WASHINGTON -- President Bush's proposal to triple Medicare premiums for upper-income senior citizens and cut the program's budget has drawn fire on Capitol Hill, where some lawmakers warn of a looming national health-care crisis.
"He is dividing the elderly," says Maryland Rep. Benjamin L. Cardin, D-3rd. "The Medicare system was not intended to be a class system for certain income levels. It was intended to be a health-care system for all the elderly."
The Bush package has prompted growing opposition from senior-citizen advocates who fear that the Medicare cuts will push many elderly Americans into poverty.
Senior citizens also are angry that Bush went beyond a 1990 bipartisan budget agreement to limit Medicare cuts to $44 billion over the next five years, and proposed cutting another $2.9 billion from Medicare in his fiscal 1992 budget.
"Frankly, the administration's commitment to Medicare must be questioned in light of this, most recent in a string of broken promises," a new senior-citizen coalition wrote in an open letter to Congress last week.
Spearheaded by the American Hospital Association, the coalition represents 16 hospital, physician, government-employee and senior-citizen groups.
"We thought the substantial cuts agreed to last fall would be sufficient for five years," said John Rother, legislative director of the American Association of Retired Persons. "So we are quite concerned about the attempt to go back and cut once again. The White House is, in effect, not honoring the understanding that was agreed to in the fall."
AARP also objects to Bush's proposal to triple Medicare "Part B" premiums for upper-income senior citizens. The plan would affect elderly people who are single and earn more than $125,000 a year, and couples with incomes higher than $150,000.
Part B covers physician services, outpatient hospital care and independent laboratory services.
Rother called the plan "a clever political ruse" designed to fend off criticism that Republican leadership is afraid to tax the wealthy.
Administration officials said the proposal will help offset burgeoning Part B Medicare costs.
The increase is "a fair way to make wealthier individuals shoulder more of the burden," said Health Secretary Louis W. Sullivan on introducing the plan.
Rother argued that the nation's health-care delivery system needs a complete overhaul, particularly in long-term care. But he predicted that Congress is unlikely to take action soon.
Many legislators are still gun-shy after last year's controversy over the Medicare Catastrophic Insurance Act.
In 1989, Congress enacted the bill to provide a catastrophic-health-care package after getting assurances from AARP and other groups that senior citizens were behind it. But the backlash against the higher premiums the plan required was strong that Congress was forced to repeal it last year.
"Folks are still stinging from catastrophic," said Rolfe Damman, an aide to Maryland Rep. Helen Delich Bentley, R-2nd, referring to the catastrophic health insurance issue. "And, while the level of debate will increase dramatically, there won't be an overhaul for at least another session."
"I think it's reasonable," Maryland Rep. Wayne Gilchrest, R-1st, said of the Bush proposal. "It reduces costs. And I think the fairness doctrine could be applied here. People with that amount of income can probably, in most circumstances, afford to pick up the slack."
Some Maryland lawmakers agreed with Cardin that charging upper-income senior citizens more for Medicare undermines the integrity of the system.
Sen. Barbara A. Mikulski, D-Md., believes such a move risks turning Medicare from a broad-based insurance program into a welfare program, said her spokesman, Mike Morrill.
"She does not support means testing, because it destroys the original concept of Medicare as a social insurance program," said Morrill. "And, if you begin chipping away at the broad base of support, you wind up creating bigger problems in the future."
Cardin also warned that charging wealthier senior citizens more to participate in Medicare may encourage some elderly participants to opt out and dilute the quality of the program.