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GOP Medicare plan has to leave someone in pain


WASHINGTON -- Perhaps it is time to review the bidding on the Medicare debate once again.

First, the Republicans tell us that they are going to save $270 billion in seven years without anybody feeling any serious pain. Medicare patients will have all these marvelous choices and that flexibility in itself will save all sorts of money. The implication, of course, is that the suppliers of services -- the doctors and the hospitals -- are going to take the hit.

Docs on board

But, no, now the Republican plan has been endorsed by the American Medical Association after, AMA leaders say, Republican leaders assured them the plan would not reduce payments to doctors treating Medicare patients. So now the implication seems to be that the big hit will be taken by the hospitals, which already were scheduled to feel a lot of pain in order to protect the patients.

Then we are told that there is no connection between the $270 billion that will be saved on Medicare and the $245 billion the Republicans plan to hand out in tax breaks for middle-class and affluent taxpayers.

In short, the Republicans seem to be saying you must believe 15 impossible things before breakfast if you are going to understand their approach to reaching a balanced budget in the next seven years and thus fulfill the campaign promises of 1994 that started the whole business.

Curious business

This is curious business. There is obviously something here that doesn't meet the eye but would provide a rational basis for the Republican actions. But we don't know what it is because the Medicare plan has been put together and rushed through the House Ways and Means Committee without ever being publicly detailed and discussed.

And that, in turn, means that the Republicans are doing this autumn what they accused President Clinton of trying to do last autumn, passing in haste a radical change in the health care system.

It is no wonder that the opinion polls are showing steadily growing opposition to the Republican plan. And it is no wonder that elderly voters in particular are up in arms about the proposals. They were not born yesterday. They know there is no such thing as a free lunch. Taking $270 billion out of federal spending on Medicare cannot be achieved by trying to squeeze 80-year-old taxpayers into giving up their own doctors for something called "managed care."

Nor are the elderly the only ones who smell something fishy here. Taxpayers of all ages remember a year ago when Republicans were accusing the Democrats of exaggerating the health care crisis and trying to move too fast. It was an argument the voters bought then, so there is no reason to believe they won't buy it this year now that it is being made by the Democrats against the Republicans.

Speaker of the House Newt Gingrich and his merry men are accusing the Democrats of using "scare tactics" to turn public opinion against their Medicare proposal, which is, of course, what the Democrats accused the Republicans of doing a year ago. It's an old rule here. What goes around comes around.

Meanwhile, however, the whole brouhaha reinforces a message quite different from the one the Republicans were sending when they won the 1994 election. They were going to break gridlock and get things done in an orderly, sensible fashion that would breed confidence in the electorate.

Instead, we have another sorry spectacle of politicians on both sides using hyperbole and calumny rather than sweet reason on a question that may have significant meaning for the 37 million Americans now eligible for Medicare and the many millions more who will follow shortly.

Needed: leadership

It is a situation that cries out for credible national leadership -- someone whose version of the truth might be widely accepted by voters. But President Clinton does not enjoy that stature today, and neither does Newt Gingrich.

So the only answer is to ask yourself what makes sense. Is it logical to save $270 billion on Medicare without causing the patients any pain? Is it logical to cut taxes by $245 billion when the first priority is supposed to be a balanced budget?

Jack W. Germond and Jules Witcover report from The Sun's Washington bureau.

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