Gop Gun-shy About How To Cut Medicare

ON THE POLITICAL SCENE

July 15, 1995|By Karen Hosler | Karen Hosler,Washington Bureau of The Sun

WASHINGTON -- Medicare is scheduled to be shrunk dramatically, but the elderly won't learn how the changes will personally affect them until just days before Congress tries to make its plan a law.

The GOP timetable calls for the Medicare bomb to drop about mid-September, followed by a blur of legislative activity building to an Oct. 1 deadline for approval of all budget-related measures.

"There's no issue that's more important in the next six months than Medicare," House Speaker Newt Gingrich told the Republican National Committee yesterday in Philadelphia.

But Medicare is also the most politically explosive element of the GOP drive to balance the budget.

So the Republicans are waiting until the last possible moment to unveil such unpalatable details as Medicare premium increases and benefit cuts -- much to the exasperation of congressional Democrats.

"They're trying to keep all the details in the dark," protested House Democratic leader Richard A. Gephardt of Missouri. "We think the American people should have a chance to be involved."

The Oct. 1 deadline almost certainly won't be met. Fallout from Medicare and other radioactive issues could well keep the lawmakers battling among themselves and with the White House until Christmas.

But at least the Republicans will be able to spare their members from attack by angry seniors during next month's summer recess.

"Why paint a target on your behind all during the summer when news is slow?" political analyst Stuart Rothenberg said of the Republican strategy.

The Republicans remember well how easy it was to kill President Clinton's health care reform proposal last year once fearful constituents began complaining.

For the record, Republican leaders contend that they can't release details any sooner than September because they haven't agreed on the final form of the most sweeping overhaul ever of popular health care program for the elderly, which is 30 years old this month.

House Majority Leader Dick Armey said: "Why would we start giving detailed expositions of a very complicated policy change in Medicare until we've worked it out?"

But House Democrats, who watched the dizzying speed with which the Republicans put together and passed a whole set of complicated policy changes during the first 100 days of this Congress, say they aren't buying that.

"They're just winding up to give us a sucker punch," Rep. Earl Pomeroy, a North Dakota Democrat, said of the Republicans.

It's already clear that the GOP Medicare plan will be nearly as bold in its way as what Mr. Clinton had in mind to overhaul the entire health care system.

The Republicans are expected to try to end the open-ended entitlement program, which basically pays all Medicare costs on a fee-for-service basis in return for a relatively small premium.

Instead, the GOP will propose a voucher system that provides Americans age 65 and older with a health care chit they can use however they choose.

Because that chit will be a fixed amount, Medicare beneficiaries are expected to favor managed care health programs that reduce costs by closely monitoring services.

But moving to a voucher system is likely to save only about $60 billion of the $270 billion the Republicans must trim from Medicare over seven years to meet their goal of balancing the budget by 2002. Higher premiums and deductibles, as well as slashed fees to doctors and hospitals, are also surely on the way.

Winning enactment of these cuts is critical to the Republicans because Medicare is the principal cash cow of the balanced budget effort.

The $270 billion Republicans voted last month to wring out of the program represents nearly one-third of the $898 billion total they agreed to cut from federal spending by 2002. Only Medicaid, the health care program for the poor, comes close -- with a $182 billion total reduction.

Nearly all the other non-defense programs are being asked to contribute a total of $190 billion over seven years.

Battles now being waged on the House floor over spending for housing, schools, the environment and transportation are expected to result in total cuts of $22 billion for the coming year.

Those are the deepest spending cuts ever in one year, but merely "chump change" compared with what's coming for Medicare, said Rep. Steny H. Hoyer, the Maryland Democrat.

In fact, the only item in the GOP budget to rival the Medicare cuts is the Republicans' $245 billion package of tax cuts, which the Democrats love to say is the reason why the GOP is squeezing the elderly.

Democrats have been trying for months to churn up public alarm and outrage over Medicare but are frustrated at the lack of response.

"A $270 billion cut doesn't mean a thing," said Mr. Gephardt. "It has to be translated into specific actions that affect real people."

"When you say the premium's going to be doubled on Medicare, then people can understand what's going to happen to them," he said.

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