BY MEGAN ARNEY
In the name of proposing a "reform plan" for Medicare June
29, President William Clinton took the lead in attacking the
34-year-old national medical entitlement for the elderly.
The White House scheme aims to weaken Medicare as an entitlement, increasing the payments workers make out of their pockets for the limited coverage it provides. Clinton says the plan would cut $72 billion from the government budget over 10 years.
Medicare, which provides medical benefits for those who are disabled or over the age of 65, was established in 1965. Along with Medicaid, which provides medical coverage for low- income families, it was a by-product of the gains of the civil rights movement and an extension of the 1935 Social Security Act.
Anyone over the age of 65 is eligible for Medicare at a cost of $45.50 a month; 39 million people receive coverage.
Clinton touts his plan as an expansion of Medicare because it will allow recipients to purchase additional coverage for prescriptions drugs, which currently must be paid out of pocket. There are substantial costs and limitations to this coverage, however. Medicare would cover half of the beneficiary's drug costs up to an annual limit of $1,000 for a monthly premium of $24 (or $288 a year) in 2002. The premium increases to $44 a month in 2008, with an annual limit of $5,000. All costs above these caps would be paid by the recipient.
The White House proposal also includes adding a 20 percent co-payment for clinical laboratory services, which currently costs nothing. The deductible for doctor's office visits - set at $100 per visit since 1991 -would go up $2-3 each year.
The scheme would also push more Medicare patients into health maintenance organizations (HMOs), which often offer poorer quality care, especially affecting working people who cannot afford private insurance. Cuts in Medicare payments to most health care providers from 1997, which were due to expire in 2003, will be extended.
As part of the package, Clinton revived his earlier scheme to "adapt" Medicare to include U.S. citizens between the ages of 55 and 65. Instead of lowering the age for eligibility, since 3.2 million people between the ages of 55 to 64 are uninsured, the president proposed allowing laid-off workers age 55 or older the option to pay up to $400 a month for health benefits. Medicare recipients between 62 and 65 would pay $300 -still well out of reach for many who need it.
This Medicare proposal is still to be debated before Congress. The Clinton administration has already led greater inroads against Medicaid. A recent study by Families USA, reports that 675,000 people - including 420,000 children - lost Medicaid coverage in 1997 because of the Clinton administration's assault on welfare. That was the year Aid to Families with Dependent Children (AFDC), the main federally funded cash relief program set up in 1935, was eliminated.
According to the study, at least one in five former welfare recipients do not have medical insurance today. In New York City, a Federal district judge ruled that thousands of people were improperly denied Medicaid at city welfare offices.