Clinton's criticism of Bush's plan to cap cost of Medicare is questioned


September 03, 1992|By Gilbert A. Lewthwaite | Gilbert A. Lewthwaite,Washington Bureau

WASHINGTON -- Bill Clinton's assertion that President Bush's plan to cap Medicare would cost the average elderly beneficiary $2,000 over five years is open to question, the record reveals.

The accusation was widely seen as an effort by the Democratic presidential candidate to frighten elderly voters away from voting for Mr. Bush and as an aggressive response to similar campaign scare tactics the Republicans have used against him.

"George Bush's new budget hits hardest at older Americans who worked their way out of the Great Depression," Mr. Clinton told a group of senior citizens in Macon, Ga., Tuesday. "George Bush's budget makes the average Medicare beneficiary pay $2,000 more over five years."

The Arkansas governor said the figure was based on the administration's mid-session budget review, issued by the Office of Management and Budget in July.

But the review contained only a broad outline of Mr. Bush's proposal to cap entitlement programs, including Medicare and Medicaid, by limiting their growth to the yearly increase in the eligible population plus inflation. To allow for an "orderly transition" to the capped levels of spending, Mr. Bush proposed an extra 2 percent growth in program funding in 1993 and 1 percent in 1994. That was all the detail of his proposal in the mid-session review.

Mr. Bush has been deliberately vague on exactly how he would implement any spending cap, but he has guaranteed that Medicare benefits will keep pace with inflation.

As an appendix to the mid-session review, the administration included possible approaches to capping programs advanced by various think tanks. Budget Director Richard G. Darman specifically said at a briefing in July that the administration did not endorse any of the proposals but simply was listing them as examples of what might happen.

Among the listed Medicare-capping proposals was a string of options originally outlined in February by the Congressional Budget Office in its annual report to Congress, "Reducing the Deficit: Spending and Revenue Options."

These involved shifting $72 billion in spending over five years from the government to Medicare beneficiaries through increased premiums, co-insurance, deductibles and payments. Such a shift would leave the 35 million elderly recipients of Medicare facing an average increase in out-of-pocket outlays of just over $2,000 over the five-year period, according to a CBO official.

But Mr. Clinton did not get his $2,000 figure from the Congressional Budget Office. According to campaign officials, it was based on an analysis of Mr. Bush's proposed health care reforms issued this week by Kenneth E. Thorpe, associate professor of health policy and administration at the University of North Carolina School of Public Health.

Mr. Thorpe said yesterday that he used the Congressional Budget Office figures in the appendix of the administration's mid-session review to arrive at a $65 billion shift in spending to Medicare recipients. Dividing that by the number of recipients, the Clinton campaign, in turn, arrived at the $2,000 figure.

In his analysis, Mr. Thorpe wrote: "The president has identified nearly $65 billion (between 1993 and 1997) in possible new co-payments shifted to the elderly."

Records do not show that Mr. Bush has ever "identified" the precise cuts or that the $2,000 figure was in the administration's mid-session review, as Mr. Clinton said.

Mr. Thorpe said yesterday that the inclusion of the CBO proposals in the appendix to the mid-session review indicated to him that the administration was seriously interested in them.

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