For six years Congress debated whether to add prescription drugs to Medicare. Finally, the House and Senate have worked out separate bills that promise to provide, according to their press releases, universal coverage. Why is Congress committing to Medicare reform now, after six years of stalemate? It has everything to do with the upcoming election.
Democrats are supporting the Medicare prescription-drug plan because they're gambling that seniors will neglect to take advantage of the new options with private companies, preferring instead to keep their Medicare simple. If that turns out to be the case, then Democrats end up with a $400 billion infusion into Medicare - just the sort of bloated entitlement they are always fighting for. Or, as former Medicare administrator under the Clinton administration, Nancy-Ann DeParle, said to the Washington Post: "Democrats should do everything they can to whisk (the Medicare bill) to (Bush's) desk. In signing it, as he will surely be forced to do, he will preside over the biggest expansion of government health benefits since the Great Society."
For their part, the Republicans are gambling that even the whiff of reform will help endear the party to the aging baby boom generation and corral valuable votes in 2004. Since the bill doesn't take effect until 2006, they can boast Medicare reform before it actually happens. This way they won't have to answer pesky questions about cost overruns.
History tells us that adding a prescription drug benefit to Medicare will almost certainly push Medicare beyond its budget. Of course, Medicare has a long history of exceeding its costs. When the program was first instituted in 1965, the projected cost 25 years out was $9 billion. The actual cost in 1990 was $67 billion.
Expect more of the same with Congress' most recent tinkering. Republicans know this. That's why they spent the better part of the last 15 years opposing proposals for government-controlled health care precisely like this one. Their response was downright vitriolic when the Clinton administration proposed similar reforms. At the time, Republicans argued that universal coverage would perilously intrude on the drug market, stifling research and the discovery of breakthrough drugs.
Now they're supporting it because it looks like another feather in the president's cap. Very good. But meanwhile Medicare continues to become the most bloated spending program out here. Currently, it consumes 70 percent of all federal spending. That's more than twice what it gobbled up just four decades ago. That means less money for schools or even for national defense.