Medicare's future

Toledo Blade, April 27, 2007

The Medicare mirror

THE latest warning on Medicare funding should be a reminder to everyone that the fiscal crisis facing the signature health-care program for senior citizens cannot be solved separately from that of health care in general.

And, with the first of 78 million Baby Boomers nearing retirement age, Medicare's plight is only going to get worse.

But we already know that. What we haven't figured out yet is how to contain the disturbing escalation of health-care costs, which may have slowed some but still seem to be growing at about 7 percent year after year.

One thing seems certain: The Bush Administration has no workable solution and is content to let the problem slide into the lap of whoever occupies the White House next.

The Democratically controlled Congress has other ideas, but so far a hard-line group of Republicans in the Senate, including Ohio Sen. George Voinovich, have managed to bottle up useful reforms, most recently a measure that would allow the government to negotiate lower drug prices with the pharmaceutical companies.

Having put Big Pharma on the government subsidy dole with the lavishly expensive Part D benefit, these GOP druggies - addicted to industry campaign contributions - have done nothing to solve and everything to exacerbate Medicare's fiscal problems.

According to the Center on Budget and Policy Priorities, Medicare now is overpaying private insurance companies by more than $10 billion a year through optional managed-care programs that were supposed to reduce costs but instead have boosted spending an average of 12 percent per patient. These so-called "Advantage" plans cover 20 percent of Medicare recipients.

With that kind of witless management, it's no wonder that the increase in Medicare costs over the past 30 years has mirrored the overall rise in American health-care expenditures.

A report this week projected that the Medicare program will hit red ink in 2019 - just 12 more years.

If Congress and the occupant of 1600 Pennsylvania Avenue put off action until the last minute, the solution for bolstering the program most likely will have to be a stunning tax increase or benefit cut, or perhaps even a painful combination of the two. More moderate remedies could be had by acting sooner, which is certainly the preferable course.

It's probably too much to expect that these problems be hashed out in the course of the 2008 presidential campaign. Political campaigns don't often provide successful incubation for solid policy ideas.

Nothing, however, is to be gained by delaying what needs to be done to place Medicare on a solid footing once again.