Why Health Care Hot Potato for Elderly Can Be Touched Efforts to Cut Medicare and Medicaid Once Hurt Careers. No Longer

Article excerpt

IT'S August 1989, and senior citizens are hopping mad. Congress has approved new Medicare benefits to protect against catastrophic medical expenses, and the elderly don't want to pay extra for it. In one of the most striking scenes from any August recess in memory, Rep. Dan Rostenkowski (D) of Illinois, then one of the most powerful members of Congress, is chased down in his district by angry seniors chanting "liar!" and "impeach!" Other members are deluged with protest. The message: Increase fees for Medicare, and you touch the high-voltage "third rail" of politics. Congress quickly repealed the law. Cut to the fall of 1995. The entire Medicare system is on the table. Republicans are contemplating an overhaul of the program that would nearly double the fees elderly pay, and could limit their choice of doctors. The protest has been polite, and opinion polls show surprising support for parts of the Republican plan. A Los Angeles Times survey last week found 60 percent support for an across-the-board hike in fees elderly must pay for Medicare. About the same number supports a plan to encourage seniors to join managed-care programs, which would save money in restricting choice of physicians. What ever happened to the "third rail?" Social Security, the main third rail, remains off the table in the Republican budget-cutting plan. But the other key pillars in the national system of support for the elderly - Medicare, the federal government's health-insurance plan for seniors, and Medicaid, the program for the poor that funds a lot of nursing home costs - are most definitely in play. Between the two programs, the Republicans plan to save $452 billion over seven years through cost-cutting. And they know they're playing with electricity. Senior citizens pay attention to issues and they vote; they represent one of the most powerful lobbies in Washington. But times may be changing. Ironically, talk over Clinton's health care reform plan and rumblings over Medicare's imminent bankruptcy may have paved the way for GOP reforms. "People know that the Medicare trust fund is going broke," says Susan Tanaka of the Committee for a Responsible Federal Budget. "In health care, people are conscious of costs going up and so they're more willing to entertain change. …