Bad medicine

As the Senate rushes pell-mell to approve a prescription drug benefit for America’s seniors, many long-time

Washington observers are experiencing a sense of political deja vu.

The Senate’s “mad rush to drug-ment” could turn out as a replay of the 1988 fiasco that produced the short-lived Medicare Catastrophic Coverage Act (MCCA). The political winds blowing then are eerily similar to today’s conditions:

? A president committed to getting a so-called “Medicare reform” bill passed.

? A Congress eager to make good on campaign promises to help seniors who want Medicare to pay for drug coverage.

? A rapidly growing senior population that wants more benefits at less cost.

The MCCA enjoyed all these elements: strong bipartisan backing, a willing White House, the backing of big-time lobbying groups, and tremendous public support.

Sure, government actuaries and independent economists raised concerns about the potential cost of the drug benefit and how it might affect seniors’ wallets. But, in cavalier fashion, these nerdy irritations were swept aside. The bill, bathed in an aura of inevitability, sailed through both Houses and became law in June 1988.

But just three months later, Rep. Marilyn Lloyd, Tennessee Democrat, took to the House floor to declare senior citizens would be “taken to the cleaners” by the MCCA. Four days after that, Rep. Bill Archer, Texas Republicans, and 32 co-sponsors introduced a bill to delay its implementation.

By August, Ways and Means Committee Chairman Dan Rostenkowski, Illinois Democrat, who strongly opposed repeal, found himself being booed and pursued down the streets of Chicago by irate senior citizens. Congress repealed the bill in November.

What happened?

For starters, Congress mistook public support for popular catch phrases as support for the MCCA. Just as people supported universal “catastrophic coverage” in 1988, so today they are said to support the idea of a universal Medicare drug benefit.

Then, as now, though, rhetoric doesn’t match the reality. Most seniors already have drug coverage. They expect a “new” benefit “for all” to offer better coverage at a lower price, but they also want the right to keep what they’ve got if they like it.

With the MCCA, though, the drug benefit was self-financing; seniors would pay the full cost. But many didn’t want to pay for the new benefits, including the drug one, especially if they were already being offered through other sources such as employers. Others simply didn’t want to pay for any new Medicare benefits. Period.

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