the prospect of a prescription drug benefit from a voucher plan and fund the benefit honestly through the regular Medicare benefit process" (3/10).
Everybody's Got an Angle
In related news, 69 House members lobbied the Medicare commission not to recommend a 10% copay for home health care services, arguing that it would constitute large out-of-pocket expenses for low-income and sick elderly people. At a rally organized by the Home Care Association of America, Rep. Bernard Sanders (I-VT), who signed a letter with 66 Democrats and two Republicans, said, "If you think of the most regressive and reactionary things to do, I have to think that going after home health copayments are it." The HCAA is "preparing a bill that would ... permanently cancel a 15% cut now scheduled for Oct. 1, 2000, if a new payment system is not implemented by then," and lift spending caps (CongressDaily, 3/9). The HCAA's Chris Dean said last year's bill that restored some funding for home health care after the 1996 cuts "was absolutely not enough," and that the benefit for the average provider was only about $250 (Reuters Health, 3/10).