Bush fools no one with “new” Medicare proposal

I’m not an expert in health care policy, so it’s difficult for me to critique the specifics of Bush’s latest Medicare proposal and its impact on senior citizens. But from a political angle, it looks like another domestic policy mess for the White House.

In January, the administration unveiled a vague outline of a proposal to revamp Medicare. The plan, which the White House said would cost $400 billion, would provide prescription drug benefits to seniors who left Medicare and joined an HMO.

In this year’s State of the Union, Bush danced around the details of his plan, realizing the continuing popularity of the Medicare program.

“Seniors happy with the current Medicare system should be able to keep their coverage just the way it is,” Bush said, failing to explain that “just the way it is” means coverage without a prescription drug benefit. In the same speech, the president said, “Instead of bureaucrats and trial lawyers and HMOs, we must put doctors and nurses and patients back in charge of American medicine.” That’s a great line that everyone can agree with, but it was pretty misleading considering Bush’s plan to shift more senior citizens into HMOs just so they can get the medicine they need.

Considering the political sensitivity of the issue, Congress balked at the Bush proposal. Even Speaker of the House Dennis Hastert indicated the lack of political will in Congress to pass what the president wanted.

Yesterday, Bush began anew with Medicare, giving a speech to the American Medical Association in which he began to outline yet another proposal. Not surprisingly, the new plan sounds a lot like the old one, with an emphasis on shifting seniors who want prescription drugs to private insurers.

Ron Pollack, executive director of Families USA, a nonpartisan health care advocacy group, apparently noticed the similarities.

“Under the initial proposal, seniors in traditional Medicare would not have been provided with any drug coverage,” Pollack said. “Under the new plan, seniors in traditional Medicare would receive coverage only after they spend thousands, and perhaps many of thousands of dollars, out of their own pockets on drugs — a cost that the vast majority of seniors cannot afford. As a practical matter, therefore, the new plan, just like the first one, will leave seniors without drug coverage unless they drop traditional Medicare for a private plan.”

Well, Families USA is an advocacy group, you’re thinking, so it’d be expected to say that. How was the reaction on Capitol Hill?

Take a guess which member of the Senate told the New York Times that Bush “has not gone far enough. Every senior should have access to comprehensive prescription drug coverage, regardless of which Medicare option they choose.” Tom Daschle? Ted Kennedy? One of the Dems running for president? Nope. It was Olympia Snowe, a Republican Senator from Maine.

Let’s try another one. Guess which member of the House openly questioned whether Bush could convince seniors to abandon Medicare, telling the Times, “You couldn’t move my mother out of Medicare with a bulldozer.” Gephardt? Kucinich? Try Billy Tauzin, a Republican from Louisiana.

Yet another GOP lawmaker, Jim Nussle of Iowa, really let the White House have it. “They are not just two weeks or two months late; they are two years late,” Nussle said of White House officials. “They have been unrealistic and unfortunately unable to come together within the administration on what their plan ought to be.”

It’s safe to assume that if Republican lawmakers aren’t going for Bush’s plan, it’s dead on arrival in Congress. Unless the White House is ready to unveil a third Medicare proposal, this will be yet another campaign promise on which Bush fails to deliver.