- The Washington Times - Wednesday, March 14, 2001

Though one influential congressional Democrat has declared President Bush's prescription-drug plan for low-income seniors "dead on arrival," none of the unresolved senior citizen issues carried over from the Clinton years will go away that easily.

President Clinton had the opportunity during his eight White House years to create a meaningful legacy for himself by modernizing the 65-year-old Social Security program and 35-year-old Medicare program. Instead, he did little but talk.

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But the time for hollow talk is past. With the Congressional Budget Office predicting a cumulative surplus of $5.6 trillion over the next 10 years, we can afford to do what's necessary and right. So to my former staffer in 1968, George W. Bush, I'll know you agree, so say, "Let's get on with it": cut taxes, fix Social Security and Medicare, and eliminate the discriminatory death tax.

Medicare's problems are both systemic and practical. All the problems grow out of the simple fact medicine has changed dramatically since the program was designed. New medical techniques and technologies, including all sorts of innovative miracle drugs, have extended the life expectancy of most Americans well into their 80s. But none of these things the drugs, the MRIs, the surgical replacement of hearts, hips, knees, valves and heaven knows what else is cheap.

This has created a dilemma for Washington. Senior citizens demand and deserve the best medicine America can provide, but soaring costs have forced the Medicare bureaucracy to put the squeeze on doctors and hospitals with thousands of pages of rules, regulations and restrictions. The end result is bad medicine.

Prescription drugs weren't included in the original Medicare program for a simple reason: Most of the specialized drugs doctors rely on today hadn't been thought of yet. Today, however, drug therapy is crucial to the practice of good medicine and Medicare needs to catch up with the times.

This can't be done by tacking a costly prescription-drug benefit onto the existing system, which already faces financial collapse in a relative few years. President Bush's proposal to provide prescription-drug coverage for the neediest among us is a sound interim step. But it is just that: an interim step.

The next step is to overhaul Medicare top to bottom. Most members of President Clinton's Medicare reform commission had the right idea when they proposed using Medicare taxes and premiums to finance the purchase of health insurance, rather than paying directly for services.

Such a system is well-known to members of Congress and to the other 9 million government employees and retirees with health coverage: It's almost identical to their Federal Employees Health Benefits Program (FEHBP). All FEHBP plans, of course, provide prescription-drug and catastrophic medical coverage.

Washington also needs to make major changes in Social Security, an antiquated relic of a bygone era. The changes wouldn't affect current retirees and the 50-somethings who will retire in the near future. But major changes are needed for the sake of their children and grandchildren.

Two problems need to be addressed: The fact that the current pay-as-you-go system won't work in the future when too few workers are trying to support many more retirees, and the fact that for each succeeding generation the government retirement plan looks more and more like a government retirement scam. Most young people can now expect to receive less retirement income from Social Security than they pay in taxes.

So why not use part of the surplus to finance the transition to a new retirement system that would allow younger workers to invest some of their taxes?

In addition to an across-the-board tax cut, which would help people of all ages, Washington has one other piece of unfinished business: eliminating the hated "death tax." This is pure lunacy: taxing people after they have died on money they have already paid taxes on. Congress voted to abolish this tax last year, but Mr. Clinton vetoed the bill. We know the legislation will get a much more cordial welcome from the Bush White House.

James L. Martin is president of the 60 Plus Association (www.60plus.org), a grass-roots seniors organization headquartered in Arlington.

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