Newspaper article St Louis Post-Dispatch (MO)

Medicare Solution Called `Shell Game' Critics Blast Clinton's Solution as `Gimmick'

Newspaper article St Louis Post-Dispatch (MO)

Medicare Solution Called `Shell Game' Critics Blast Clinton's Solution as `Gimmick'

Article excerpt

A battle is looming over President Bill Clinton's proposal to solve some of Medicare's most serious financial problems by shifting the cost of home health care from one account to another. The home health benefit is the fastest growing component of Medicare.

Critics termed the proposal a bookkeeping shell game and "accounting shenanigans."

Clinton plans to send his budget to Congress early next month. If there is no change in current law, the Medicare trust fund that pays hospital bills will, by the administration's estimate, run out of money in 2001. That is 10 years before the first baby boomers reach 65, the age of eligibility for Medicare. A bipartisan group of experts summoned to the White House to advise the president's new budget director, Franklin Raines, said that Clinton's proposal on home health care was little more than a bookkeeping gimmick. Under Clinton's proposal, most of the cost of home health care for people who are elderly or disabled would be shifted from the Hospital Insur ance Trust Fund to a separate Medicare account, which has unlimited access to general revenue. Medicare spending on home health care services has exploded in recent years. It exceeded $18 billion and accounted for nearly 10 percent of Medicare benefit payments in 1996. Under Clinton's proposal, these expenses would be excluded from the computation of Medicare premiums, so beneficiaries would not have to absorb any of the cost. When Clinton suggested a similar change last year, Republicans said it was not a serious proposal. After the November election, they told him that they wanted a good-faith gesture on the budget, and that a repeat of his earlier recommendations would not do the trick. In an interview last week, Rep. Bill Archer, R-Texas, who oversees Medicare as chairman of the Ways and Means Committee, said: "We're looking for a signal from the president as to how real his budget will be. I want to work with him on a bipartisan basis, but this proposal on home health care is a shell game, an artificial solution. It may help the trust fund, but it creates enormous problems in the general Treasury and for future generations. …

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