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Medicare's Political Mire

September 14, 2004

On the suddenly hot subject of Medicare, the two major presidential candidates are competing over who can produce the most noxious combination of nasty charges against the other guy and false promises of his own.

President Bush touts his prescription drug plan, which at the moment consists mainly of allowing drug companies and other organizations to sell drugs at a discount to seniors who join a group and carry a card. This was more appealing to the drug companies in the abstract than it has proved to be in the particular. Some companies are already dropping out. The real, government-subsidized drug benefit for seniors begins in 2006. While we're waiting for that, we will be entertained by watching the cost estimates escalate.

Meanwhile, the federal government announced Sept. 3 that Medicare premiums -- the amount seniors pay for coverage worth much more -- will be going up 17.4% next year. That's after a 13.5% increase earlier this year. Presidential challenger John F. Kerry says he would rescind most of the premium increase, but he doesn't say where he'd get the money. Healthcare costs are rising fast. Does he have a magic formula to contain them? Or would he cut benefits? Or would he stick taxpayers with more of the cost?

The Bush reelection campaign is running TV spots accusing Kerry of "voting for higher Medicare premiums before he came out against them." This nicely adapts the Medicare issue to fit into Bush's "Kerry flip-flops" theme. And, in doing so, it demonstrates how trivial and strategy-driven our politics have become. Medicare is a real issue. "Flip-flops" are a campaign concoction. But Bush's strategists happily put Medicare at the service of flip-flops.

They've got the goods. The Bush ad shows Kerry excoriating Bush for the Medicare increase. Then it points out, accurately, that as a senator in 1997, Kerry supported a funding formula that all but dictated the hikes. That formula was part of the successful effort to turn the huge deficits of the 1980s and early 1990s into surpluses. And that effort was the greatest -- possibly the only -- exercise in responsible bipartisan governance of recent decades. So naturally it has become an albatross around the neck of a senator who participated. Meanwhile, by focusing on Kerry's so-called flip-flops, Bush avoids taking a stand of his own on the 17% premium hike, or saying what he would do to prevent it.

Don't tell anyone, but Kerry actually has proposed some sensible Medicare reforms. For example, repealing the insane Bush administration rule that forbids Medicare officials to negotiate with drug manufacturers for lower prices, as any bulk purchaser can and should.

It is perfectly natural that Bush would not want to talk about the good things in Kerry's healthcare plan. What's pathetic is that Kerry doesn't want to either.

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