March 25, 2004 - If you are 50 years old or younger don’t count on Medicare to cover your health care needs when you reach 65. The Bush “reform” privatizing the coverage will break the system by 2019 – the year you reach retirement age. According to the Medicare Trustees’ Report it is the cost of the just passed Bush Medicare bill, opening the trust fund to the HMOs and drug manufacturers, combined with reductions in revenue that will push the system over the edge seven years earlier than previously predicted.

The Bush Administration, the drug company spokesmen, and ARRP, that backed the prescription drug benefit bill despite widespread membership dissention, have all weighed in to dispute the Trustee’s finding. HHS Secretary Thompson suggested that cost savings built into the bill will improve the picture. At the White House spokesman Trent Duffy said that it wasn’t the Bush Medicare Bill that caused the problem but soaring medical costs. Of course nobody is talking about what those soaring medical costs consist of. Is it drug costs? Is it hospital administrator’s salaries? Is it the incomes of Doctors and Nurses that are soaring? Just what is it that is soaring out of control?

This is an alarm bell that must be answered, not with denials and wishful thinking but with a clear look at the way we finance health care in the only industrialized nation without a tax paid single payer health care system. We need to take immediate steps to finance the present Medicare system without turning it over to Eli Lilly, Searle and the other drug companies. We need to take immediate steps to cure the imbalance between revenue and expenditure. Benefit payments going to healthcare providers passed tax revenue last year. We are already tapping the reserves.

In the short term we need to lift the $125,000 cap on wages and salaries subject to the Medicare tax and extend it to all income, earned and unearned. We need to give the Medicare Trustees the authority to negotiate prices with the drug companies and other providers to make it uneconomical for patients to travel to Canada just to fill their prescriptions and uneconomical for providers to remain outside the system. We need to permit individuals to purchase private insurance to fill the gap between what Medicare pays and what prescriptions actually cost. We need a real policy of cost control and that means a mandatory system requiring the providers to justify the costs that they impose on the patients and the system. Feel good measures such as the Bush prescription drug plans cobbled together with something for every special interest just won’t save the system.

At the same time we must insure that the Medicare – Medicaid system does not shift the cost burden to the privately insured workers and employers who are financing the present system. That will require us to move rapidly to a single payer tax financed system of quality clinical care in which patients have the option to supplement that coverage with private financing of fee-for-service providers.

This crisis is real and as serious a threat to our present standard of life as is the treat that someone will fly an airplane into another building. It has to be addressed now and treated seriously. It is not a campaign scare tactic and affects far more Americans that those of us who have already reached that 65 year landmark. It affects every American equally. We have to cure the sick system or watch it die. But then, that is what Newt Gingrich promised us 10 years ago when he said the Republican objective was to let Medicare wither on the vine. Thanks to George Bush we can see the leaves falling and if we don’t nourish it now the vine will die