Resolved: To Tell the Truth

Published January 1, 2004

My annual New Year’s resolution goes all the way back to the day my Dad administered some attitude adjustment while blurting out, “Always tell the truth, even when it hurts.” So here’s the truth: Color me conflicted.

Early in the Medicare reform debate I wrote in favor of the emerging plan, citing its potential to inject free enterprise, self-reliance, and individual initiative into an overly centralized and bureaucratic entitlement program, not to mention a prescription drug benefit for those who really need it. I was a little skeptical when it appeared Republicans and Democrats agreed on something, but I figured stranger things have happened before and we have dealt with them.

Reports of backroom deals started leaking out, and my DC contacts were being shut out of closed-door meetings. I saw flashes of the old Hillary Clinton Health Task Force meeting in secret. Then word came about the 10 year, $400 billion price tag hanging on the drug benefit, which included an entitlement for wealthy seniors who do not need it.

It makes sense, I thought, to update Medicare by including a drug benefit, because for every $1 we spend on new drugs, we save about $5 on hospital bills. Then someone asked me, “so why should the drug benefit cost taxpayers anything? Why wouldn’t it mean a savings for taxpayers, or at least come in revenue-neutral?” That, I thought, was a very good question … and it made me reconsider my support for the plan.

Medicare Angst

Now President Bush has signed the reinvention of Medicare, and competing interest groups are choosing to support or criticize one or the other of the reform measure’s many elements. The dueling opinions from AARP, talking heads, and policy wonks on both sides of the aisle have senior citizens really nervous over losing their health care entitlement as they know it.

Demonstrating the extent of this Medicare angst was a gutsy Floridian who spent $4,000 of his own money to run a full-page ad in the Tampa Tribune, slashing and burning the Medicare bill. He warned readers they were about to get their pockets picked by hospitals, doctors, drug companies, pharmacists, politicians, and bureaucrats. More than 15,000 card-carrying members of AARP have cancelled their memberships in protest of AARP’s support for the reform bill.

Who Moved My Keys?

Speaking as a senior citizen myself–and thus knowing quite a few of them on a first-name basis–it seems to me many seniors simply don’t understand Medicare needs major surgery in order to function properly for future generations as well as their own. Either that, or they understand this just fine but have become stingy, single-minded, and set in their ways in their advanced years.

Change–especially dramatic change, from one established and comfortable pattern to something very different–is a powerful force. Even the possibility of such change, not to mention the reality, can induce heated rhetoric and cloudy thinking. The older we get, the more difficult it becomes to adapt.

Even something as simple as having someone change the location of your car keys from where you usually put them can cause a fair bit of discomfort. Any surprise then that changing Medicare–taken for granted for so long by so many–would induce discomfort for those accustomed to using it?

Congressional Angst

No one in Washington is really satisfied with what they’ve done to Medicare either. For many conservatives, the shift to private health plans is too limited and the price tag too high; for many liberals, the provisions for competition go too far toward the privatization of Medicare.

Charles Rangel, the Democratic Representative from New York, fears “this bill will not reform the Medicare system as we know it but rather dissolve it.” Republican Bill Thomas from California responded, “Our answer to that is, we certainly hope so.”

I believe everyone has a right to express his or her opinions, and to act on those opinions. For my part, I believe we no longer have a functioning Medicare system. It has been suffocated by too many administrations with too many counter-productive, anti-consumer regulations. To flourish, Medicare needs to be allowed to breathe freely and function with a minimum of government intervention. It needs a lot of fresh air.

I think this Medicare reform bill is not as bad as some pundits claim, nor is it as good as others have told us. It needs a chance to prove itself during the implementation and shake-out stage.

I will follow it closely and report truthfully in Health Care News. And if some new ideas don’t actually work out as planned, we should learn from the things we have done wrong and fix them immediately.

Conrad F. Meier is managing editor of Health Care News. His email address is [email protected].