Newspaper article St Louis Post-Dispatch (MO)

Medicare, Medicaid and Budget Priorities

Newspaper article St Louis Post-Dispatch (MO)

Medicare, Medicaid and Budget Priorities

Article excerpt

Of all the cherished myths of the American polity, perhaps the most enduring is that we can have our fiscal cake and eat it too. Lyndon Johnson claimed we could afford guns and butter. Jimmy Carter told us if we just made government more efficient, we could have the public services we wanted. Ronald Reagan said we could raise revenue by cutting taxes.

We believed them all because we wanted to - because they told us what we wanted to hear.

Today, many in both houses of Congress seem convinced that we can balance the budget by the year 2002 and treat ourselves to a major tax break without inflicting any noticeable pain on most of us hard-working, middle-class Americans.

Public opinion polls are a study in collective denial. Large majorities favor a balanced-budget amendment, and there is widespread support for a tax cut. Yet, when asked whether the publicly funded health-care programs, Medicare and Medicaid, should be cut to achieve a balanced budget, we answer "NO!" by a 2-to-1 majority.

Within this apparent contradiction, however, lies an important message for the inside-the-Beltway crowd, whether members of the new or the old majority: Medicare and Medicaid have served two generations of American families, and they know it.

Medicare provides hospital and doctor care for more than 30 million elderly. Medicaid provides a safety net for children, the unemployed, the disabled and the working poor, including a significant amount of nursing care for poor and middle-class elderly and mentally retarded children.

The truth is that, directly or indirectly, all of us have a stake in the quality and financial integrity of these programs. If Congress proceeds with plans to drastically slash Medicare and Medicaid funding, it will do so at the peril of those who are most dependent on America's health-care system.

At the same time, we know that the growth rates in Medicare and Medicaid are simply not sustainable. Clearly, we must reduce the deficit, the interest on which now consumes 15 percent of the federal budget, and just as clearly Medicare and Medicaid must be an important part of that exercise. By restructuring these programs intelligently, we can achieve vital savings without destabilizing the delivery of health care to the millions who depend on it.

But the severe and arbitrary cuts necessary to balance the budget and simultaneously provide billions in tax breaks could cripple these programs, creating a backlash that would put much needed reforms politically out of reach for years to come.

Trying to reverse 30 years of deficit spending and balance the budget in just seven years would require Congress to cut $1.2 trillion from federal programs between now and 2002, according to the Congressional Budget Office. On top of that, both the president and congressional leaders are advocating tax cuts that would require an additional $80 to $375 billion in budget cuts over the same period. …

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