BY MEGAN ARNEY
A bipartisan chorus of Democrats and Republicans are waging
a political campaign to begin dismantling Medicare, the federal
medical program for elderly and disabled people. One of the
most serious probes has been the proposal a bipartisan federal
advisory commission established by Congress and the White House
in 1997 to look into ways to "reform" Medicare, the second-
largest government entitlement.
On January 6 the commission announced a proposal, drafted by its chair, Democratic Sen. John Breaux, and Republican Rep. William Thomas, that would essentially put Medicare on the auction block. Breaux commented March 16 that while the plan was not adopted, "We have advanced the Medicare debate in a very significant way" by putting it on the table.
Under the proposed scheme, each of the 39 million Medicare recipients would receive a fixed sum to be used to buy private health insurance. Under the current system, the government program reimburses doctors directly for services to Medicare recipients
In order to sugarcoat this plan, commission members suggested that more people could have coverage for prescription drugs. Currently, about two-thirds of those recipients of Medicare purchase supplemental insurance policies that cover drugs. The remaining 13 million pay for medicine taken outside of hospitals out of their own pocket.
Breaux also proposed making higher-income Medicare beneficiaries pay higher premiums than others, implementing means-testing. Currently, everyone pays exactly the same and gets exactly the same coverage (though those who can afford it can get additional coverage privately). The proposal would have raised monthly co-payments -already set to double from $45.50 to $105 in 2009 - across the board. The eligibility age for Medicare would gradually increase from 65 to 67 years. And Medicare would no longer directly pay to help train doctors, interns, and medical residents, cutting $2.2 billion in yearly subsidies.
By early March it became clear that the commission was slightly short of the majority of 11 needed to present an official recommendation to the White House and Congress. Ten out of 17 commission members - 8 Republicans and 2 Democrats -voted in favor of the plan.
U.S. president William Clinton announced he would come up with his own plan for long-term overhaul of Medicare, vowing to push it through Congress.
Medicare, which provides medical benefits for those over the age of 65, was established in 1965 as an extension to the 1935 Social Security Act. It is one piece of the social wage won through struggle in working-class battles of the 1930s and 1960s. This and other entitlements are the socialized part of workers' wages - universal rights for a class. The employers' assault on workers' wages and working conditions, and the government offensive against social entitlements go hand-in- hand, as the capitalist class tries to boost its sinking profit rates by keeping a larger portion of the wealth workers produce.
While there is bipartisan agreement in Washington that social entitlements should be cut, there is debate among wings of the capitalist rulers over how far and how fast to go. Liberal Democrat Senator Edward Kennedy, for instance, criticized the federal commission's plan, saying the approach was "the wrong prescription."
Senator John Rockefeller, a Democrat from West Virginia, said the proposal was "not an acceptable starting point for Medicare reform" as it was "simply too risky."
The liberal New York Times editors warned January 31, "Relying on the market means accepting a lot of flux. Last year, several private managed care plans abruptly decided to pull out of Medicare because the premiums were not covering their cost. That left 400,00 beneficiaries scrambling to find new doctors."
Breaux and Thomas have said they will bring the plan before other members of Congress anyway. Several prominent Republicans had backed the measure. "I believe we can pass this proposal or something very close to it in the Finance Committee and in the Senate," said Republican Sen. Philip Gramm. He also proposed that Medicare "have a budget" instead of being an open- ended entitlement.
Gramm was joined by Democratic Sen. Joseph Robert Kerrey, who called for an "income test," which would require Medicare recipients with incomes over $75,00 a year to pay higher Medicare premiums.
Meanwhile, Clinton asked Congress January 9 in his 1999 budget request to discuss a plan he proposed last year that would "adapt" Medicare to include U.S. citizens between the ages of 55 and 65. Instead of lowering the age for eligibility, since 3.2 million people between ages 55 to 64 are uninsured, the president proposes allowing laid-off workers age 55 or older the option to pay up to $400 a month for health benefits. Medicare recipients between 62 and 64 would pay $300. Today, anyone over the age of 65 is eligible for Medicare at $45.50 a month. Nationwide, 17.6 percent of people under 65 years of age lack medical coverage.