IT MAY be an understatement to call President Bush's plan to substantially reduce federal spending on the Medicare an exercise in futility.
According to recent reports, the president wants to cut the growth of Medicare spending by about $20 billion. Although this would amount to only a reduction in spending growth, it would require scaling a political mountain that's defeated all challengers in the past 20 years.
Medicare costs [rose] from $33 billion in 1980 to more than $100 billion by the end of the decade. But the cost-cutting measures enacted by Congress have been limited and disjointed, and often have been offset by expansions in Medicare benefits. Also, when Congress substantially expanded the Medicaid program for the poor, it included a mandate that Medicaid pay Medicare premiums for retirees with incomes up to 20 percent above the federal poverty level.
Federal health care spending is driven by a powerful coalition of politically active retirees, well-heeled members of the health care industry and various social welfare advocacy groups. This coalition exerts great pressure on congressional representatives who tend to find fiscal indulgence more politically rewarding than fiscal restraint.