Democrats have led on Medicare reform


IN THE LEAD EDITORIAL OF Oct. 13, The Sun stated that only the Republicans have shown leadership in reforming Medicare.

As a Democratic member of Congress who serves on the Ways and Means Committee which just completed consideration of Medicare reform, I vehemently disagree with such an assertion.

First, the Republican party has never supported Medicare. In 1965, when Medicare was first enacted, 93 percent of the Republicans opposed the legislation. Over the past 30 years, it has been Democrats who have consistently improved and protected Medicare. In recent years, Democrats in Congress have put in place major Medicare reforms including the DRG system (a hospital payment system) and PPG (a payment methodology for doctors' bills). These reforms have held down costs and made Medicare more efficient.

Republicans say there is a crisis facing Medicare because the Trust Fund will be insolvent in seven years. The reality is far different. Since 1970, the Trust Fund has had less than seven years of solvency a total of nine times. It has been congressional Democrats who have kept Medicare from the brink of insolvency.

In 1993, the Trust Fund was projected to become insolvent in 1999. The Democrat reacted. We made significant cuts in the Medicare program totaling $56 billion over five years. The Republican reaction? "The health care provisions of the Committee bill essentially consist of a two-year freeze on Medicare provider payments. This freeze was concocted as an 'easy' method for meeting the arbitrary reduction target."

Last year, as part of health care reform, we proposed $168 billion in Medicare reductions. Every single Republican member of the Ways and Means Committee voted to restore those cuts. The ranking Republican minority member of the Ways and Means Committee stated at that time, "Make no mistake about it for the elderly in this country [these cuts are] going to devastate their program under Medicare. I just don't believe that quality of care and availability of care can survive these additional cuts. And that is the price that is going to have to be paid to pay for these cuts."

As a result of Democrats' action in 1993, the Trust Fund obtained three extra years of solvency. The Sun acknowledges the recklessness of the Republican proposed tax cut. But the fact of the matter is that the tax cut is precisely why such drastic Medicare cuts are necessary. In order to meet their stated goal of balancing the budget in seven years and providing a $245 billion tax break for the rich, Medicare must foot the bill.

The Democrats did offer an alternative Medicare reform bill in the Ways and Means Committee. I helped craft this solution. We made dramatically fewer Medicare cuts, but our bill would reach the same Trust Fund solvency date as the Republican plan.

Both plans would maintain the Trust Fund to 2006 -- another decade. That extension of solvency would provide the time for a bi-partisan commission to craft a long-term solution to the crisis facing the Medicare Trust Fund when the baby boomer generation becomes eligible.

Rather than raid Medicare to fund tax breaks, our bill would have reduced Medicare spending by $90 billion. We included important reforms to Medicare such as expanding choice of private health insurance plan options and adding new preventive benefits such as colon-rectal cancer screening, yearly mammographies and training for diabetics. In addition, we included strong, effective fraud and abuse protections.

So far this year, the only action the House Republicans have taken affecting Medicare is to remove $45 billion from the Trust Fund over the next seven years. This revenue loss to the Trust Fund is another reason that their Medicare cut must be so large.

I welcome the opportunity to work with Republicans to create a bi-partisan solution to Medicare. Unfortunately, so far the Republicans have proven unwilling to consider Medicare reform on its own merits.

As long as they insist on using Medicare savings to offset their tax breaks, the dollars needed are too much for the program to sustain and the result will be a return to the time when seniors went without health insurance and their families were impoverished to help provide for them.

Benjamin L. Cardin


The writer represents the Third Congressional District of Maryland.

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