Health Care Reform: Where Are We?
Health Care Reform: Where Are We?
By
Ken Eliasberg
Where are we today on our Health Care Reform journey? Somewhere between two 2,000+-page reform proposals — the one that was recently passed by the House, and the one currently under consideration by the Senate. In short, we are some way from passage of a final bill, but we are on a clear legislative glide path. First, the bill goes to the Senate floor for consideration by the full Senate. Thereafter, the final Senate bill will go to a Conference Committee, where it will be thrown in to the hopper with the Pelosi bill and pushed through the legislative meat grinder to produce the sausage that will be shoved down our throats (unless, of course, Nancy Pelosi, in the interest of producing something quickly, decides to just accept the Senate Bill in tact). In view of the bill’s still being in an embryonic state of development, a final critique at this point would be premature. That said, a couple of observations might help to put the current health care reform situation in perspective. That is, while it might be a bit premature to comment on the Bill’s final contours, it would not be out of line to address certain of the premises advanced in defense of the measure. For example, the underlying argument that the measure is “cost neutral.” I could say that if you believe that I have a bridge to sell you, but, for the moment, I’ll suspend such cynicism and merely point out what the Bill’s architects rely on to reach that conclusion.
Medicare Cuts.- A key provision relied upon to arrive at this cost-neutrality conclusion is the one that slashes Medicare costs by $500 billion (that’s a half a trillion dollars for those paying attention). Do any of you really believe that such a provision is going to get through Congress? We’re talking about our seniors here - you know, the group that relies heavily on Medicare, and, quite coincidentally, the group that shows up to vote in the largest numbers.
In addition, Medicare is in serious financial trouble, more serious than Social Security, which is slated to go completely bankrupt in the not too distant future. As I have previously observed, we have an unfunded liability of approximately 90 trillion dollars for Medicare. That means that if we were to provide for Medicare to be funded on a sound actuarial basis with respect to its current prospective beneficiaries, we would have to put that much in the Medicare fund. Granted, that that’s not the way it is typically done, but it does reflect an accurate statement of the debt with respect to which Medicare is pregnant.
We — to be fair, both Parties - have dealt with this problem (as well as that of Social Security) by something in the nature of not so benign neglect. Indeed, when Bush 43 tried to come up with something to address the Social Security problem, his proposal was soundly defeated and it may well have colored his prospects for a successful second term. No, both parties are guilty of kicking these 2 problems — Medicare and Social Security — down the road, hopeful that they would reach critical mass some time after the current batch of legislators were out of office. Political hackery is bad enough, but when you combine it with supreme cowardice it is not a pretty picture.
As far as hypocrisy is concerned — and here again, both Parties are guilty of slipping on this banana peel from time to time — the hypocrisy present in this case is monumental. Do you recall when, in about 1995, Newt Gingrich proposed to merely reduce Medicare’s rate of growth (since it was outpacing the inflationary rate present in other economic sectors) the fuss that the left made? For those of you who may have forgotten, let me help you — they were OUTRAGED! You would have thought that Republicans were proposing something which will undoubtedly be a significant feature of the currently proposed legislation, to wit the rationing of health care.
And, incidentally, we’re going to cut Medicare costs while adding some 30 million people to our Medicare rolls, i.e. those over age 55 — granted, on some sort of conditional basis, but that’s a start — the camel’s nose under the tent, so to speak. In this regard, Congressman Anthony Weiner’s comment is instructional. With regard to this feature Weiner observed ‘[E]xpanding Medicare is an unvarnished, complete victory for people like me [people who favor a single-payer option]. * * * It’s the mother of all public options. We’ve taken something people know and expanded it