Medicare in the '96 Elections
Among the many differences between President Bill Clinton (Democrat) and
Presidential Candidate Bob Dole (Republican), lays a common debate topic,
Healthcare. The issue is the fact that funding in Medicare's budget will not
last but another four years. Both Republicans and Democrats have ideas on
how this budget should be reformed, but the two have not yet come to a
median resolution. In the beginning of the Presidential campaign Medicare was
a hot topic. It will be shown that as Election Day drew nearer Republicans
were forced to attack President Clinton's policy because they had no
substantial plan of their own.
Prior to 1965, payment for a particular medical service was paid for either
directly by the recipient of the care or by the recipient's insurance
company. Usually to get full coverage or even coverage with a low premium
the rates are outrageous. For this reason many poor, elderly and severely
disabled Americans were unable to receive proper medical treatment. Then, in
1965, Lyndon B. Johnson proposed one of his Great Society programs, Medicare.
Medicare would allow those who were severely disabled, elderly or poor to
receive quality medical treatment without worrying about the cost . This
government funded program would subsidize the service of physicians, inpatient
hospital care and some limited home care. The money would come from that
money set aside for Social Security. Medicare, along with its sister program,
Medicaid, allow broad access to physician and hospital care to all disabled
Social Security recipients, most all elderly and some of the poor.
Medicare has two parts, A and B. Part A, which covers all enrollees,
covers hospital costs only. Part B, also known as Supplementary Medical
Insurance (SMI), is an optional plan for which a premium is charged. The
SMI plan covers 80 percent of office visits, preventive medicine, surgery and
diagnostic specialties (x-rays, etc.). What Medicare does not cover include:
hospital stays over 60 days, extended nursing-home care, or the cost of
lengthy illnesses. In the cases where Medicare will not cover costs,
recipients usually use secondary retirement programs either from pension plans
or retirement programs such as AARP (American Association for Retired People).
Those who do not have such plans, are forced to drain their assets until
they qualify for the sister program Medicaid.
Medicaid is a program set up the same as Medicare but primarily for those
who fall short of the state-specified income level. Costs covered by
Medicaid are close to those covered by Medicare differing only by nursing-home
care and treatment in state mental hospitals . In 1965, at the same time
the U.S. began bombing Vietnam, those who were involved with planning the
budget for Medicare failed to foresee the fact that funding would not last
past the year 2000. This error is what led each party to devise its own
plan for reforming the program.
Richard Feinberg, Ph.D. the Executive Director at Purdue Retail Institute in
his writing, The Clinton Health Care Reform Proposal, outlines a few goals
and restrictions of Clinton's proposal. The three main goals are as follows:
Control the costs of Health Care, Guarantee comprehensive coverage, and
improve the quality of care. President Clinton began his campaigning in what
looked to be like a relatively clean manner, as one reporter put it, "It
looked in the beginning as if President Clinton were already a 'shoe-in'...
he clearly stated his actions and anticipation for the direction of Health
Care." The confidence of President Bill Clinton was prevalent. He spoke of
his actions as definite future President and not "if I become...." This
confidence allowed him to focus on the important issues such as making clear
his position on Health Care and outlining steps to take in order to
accomplish his goals.
While Republican hopeful Bob Dole criticized the President's plan, he had no
concrete plan of his own. According to Senator Bob Kerry, the Republican
"balanced" budget plan is a phony; "we'll tax our children to poverty --
unless we get control of Medicare." GOP Senator John Danforth agrees that
the Republican proposal is tenuous but goes on to say, "...it [Medicare]
should definitely be means-tested, without a doubt." By means-tested, Senator
Danforth means each potential recipient of Medicare should be screened: the
more money one has, the less government support he/she should receive. This
sounds good in theory, however, when everyone receives the same deductions
from their pay, they tend to want equal claim to their portion of the
support.
President Clinton's Plan would give everyone equal access to the service. To
support this he would require employers to subsidize 80 percent of the costs
of a standard benefit package , other financing would come from a new tax on
tobacco and alcohol products which is projected to raise $100 billion over
the next six years. Clearly we see that President Clinton's plan has been
thought out and analyzed quite a bit more than that of the Republicans.
