It's time for a moratorium on the posturing and dissembling in the debate on Medicare spending growth reductions.
Republican proposals for balancing the budget by 2002 have unleashed a rhetorical firestorm following their adoption by House and Senate budget committees. As difficult floor debate unfolds over which programs will be reined in and by how much, some participants should take advantage of the opportunity to clean up their acts.
Two years ago President Clinton was defending his ill-fated Health Security Act and bemoaning the runaway costs of Medicare and Medicaid. Clinton's plan would have reduced spending for the two federally supported health programs by an annual average of $66 billion over a 10-year period. Combined spending still would have been rising at twice the rate of inflation, and Clinton insisted quality wouldn't suffer.
Now the Republican Senate budget resolution calls for savings averaging $65 billion each year for seven years, and the House resolution calls for $69 billion annually during the same period. But the administration alleges such cuts are Draconian and will lead to second-rate or reduced healthcare. Clinton's hypocrisy deserves denunciation.
Newt Gingrich and the GOP
Republicans have offered few details of their spending blueprint, but House Speaker Newt Gingrich (R-Ga.) would have Americans believe that Congress can cut taxes and provide a new and improved Medicare system without asking seniors to pay more. This is hogwash, pure and simple.
Republicans will be forced to rely on some of the same proposals that were part of Clinton's reform scheme. These include cuts for providers, increased copayments from patients and more choice restrictions. The latter is ironic, because Republicans last year blasted Clinton for healthcare proposals they said would reduce choice.
Healthcare providers are striking some sour notes with their oft-repeated song warning that Medicare reductions will cripple hospitals and reduce quality. Most Americans believe much healthcare can be delivered more efficiently. The public also recognizes that the government must get control of spiraling federal healthcare expenditures.
Executives are devoting too much time and attention to turf battles and efforts to expand market share, and not enough to operational reorganizations that yield significant efficiencies. They aren't likely to get much sympathy from employees of other enterprises-airlines, banks and the automotive industries come to mind-that have transformed themselves because of the threat of new competition and technology.
Executives should encourage Congress to nix the idea of a bipartisan commission to recommend changes in Medicare. Lawmakers know all too well what the options are. Instead, they should make the hard choices required to fix the program.