By attempting to liken GOP presidential nominee George W. Bush to
former Republican House Speaker Newt Gingrich — the politician the
press and the Democrats demonized to death a few years back —
Democratic White House hopeful Al Gore has finally shown voters just how
desperate his campaign really is.
Gore tried to make the connection over Bush’s support for Gingrich’s
alleged “plan” to — now get this — “dismantle Medicare” and (you
guessed it) throw millions of old people off the dole and out into the
streets, leaving them without (the coup de grace here) “adequate
health care.”
Yada, yada, yada. Heard it all before, Mr. Gore. “If you can’t
convince ’em, scare ’em!”
Gore has a severe case of “selective memory” when it comes to the GOP
Medicare plan of 1995 and the Clinton administration’s eventual
support for a version of it.
It’s true that House Republicans wanted to cut some Medicare spending
— that is, if you consider a reduction in overall increases in
Medicare actual cuts. Only Washington’s elite beltway boys and
girls do math this way — which is probably why our nation’s public
school students rate last in math among the world’s industrialized
countries.
The GOP wanted to cut the rate of Medicare spending growth —
not “dismantle” the Medicare program (which is patently absurd) —
because lawmakers knew back then that within a decade tens of millions
of baby boomers are going to be ready to retire and, without reforms,
there won’t be enough workers earning enough tax money to pay all the
new beneficiaries all of their new benefits (like drug coverage).
But the 1994-95 GOP class made its projections using 1995 dollars —
before the huge government tax windfalls, before the huge
trillion-dollar budget surplus began rolling in, and before Gore began
listening to campaign advisers who began giving him bad Medicare issue
advice.
After Republicans — and Democrats — worked the numbers over
the next two years, the Clinton-Gore regime finally faced the reality of
projected Medicare funding and benefits shortfalls and backed the GOP
reform measure, albeit in a reduced form. In 1997 and instead of backing
$360 billion in spending increase reductions, Clinton signed a bill into
law mandating $112 billion over the next several years instead.
But as I said, there never really was a cut. The bill only
called for reductions in the growth of Medicare spending
increase. In reality — Mr. Gore, pay attention here — the
budgetary line item for Medicare has actually increased each year
since Clinton signed the measure.
Mr. Gore knows that. He has always known that. Now you do too.
Gore, though, is choosing to forget about these details,
because if he were being honest he would not now be blaming “corporate
insurers” and Health Maintenance Organizations for making the decision
to stop accepting Medicare patients.
Though Medicare funding overall has increased under Clinton-Gore and
the GOP Congress, getting the government to actually pay for
covered expenses is like pulling healthy teeth out of a hungry lion’s
mouth. Ask your doctor — or any doctor- — just how hard it is
to get reimbursed for covered Medicare expenses. Physicians will tell
you because they — unlike Gore — know how messed up the
government’s Medicare program really is.
HMOs are experiencing the exact same problem; they too cannot get the
Clinton-Gore Health Care Financing Administration — which manages
Medicare payments — to cough up money specifically budgeted by
Congress for the expenses Medicare patients incur on doctor visits.
That’s not George W. Bush’s fault; it’s not Newt
Gingrich’s fault; it may not even be Al Gore’s fault — but for Gore to
blame poor HCFA-mandated Medicare reimbursements on Bush or Gingrich is
the worst kind of political pandering to a class of Americans — senior
citizens — who deserve a hell of a lot better than they’ve been getting
for the past seven years.
At the same time Gore is also blaming “big corporate HMOs” for
dropping coverage of Medicare recipients. Yet he fails to enlighten us
just how it is that private industry HMOs have the authority to
influence government-run Medicare, or how private insurers have
somehow mysteriously inherited the authority to tell the federal Health
and Human Services department what to do.
HMOs don’t make the rules for Medicare fee and coverage compliance —
HCFA does; in other words, the Clinton-Gore administration does.
So if insurers must drop a million senior citizens on Medicare because
they’re not getting paid by the administration, how can that be
their fault?
I have an answer. Gore habitually and instinctively blames corporate
America for every problem ever encountered — or created — by
the current administration. So it’s no wonder that now he is blaming
lousy Medicare reimbursement rates on “big HMOs” — even though they
don’t control how they get reimbursed.
Many people believe that whatever a doctor or HMO “charges” a patient
that Medicare automatically pays that exact amount. They don’t, and in
some cases the reimbursement rate is less than 50 cents on the dollar.
Try running your business for long by getting paid half
of what you are owed. That’s just what Gore expects the HMOs and doctors
to do, however.
The irony here is that HMOs became what they are only when first lady
Hillary Clinton began threatening to socialize the entire U.S. health
care industry. Insurers and physicians, health care providers and
medical business leaders already saw what a disaster that could be (see
Canada), so they decided to try to prevent being regulated into poverty
while the U.S. health care industry became akin to that found in a
third-world toilet.
Rightfully fearing overt, financially devastating, over-regulatory
edicts imposed by the Clinton administration, health insurers banded
together to form coalitions that attempted to offer basic health
services and other extended and surgical care services for less money
than they could afford to offer individually.
In the process HMOs co-opted physicians by deciding themselves what
patients did or did not need; tests they should or should not have;
operations and procedures that were or were not medically necessary.
That was wrong and indeed that needs to be fixed because only a doctor
and a patient should make health decisions.
The point is these groups formed because of a perceived threat from
the Clinton-Gore regime. In many cases they overreacted, but only
consumers, doctors, and smaller medical groups — not Uncle Sam — can
force changes by making other insurance choices. The government could
(and should) help by removing burdensome rules that would help
reestablish physician control and foster consumer choice.
The point here is that the government needs to get out of the health
care and insurance business altogether. Lawmakers cannot cut Medicare
out in one year, but over several years through reforms and the repeal
of various mandates and regulations, Americans can and should be
encouraged to provide for their own retirement and medical care.
Then we won’t have to listen to politicians scare people with lies,
innuendo, false information and purposeful redirect of blame for policy
failures.