This is due in part to the confidence President Bill Clinton had on the
campaign trail. He was able to maintain domestic relations and negotiations
while actively seeking reelection.
Obviously doctors are a key target in the proposals. The President can draw
upon two options: Force doctors to accept Medicare patients and receive only
a set amount of reimbursement, or Offer certain benefits to those doctors who
accept Medicare patients. More than likely, these "benefits" would entail a
higher reimbursement for the doctors, which would clearly come from Medicare's
budget, and in turn require more money to be allocated. In Doctor Feinberg's
write up of Clinton's plan, An Analysis by the Professionals, he says, "Yes,
it will limit our [doctor's] options, yet we gain the safety of the
Proposal's Malpractice clause" The malpractice clause of which Doctor Feinberg
writes would limit the amount doctors and their hospitals could be sued.
This would prevent the cases blown out of proportion from ending in million
dollar settlements. This cap would only be eligible for those doctors who
are members of particular regional alliance.
The question raised by Lewis Lord of U.S. News and World Report is why not
require the doctors who are already members of particular medical associations
(alliances) to treat a certain number of Medicare patients in order to
maintain coverage under that association. The Assistant Manager of Vascular
Services for Good Samaritan and Bethesda Hospitals, Susan Mueller, says that
in some cases doctors would rather maintain a relatively private practice
where they could earn a good deal more than being in an alliance and take
their chances with a malpractice lawsuit.
Many experts believe that with a Republican majority in Congress, numerous
minor propositions will be added in favor of the Republican view. These
propositions are expected not to change the final Reformation Proposal but
rather to shape the Plan into a "balanced" plan that should be agreed upon
by both parties.
" Republicans will definitely reform Medicare, most likely evoking less opposition than
what was aroused in the campaign year ... passing 'little things' such as expanded
medical leave for parents of sick kids."
It is expected that Republicans will attempt to make minor changes to the
overall Democratic Reform Policy, and in the eyes of Michael Barone this is
good for maintaining a balance between the conservative and liberal ideas for
reform. As Mr. Barone goes on to say, many of the changes that the
Republicans make will draw far less attention as they would if they were
done during the campaign/election process. This is due in large part to the
fact that political leaders can twist the meaning of their opponent and make
their intentions seem unthinkable to the common man.
No matter what the Reform Policy ends up including, the one thing both
political parties agree upon is the necessity of the Plan soon. Statistics
show that without a Reform Policy this country, by the year 2005, will be
407.8 billion dollars in debt to Medicare ONLY . Now we can see that amid
the differences between both parties lays a common solution; the ways by which
to reach that solution may differ, but the country is aware that the longer
our government plays childish debate games, our economy slips deeper and
deeper into debt. Much like in 1965 when President Johnson's department
established Medicare, it solved an immediate dilemma, but resulted in problems
in the future. Odds say that Clinton's plan is solving an immediate problem
but may create problems in ten to fifteen years when the baby-boomers begin
to retire. As in everything else, says Lewis Lord, you fix the only things
you can see. It seems that when Clinton finally gets the Reform Proposal
passed it will fix only what we can see.
Bibliography
Barone, Michael. "What a New Crew Might Do." U.S. News and World Report. (September
23, 1996).
Cohen, Joel. Grolier Electronic Publishing. "Medicaid" (1993).
Cohen, Joel. Grolier Electronic Publishing. "Medicare" (1993).
Dole, Bob. "Meeting Challenges of the Next American Century." USA Today. (November,
1996).
Feinberg, Richard Ph.D. "An Analysis by the Professionals." Purdue Department of
Political Science, 1996.
Feinberg, Richard Ph.D. "The Clinton Health Care Reform Proposal." Purdue Department of
Political Science, 1996.
Folz, Ann-Marie. An Ounce of Prevention. New York: Simon & Schuester, 1988.
Gaffney, Janet. "1996 Election in Review." USA Today. (November 1996).
Klein, Joe. "Pretty Close to Awful." Newsweek. (September 16, 1996).
Lord, Lewis. "A Bankrupt Medicare." U.S. News and World Report. (June 17, 1996).
Stevenson, Daniel. "Health Care Reform Requires Passage of Clinton Plan." San
Francisco: Tech Publishing, 1996.
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