Medicare Malaise

The synthesis of ideology and corruption and the ‘other’ great lie of 2003

Andrew Garib, Turn Left | There are a lot of ways one can explain how a Republican federal government just left of Attila the Hun can pass a massive piece of legislation which supposedly intends to expand Medicare, a program symbolizing social welfare. Sure, when the bill passed it was a mere year away from elections. Sure, the Bush Administration knows that it’s only major base of support was for its handling of the War on Terror, and that it needed to shore up efforts on domestic issues for votes. It’s true Bush and company needed to help deflect attention away from lackluster job growth and what they knew to be an upcoming ‘oops’ from U.S. weapons inspector David Kay this year. But the November 2003 Medicare mega-bill was much more than any of these. It was pure fraud.

This is not something the American public is unaware of, either. A Washington Post/ABCNews poll suggests that nearly forty percent of Americans disapprove of the legislation, with slightly less than a third approving of the passing of the bill. What’s more is that the very people who the bill was designed to help – retirees – are the biggest doubters. Among senior citizens (65+), 47% disapprove of the bill, versus 26% who approve, according to ABCNews.com. The 2003 Medicare bill is clearly not meant to be an election issue.

The bill is designed to provide drug-benefit coverage for retirees through the subsidization of health insurance companies. The plan is complex and sophisticated – in fact it’s so vast that, according to Lewis Lapham in his article in the February edition of Harper’s, few or none of the politicians who voted on the bill even read the document. This is hardly a coincidence – the bill was rammed through Congress with the greatest expediency (anyone remember the Patriot Act?) at the same time as another fiasco of a mega-bill made its speedy attempt through the halls of government: that concession- packed and equally heinous energy bill.

The Medicare overhaul, the largest change in Medicare since the program’s 1965 inception, passed both the House and Senate by the slimmest of margins. The House passed the 681 page bill at 6:00 a.m. on 22 November with a vote of 220-215 – the bill was such an atrocity that it took hours of arm-twisting and bribery in order to coax even Republican members to fall in line.

I, like Lapham and Congress, am dependent on the press for information on the bill and have not had a chance to sit down and scan its nitty-gritty. Nevertheless, we and the rest of the public seem to share the same doubts based upon what we learn from the media: According to the above-mentioned poll, 58% of the 1/6 of the population who have followed the story closely disapprove of the bill, many strongly disagreeing. What can be concluded from this? (No, Ms. Coulter, it’s not liberal bias.) The more one knows about it, the less likely he or she is going to like the 2003 Medicare bill, which is now law like-it-or-loathe-it.

The flaws are many but easily enumerable. Lapham’s list of woes, as well as those of many other journalists and Hill-watchers, go something like this: The government is now forbidden, in the vast majority of cases, to negotiate a bulk discount on drugs, as Canadian governments do regularly to provide their citizens with cheap medication; it is now illegal to (re)import drugs from Canada where drugs bought in bulk are fractions of the usual price; for drugs outside the Medicare plan, it’s forbidden to purchase supplemental private insurance; 6 million people have a reduced or eliminated current Medicare drug coverage thanks to the law; and payment is suspended for seniors exactly at the point when most need the most coverage, at $2250 a year, only to resume at $3600. Lapham adds that companies are given ‘maximum flexibility’ in choosing their beneficiaries (offering their services only to those whose business is profitable) and that the government now as much as ever depends on drug and insurance firms to control costs and curtail spending – leaving Medicare and taxpayers to foot the bill on whatever decisions the industry makes.

Oh, and what a bill. The cost is projected at $400 billion over the next 10 years (falling $121 billion short of our federal deficit), but Lapham is quick to add that since costs are regulated by the market alone, that $400 billion could share the fate of our federal deficit, and balloon to corporate subsidy record numbers. So much for conservative small-government – this is neoconservative debt-boosting at its best.

I should mention that as it stands, America’s current medical system, utterly dependent on markets and private business, ranks 37th in the world for health system performance, and 54th-55th in its fairness of financial contributions to the health system – despite spending more money by percentage of GDP and overall than any other country – according to the World Health Organization. Yet with this Medicare bill or without, problems with the private system are nonetheless mounting. A recent New York Times article (“Companies Limit Health Coverage of Many Retirees”, 3 February 2004) reports that companies are beginning to drop retired employees from their own health-benefit programs, offering instead group plans that are often out of the financial reach of retirees. There’s pressure on the system from all sides – and this travesty of a law only makes the situation worse.

A piece of legislation this crooked must have a shady upbringing – and indeed this idea is born out in the birth of Dr. Bill Frist’s love-child with corporate America. Senate majority leader Frist himself has a $26 million stake in this country’s largest consortium of for-profit hospitals and medical centers, the Hospital Corporation of America (or HCA, founded by Frist’s father). Frist’s partner-in-crime J. Dennis Hastert, as well as House majority leader Tom DeLay among others, could be named in the next House ethics committee hearing in a few months, as complaints of bribes and other arm- twisting tactics used to pass the bill in Congress (including subsequently muted cries from the Republican side) have surfaced, if only temporarily. What we do have as concrete evidence of fishy business is the 3-hour stretching of the 15-minutes allotted for voting on the Medicare bill, giving Tom DeLay sufficient time to pull representatives in line in order to produce the razor-thin margin of victory. It certainly makes one wonder just how bad a bill has to be for a party to resort to such tactics in order to pull fellow party members on board.

As the ABC/Washington Post poll shows, America is responding. Cities and states across the Northeast – including Boston – have vowed to break the new Medicare law and purchase Canadian drugs at a 30%-80% savings. If there were ever an example of a bill out of sync with the needs of the average American, this would be it.

For the Bush Administration, it is not enough to fight the nationalization of healthcare on ideological grounds. There is somewhere a perhaps unwritten requirement that in the process of quashing progress, corporate friends of government, no matter how crooked, are to make the real gains. That’s why Lapham’s article uses the term ‘medical- industrial complex’ – for military expenditure, as a portion of GDP, is a mere polished coin to the gold mine that is the private industry of human health. The corruption and ideology of free-market exposure of our most important capital go hand in hand. No moral and well-informed citizen can ignore the need for a new deal for America’s health care system.

Source:
http://www.abcnews.go.com/sections/politics/US/medicare_poll_031208.html End.