Medicare in the '96 Elections
11 / 25 / 96
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.
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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