- The Washington Times - Wednesday, September 6, 2000

George W. Bush has a novel idea for providing health care to the nation's 40 million seniors. At least it's novel by Washington standards: Allow the private sector to compete to serve them.

Right now, of course, those seniors are subject to a government monopoly known as Medicare, the U.S. Postal Service of health care, which ostensibly covers their hospital and other provider costs. This monopoly has generated all the benefits one would expect: The cost of the program is rising to the point that David M. Walker, comptroller general of the United States, suggested in 1999 that it was not "sustainable." At the same time, service is deteriorating; Medicare coverage can't keep up with the latest innovations in health care. Indeed as noted in these pages and by Mr. Bush in a speech Tuesday, Medicare has actually complained that some seniors in hospice care are living too long. The program needs seniors to die on time so that it can balance its books.

Mr. Bush proposes not to junk the existing program but to "modernize it." In particular, he proposed in his speech to cover the full cost of Medicare premiums including prescription drug coverage for those seniors with incomes at or below 135 percent of poverty currently $11,300 for an individual or $15,200 for couples. He would subsidize prescription drug coverage for those above that limit. He would also cover all catastrophic Medicare costs in excess of $6,000 annually for seniors regardless of income. And he promised to do so without raising either the age of eligibility, raising taxes or reducing benefits.

But the most interesting part of his proposal was his invitation to the private sector to join in to serve seniors. In short, any company that provided the minimum level of benefits including drug coverage would be welcome to do so. There is a precedent for the plan right here in Washington, Mr. Bush reminded his audience the Federal Employees Health Benefits Program.

"Nine million federal employees already have a similar plan," Mr. Bush said, "and they report one of the highest levels of satisfaction of any health care system in the country. Like federal employees, including members of the United States Senate and the United States House of Representatives, seniors will get a book each year … It will list all the health care plans and compare the benefits of each plan. Seniors can stay in the current Medicare system with no changes at all, or they can choose another plan for no cost at all, or they can choose to pay a little more for a plan with additional benefits. And every low-income senior will get a high-option plan for free.

Some companies might choose to offer more than the minimum benefits as a way of attracting customers. Others might see a market for customers who want minimal coverage. Medicare coverage could continue for those who want it. The choice, however, would be for seniors, not government, to make. Seniors, like non-seniors, deserve no less when it comes to their own health.

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