A closer look: President’s speech outlines plan for Medicare reform
By Robert Salonga
Jan. 20, 2004 9:00 p.m.
Journalists, politicians and citizens watching TV or listening
to the radio anticipated most of what President Bush said during
the third State of the Union address of his term.
Generally speaking, the president addressed various aspects of
the country’s health. More specifically, he outlined recent
legislation to address the health of 40 million citizens who depend
on the federal government for insurance coverage.
Health care was a key policy issue the Bush administration had
been tackling in the past two months, with the president having
signed sweeping health coverage legislation.
The bill aimed to reform Medicare, the federal
government’s health plan, by changing prescription drug
coverage benefits and increasing the role of private health
providers in covering subscribers.
Bush had pushed for the legislation for a substantial period of
time, addressing the issue in consecutive weekly radio addresses.
But for many watching the State of the Union address, it was the
first time the President had given an explanation of the new
legislation.
“Our nation’s health care system, like our economy,
is also in a time of change,” Bush said in the latter half of
his address.
Many of those changes include a temporary discount card for
seniors for prescription drug costs, with drug coverage under
Medicare by 2006. With such reforms, Bush said seniors can
anticipate an approximate 50 percent reduction in their current
prescription drug bills under Medicare.
One UCLA professor specializing in health care issues said the
president was effective in presenting the Medicare bill in his
address. But that effectiveness, he said, disguised elements of the
policy that are misleading at best.
“There are many reasons to be fairly skeptical about
this,” said Mark Peterson, chairman of the UCLA department of
policies studies who also teaches political science.
Peterson noted that Bush identified a particular category of
beneficiaries who would see their drug expenditures decrease by
half.
But a large number will see either less coverage or be surprised
that as their coverage needs increase, they will encounter a gap in
coverage.
In his response to the State of the Union address, Senate
minority leader Tom Daschle, D-S.D., said the country needs to
seriously explore cheaper avenues for prescription drugs. These
avenues, he said, should include crossing borders into Canada.
Bush also talked about increasing the role that private insurers
play in providing Medicare benefits, saying a government-run health
care system is “the wrong prescription.”
Instead, he said the country should “preserve the system
of private medicine that makes America’s health care the best
in the world.”
Peterson said the statement needs to be considered in a broader
context. He cited that Bush was correct in regard to aspects such
as physician training, but argued the U.S. health care system has a
dismal record on equally providing services along racial, economic
and educational categories.
“He is determined to create an environment where private
insurers can reenter the Medicare market,” Peterson said.
He added that the colleagues with whom he served on the National
Academy of Social Insurance are skeptical of a
“schizophrenic” plan to control costs by throwing
“massive sums of money to privates to get them to play in the
first place.”
