REPUBLICANS have every right to be angry about the way President Clinton has demagogued the Medicare issue. They have every right to demand that he come up first with a definite proposal to save the Hospital Trust Fund from early bankruptcy. He and his Democratic allies trashed the GOP plan in the last election even though it merely proposed somewhat greater restrictions on the growth of Medicare costs than the administration had offered.
When the president meets with congressional leaders today, an apology as demanded by Senate majority leader Trent Lott would take a lot of sting out of the political atmosphere. But don't count on it. Nothing the president has said encourages a substantive approach to a Medicare problem that will mushroom through the years as the population ages.
For example, Mr. Clinton appears to have ruled out any increase in the payroll tax financing the hospital fund, any increase in premiums or deductibles on medical bills or any means testing to have the affluent elderly pay a larger share of their medical costs. Instead, he would keep cutting payments to hospitals and doctors and pretend a remedy lies in Reaganesque bashing of "waste, fraud and abuse."
The president's idea about shifting home health care costs from the hospital trust fund (Part A) to medical bills (Part B) financed by premiums and funds drawn directly from the general treasury is the wrong way to go. Rather, both he and the Republicans need to address the long-term prospects for merging these two systems in light of converging methods of treatment in the health care system.
A year ago, the president was proposing a $124 billion decrease in Medicare spending over six years while the GOP last offer was $164 billion. Some very sound centrists in Congress thought this difference could be bridged until partisanship intervened. Precious time was lost as the estimated date for bankruptcy advanced from 2002 to 2001.
What to do? Probably this is not the moment for a long-term solution to Medicare costs when the Baby Boom generation starts to hit retirement age in 2011. That may have to be left to a bipartisan commission. But there is an imperative for immediate action to deal with foreseeable problems in the 10-year span that is the target of the Clinton quick fix.
Since both parties are committed to the mantra of a balanced budget by 2002, it would help if both came out of the White House meeting stressing that the road to this goal leads right through Medicare. It can't be bypassed.
Pub Date: 11/12/96