THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Monday, June 10, 1996 TAG: 9606070016
SECTION: FRONT PAGE: A6 EDITION: FINAL
TYPE: Editorial
LENGTH: 55 lines
It's deja vu all over again. The trustees of Medicare report that the system is going bankrupt faster than ever. Politicians point fingers, but nothing happens.
Now the president of the American Hospital Association says the issue is too important to be entrusted to the partisans and proposes that a panel of citizens be appointed to solve the problem. That sounds refreshingly straightforward, like Ross Perot getting under the hood and fixing what ails Washington, but things aren't quite that simple.
The reason politicians can't agree on a fix is because the problem is a huge one with all sorts of conflicting constituencies hauling and tugging in opposite directions. The divisions expressed by politicians reflect a divided electorate.
There are more seniors. They're living longer. Medicine has gotten better. But the cost of prolonging life and repairing the ravages of age for more people by more-extraordinary means is high.
The existing health-care-delivery system is flawed, but changing an industry that accounts for more than 12 percent of the nation's economy has to be approached with caution. Billions a year are squandered on waste and fraud, but policing the system has proved very difficult.
Finally, and most crucially of all, reforms that avoid bankruptcy for the system might spell bankruptcy for individuals. Fixing Medicare will entail very hard choices for health-care consumers and taxpayers.
We must be willing to buy less health care, which implies something like rationing. Or we must be willing to pay more for health care, which implies higher taxes. Or we must buy health care cheaper, which surely means squeezing the providers and is likely to mean lower quality of care.
It's that hard equation that has stalled reform. Politicians are understandably gun shy after the events of the past several years. President Clinton proposed an elaborate reform that had its Rube Goldberg aspects but might have provided a starting point for a fix. His critics made a mockery of the plan, and it was dead on arrival in Congress.
When a Republican Congress proposed $270 billion less in Medicare spending without explaining who would lose, Clinton got revenge by shamelessly demagoguing the issue. Perhaps in an atmosphere where political expediency triumphs over pragmatic reform, there really is no way for politicians to address the issue.
But there's no escape from it. The need for reform of both Medicare and Social Security must be faced. Inexorable demographic and economic forces are at work. The needed fixes are likely to be unpalatable - means testing, rationing, an end to automatic cost-of-living adjustments, higher deductibles.
But the longer the wait until repairs are made, the more intense the eventual pain. As the fall approaches, voters have got to stop punishing candidates who dare to tell hard truths. Instead, they must make straight talk on the crucial issue of entitlement reform a litmus test when assessing candidates for the House, the Senate and the White House. by CNB