MEDICARE REFORM: Everything Is On The Table
The bipartisan panel on the future of Medicare met for the first time Friday and "raised as one possibility the idea of redesigning the system from scratch," the Washington Post reports. If the system is redesigned, commission members would "take into account the tremendous changes in health care since Medicare was created ... and [would] attempt to design a system to insure the elderly in a more efficient and comprehensive way." However, the commission will also consider more incremental changes in the system (Havemann, 3/7). "Everything will be on the table," said commission chair Sen. John Breaux (D-LA).
Divide And Conquer
The Washington Times reports that the commission will be divided into three task forces to determine how best to reform the program. The first task force will "approach Medicare's financial problems from what Mr. Breaux called a 'blank sheet of paper.'" A second task force will look at "ways to cut fraud and waste and reconsider raising the Medicare eligibility age or requiring wealthier retirees to pay higher premiums." The third task force will "develop a future model for Medicare and examine what type of benefits should be covered, the program's role in paying for physician training and how it should fit with private and other public health programs." Breaux said, however, that the task forces "will not drive the commission" (Goldreich, 3/7).
All On The Same Page?
Although the panel members seemed determined to "disprove the conventional wisdom that they will become bogged down in partisan bickering," members nonetheless voiced different opinions on the future of the program, the New York Times reports. Rep. Jim McDermott (D-WA) said, "This commission will fail if we limit the discussion purely to one about money." He suggested other improvements "to add or expand coverage of prescription drugs, long-term care and mental health services." Sen. Bob Kerrey (D-NE) called for means testing, while Sen. Phil Gramm (R-TX) said that "'Medicare should have a budget,' rather than being an open-ended entitlement system" (Pear, 3/7). Gramm also said, "The structure of incentives in traditional Medicare are totally irrational, and, in my opinion, have to be changed" (CNN, "World Today," 3/6). Several members stressed the need for continued quality in the program. Sen. Bill Frist (R-TN), one of three doctors on the panel, said, "People are going to continue to insist on receiving the best care out there. They are going to demand it in this country" (Zaldivar, Philadelphia Inquirer, 3/7).
Expansion On The Table
Members also discussed the feasibility of President Clinton's proposal to make Medicare available to the near elderly, the New York Times reports. Laura D'Andrea Tyson, former White House chief economic adviser, contends that because an analysis by the Congressional Budget Office shows the plan "essentially pays for itself," Congress can pass it without waiting for the commission's report. Breaux said Congress would likely "wait to hear from the panel" on the near-elderly proposal, but he said he is "intrigued with the idea of allowing the uninsured to buy into the Federal Employees Health Benefits Program." The commission has until March 1999 to issue a report, and the final draft will contain "only those recommendations and conclusions that get at least 11 votes" from the panel's 17 members (3/7). CNN's Brooks Jackson reported that the commission members "agreed to meet again in April" ("World Today," 3/6).
CongressDaily reports that the commission members also "grappled with how to permit dissenting views to be presented when the commission makes its final recommendations." The law creating the commission states that only those recommendations garnering 11 votes should be forwarded to Congress for consideration. But some members, including Tyson, argued in favor of having a "minority report." Breaux agreed that "consensus and dissent must both be presented in the final report." "In the end," according to CongressDaily, the "commissioners adopted what the law directed, but with the understanding that staff would draft language to clarify the matter" (3/6).