Bush & Gore Medicare Plans Compared.

 
A synopsis of the WSJ editorial of 9/8/00 Medicare is going broke.

As 78 million boomers start to retire, the system in 2010 will start sliding into bankruptcy and go bust in 2025. Seniors have cause to be confused about the state of Medicare and the differences between the Gore and Bush plans to salvage the system. A synopsis of the Wall Street Journal editorial of September 8, 2000, will help clarify these differences.

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Gore's Plan (More of the same) Al Gore's plan keeps the Medicare System as it is, and adds a cumbersome prescription drug benefit atop its creaking structure. It cleaves to the same top-down government control. Enrollees have no choice except to decide at age 64-1/2 whether to enroll in the one-and-only-one drug program. But they cannot revisit this decision. Second, Mr. Gore seems unfazed by the bureaucratic gridlock that keeps advances in medical technology from its enrollees. For example, it took Medicare 7 years and an act of Congress to cover the scanning device for measuring bone density. Consider. Also, PET, an imaging technique for tumors, that has been covered by private insurers for 10 years still isn't reimbursable under Medicare. Third, Mr. Gore seems undisturbed by the fact that, married to the Medicare program, his drug benefit will result in price controls. Price controls mean that eventually drug companies will not earn the returns necessary to develop more and better cures for arthritis, Alzheimer's, diabetes and cancer. Fourth, Mr. Gore offers a schedule that starts in 2002 and takes six years to be fully implemented. (How many Seniors can wait that long?) Finally, Mr. Gore estimates a total cost of $253 billion over 10 years, almost $100 billion more than Mr. Bush's plan: It does nothing about Medicare's looming insolvency. In fact, the speed and risks of Medicare's bankrupts are increased.

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Bush's Plan (Competition to lower prices and increase choices) Mr. Bush's plan lets market competition offer plenty of choice. Enrollees can elect to stay in Medicare or they can choose from a number of health care insurers and providers. Moreover, enrollees can choose to switch plans if their needs change or if they become disenchanted with their provider. By offering several competing private programs, Mr. Bush's plan increases the chances that seniors can find plans that cover new and advanced medical technologies. To keep prices in line, the Bush plan relies on competition, not controls. There will be downward pressure on prices just as obtains currently with large HMOs and PPOs that negotiate lower prices with drug companies. But even 10 years of such pressures have not stopped U.S. drug discoveries. Mr. Bush's plan provides for immediate -- starting next year -- access. As to costs, not only is his total estimated tab over 10 years about $100 billion less than Mr. Gore's plan, his spending is better allocated. The largest share, $110 billion will go to the modernization of Medicare, and an additional $48 billion will be given to states to provide immediate insurance for those not poor enough for Medicaid, but still in need of help. The Bush plan gives Medicare a good chance of remaining solvent. "Introducing competition offers the best hope that Medicare will survive the cost nightmare when the boomers start retiring," says Gail Wilensky, an economist and Bush adviser.

                                                                                           
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