The medical condition of the late Spanish dictator Francisco Franco was a recurring subject of media speculation. One day he was on the verge of death, the next healthy as a horse and the following week critically ill. This went on for years until the general finally passed away in 1975 at the age of 83.
Weeks afterward "Saturday Night Live" 's Weekend Update anchor Chevy Chase would dutifully report that Franco was still dead.
The Medicare hospital trust fund is the target of that same kind of topsy-turvy, shoot-from-the-hip prognostication. Earlier this month, trustees of the multibillion-dollar trust fund, which covers Medicare Part A payments, said it will stay solvent until 2008, seven years later than last year's estimate.
But before thanking the trustees for the new-found breathing room, remember that for the third straight year, expenditures from the fund exceeded revenues. It paid out $138 billion in fiscal 1997, while taking in $129 billion from working Americans. The gap was narrower than expected primarily because the Balanced Budget Act sliced payments to providers.
But this lease on life for the Medicare hospital trust fund is like saying a brain-dead patient on a ventilator will live longer than anticipated. When it comes to Medicare, the only sure bet is the devastating impact aging baby boomers will have on the trust fund.
Lower payments to providers will not be enough to save the current system from bankruptcy. That's why the National Bipartisan Commission on the Future of Medicare needs to show courage as it searches for ways to restructure the program. Once the panel settles on an actuarially sound strategy, politicians must sell radical change to wary voters, including the influential senior lobby. The political risks are high, but without the will to change the program, the hospital trust fund, like Franco, will still be dead.