Newspaper article St Louis Post-Dispatch (MO)

Medicare's Demise Has Long Been Predicted and Congress after Congress, `Virtually Nothing' Was Done

Newspaper article St Louis Post-Dispatch (MO)

Medicare's Demise Has Long Been Predicted and Congress after Congress, `Virtually Nothing' Was Done

Article excerpt

MEDICARE WAS barely hatched when its trustees began clucking about its future like so many mother hens: If they've told Congress once, they've told it a thousand times.

But the predicted demise of Medicare, the national health insurance program for the elderly and severely disabled, was always pushed ahead to another day.

That day may be near. The forecast is for insolvency in Medicare's hospital trust fund in seven years. That vast reserve - now $133 billion - could evaporate in 2002, and the government would be unable to pay its part of hospital bills.

Congress has always walked a tightrope with Medicare, letting the voices of actuarial alarm mount until they couldn't be ignored, ignoring them a bit longer anyway, and then doing something to buy time.

Year after year the program's trustees gave the same warning: "Early corrective action is essential in order to avoid the need for later, potentially precipitous changes."

Now "the problem is so large that there isn't any painless way to solve the problem," said Guy King, who left Medicare last year after 15 years as chief actuary. "The hole is just going to continue to get deeper for many years."

It's against that backdrop that budget-conscious Republicans are coming forward to present themselves as rescuers of Medicare. They hold out hope of performing a feat of acrobatic arithmetic, giving the elderly "better Medicare with a better range of choices," as House Speaker Newt Gingrich, R-Ga., put it, while saving big money.

The rescuers will need to save up to $283 billion over seven years from a program costing $175 billion this year and growing fast.

Starting in 1969, barely four years into the Medicare program, the warnings have come like the tide, rising, ebbing, rising again. The hospital fund's projected time left has been as short as two years, although frequently projected at seven to 15 years.

Never has everyone been convinced of the need for immediate, drastic action.

Even now, Donna Shalala, secretary of health and human services, is quick to point out that Medicare's imminent demise has been forecast many times before. President Bill Clinton's administration wants to deal with Medicare as part of broad health reforms, for which Congress has had no appetite. …

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