He feels our pain.
So much so that William Jefferson Clinton cannot bear to ask the American people to make painful choices.
And he’s probably right. We aren’t ready.
How else to explain President Clinton’s switcheroo last week when he pulled the rug out from under the National Bipartisan Commission on the Future of Medicare?
Never mind that Medicare, the health-insurance program relied upon by 40 million elderly and disabled Americans, is terminally ill. Never mind that its Part A (hospitalization) Trust Fund goes bankrupt in 2008 or that its Part B expenses (doctor fees, etc.) are chewing into general revenues at an alarming and unsustainable rate. Never mind that the house of cards collapses in 2011, when 77 million Baby Boomers start filing claims.
As soon as Bill Clinton heard that the blue-ribbon commission was about to recommend less, not more; that they wanted to slide Medicare’s eligibility age back two years, to 67; that they didn’t add a prescription drug benefit for everyone and expected seniors to start covering a larger percentage of the cost via higher premiums and co-pays, the president marched onto the South Lawn of the White House and issued a statement.
The president said, in effect: Thanks, but no thanks. He will draft his own plan to save Medicare–a plan that won’t trim benefits, won’t raise taxes and won’t go broke.
This he announced less than an hour before the commission convened Tuesday for a final vote on what was supposed to be a consensus, tough-choices plan. And not surprisingly, the president’s appointees to the commission promptly voted “nay,” as did most, though not all, of the panel’s congressional Democrats.
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And so, failing by one vote to get the minimum 11 of 17 required by the commission’s charter, two years worth of work on America’s most vexing domestic policy dilemma was abruptly and unceremoniously shelved.
“We looked at some hard facts and had to make some hard choices,” said a disappointed Sen. Bob Kerrey of Nebraska, the only Democrat to vote “yes” besides Sen. John Breaux of Louisiana, the commission’s co-chairman.
These were courageous votes for Democrats to make. Especially after the president had just cut them off at the knees, claiming he can come up with a better, less painful alternative.
Republicans, of course, are assuming the worst. They’ve seen this act before on the eve of a presidential election. They remember 1996, when Clinton won re-election after repeating over and over again that Republicans wanted “tax breaks for the rich,” paid for with reductions in Social Security and Medicare. Now they envision Al Gore repeating the same charge, over and over again, on the 2000 presidential stump.
Not that the GOP learned anything last time around. The same day Clinton deep-sixed the Medicare commission’s prescription for pain, congressional Republicans unveiled their latest plan for massive income tax cuts–$778 billion worth over the next decade. That’s enough money to extend the solvency of Medicare, as is, for several years.
Clinton, of course, wants to extend the solvency of Medicare and Social Security by dedicating the lion’s share of future budget surpluses to that purpose. In effect, the nation would abandon any pretense that Medicare is a self-financed program, paid for with payroll taxes (the 2.9 percent levy that now feeds the Part A Trust Fund) and monthly Part B premiums paid by seniors (which now cover only a quarter of Part B costs).
This, by itself, is a major reconception of Medicare, a program that was supposed to pay its own bills, save for a 50 percent general revenue subsidy for Part B. But even if Clinton gets his way, and even if those future budget surpluses do materialize (which I doubt), Clinton’s $700 billion, 15-year cash infusion doesn’t come close to saving the program once Boomers start asking, “Where’s mine?”
What else will Clinton propose?
My guess is he’ll draw heavily on his ill-fated 1993 plan to steer almost everyone into managed care. Medicare eligibles still would be able to choose today’s fee-for-service plan, but incentives would be reloaded (generous pharmacy coverage, minimal co-pays) so as to lure a majority into HMOs. The HMOs, in turn, would negotiate ever-tighter deals with hospitals, physician practice groups and drug companies. Medicare would keep a thumb on HMO premiums, paying them just enough to offer a basic, government-approved menu of services and treatments.
Clinton’s plan, whatever it is, would delay the bankruptcy of Medicare, but it won’t change the inevitable. Not by midcentury, when there will be only two tax-paying workers for every recipient.
By then, though, the Clinton-Gore regime will be long gone. And in the meantime, we Boomers will go on getting our Viagra, our arthritis pain-killers and whatever else science lays at our feet.
Our obsession with unlimited health care can be seen on the cover of national news magazines, on TV news, on the self-help bookshelves. We want longer, better-looking, more active lives. We do not want to skimp on health care. Not our health care.
President Clinton understands this. The Sen. Kerreys of this world, courageous though they may be, do not. Say what you will about Slick Willie. What does that say about the rest of us?