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Medicare set to "wither on the vine" by Ramon Castellblanch | ||||
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The following column was written by Ramon Castellblanch, an assistant professor of health education, and an expert on the recently passed Medicare bill, health policies and long-term care. The views expressed in this column do not necessarily reflect the views of the University. On Dec. 8, President Bush signed the Medicare bill into law with Republicans beaming by his side. They had reason to gloat, since they achieved the first STEP in their drive to make Medicare shrivel JUST WHEN BABY-BOOMERS BEGIN TO NEED IT. Eight years ago, then-House Speaker Newt Gingrich outlined the long-term plan. In a speech to Blue Cross in October 1995, he said he didn't want to "get rid of (Medicare) in round one" because it wouldn't be "politically smart." Instead Gingrich said Medicare is going to "wither on the vine." The bill the president signed provides for cuts in federal support to Medicare that will start the withering process. The hatchet for these cuts is hidden deep in the Medicare law in a section ironically entitled "cost containment." That section requires the Medicare trustees to predict, seven years in advance, when 45 percent of Medicare's income will be from federal general revenues. Since the 45 percent mark is likely to be met around 2017, the trustees will submit their prediction around 2010 -- the year the first Americans born after World War II turn 65. The law then requires the president to send to Congress a plan to cap federal spending on Medicare -- most likely with huge program cuts. The bill requires that the plan be put on a congressional "fast track." Fast track is Congress' way of doing something highly unpopular, such as passing free-trade or base-closure bills. A preview of these likely cuts was in this year's Medicare law. It requires some Medicare beneficiaries to pay 80 percent of the monthly cost of their Medicare Part B (physician insurance) premium -- or nearly $200 a month -- to maintain coverage. Although, for now, this will be the premium for high-income seniors only, its high price provides a model for how to charge seniors with lower incomes for Medicare in 2010. Right now, monthly charges for Medicare coverage are $58.70 for people who signed up for Part B when they were 65. In 2010, those monthly charges for hospital (Part A) and physician coverage could go to hundreds of dollars a month. The huge cuts could also include exorbitant deductibles and co-pays. Rising out-of-pocket costs would either force many seniors to forgo necessary health care or go out of the program altogether. For the first time in more than 40 years, the United States would have uninsured seniors. Baby-boomers have been paying into Medicare their entire working lives. They have helped to free their grandparents and parents from worry over medical bills. Now, they better start thinking about their own retirements with little or no health insurance. They better consider how they will handle medical bills with their home equity or any other resources they or their children might have. Thanks to the Republicans and Democrats who voted for the Medicare bill, and to the president who signed it into law, many baby boomers need to start planning for disaster today. -- Ramon Castellblanch is an assistant professor in the Health Education Department at San Francisco State University. He can be reached at ramonc@sfsu.edu or pmproj@progressive.org. © Ramon Castellblanch
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