Prescription drug benefits. Lowering Medicare eligibility to 55. A chicken in every pot.
The government giveth, and, as healthcare executives have discovered with the Balanced Budget Act of 1997, the government taketh away.
Now politicians are eyeballing the big budget surplus and the year-2000 elections. The goal of members of Congress is to ensure their political futures, while scandal-plagued President Clinton frantically searches for a better place in the history books. Expanding Medicare entitlements might accomplish Congress' objectives and his.
Hospitals and other providers, meanwhile, are looking for some relief from Medicare reimbursement cutbacks. Good luck.
As they try to ease the squeeze, healthcare lobbyists would be wise to add a dose of reality to the debate over Medicare benefit enrichments.
Clinton says he believes that giving a prescription drug benefit to Medicare beneficiaries could save the government money by reducing the need for hospital stays and nursing home care. He also says no price controls on drugs will be necessary to pull off this act of legerdemain.
If the guy inhaled, one would be tempted to ask what he's smoking.
More rational voices in the administration are backpedaling, estimating the benefit could add billions in Medicare costs, regardless of the premium increase.
As the president's plan unfolds, the public needs to be reminded of health insurance industry estimates that a drug benefit would cost as much as $1,200 per year per Medicare beneficiary. Meanwhile, the National Academy of Social Insurance, an independent think tank, projects a drug benefit would add between 7.2% and 10% to Medicare costs, which would equal about $17.5 billion to $24 billion in 1999.
And certainly hospital lobbyists should have something to say about an administration claim that every $1 increase in pharmaceutical expenditures is connected to a $3.65 reduction in hospital care.
A lot has changed in healthcare since Medicare was hatched in the 1960s. Hospital stays are shorter, and surgery is less invasive. The use of outpatient care and drug therapy has skyrocketed.
The Medicare program badly needs reform-especially a benefits package that reflects marketplace realities. As the Medicare debate continues, we can only hope lawmakers and voters deal with information realistically.