Medicare Reform: Why Not the Rest?
The "bipartisan" plan to reform Medicare by giving seniors vouchers
and leaving them at the mercy of health-care corporations fell apart and
deserves oblivion. Chairman John Breaux, a business-oriented Democratic
senator from Louisiana, failed to round up two-thirds support for the privatization
plan that would trim benefits and send the profits to managed care providers.
Breaux and the health care lobbyists who drove the commission apparently
didn't learn from the 1994 health care debacle, which also was built on
the idea of encouraging "managed competition," where the government
would set rules for private health plans, steer subscribers into lower-cost
HMOs and, hopefully, expand benefits with the savings. Given the structure
of the Medicare commission and Republican congressional leaders waiting
for any excuse to cut Medicare spending, deadlock was perhaps the best that
could be hoped for. But with 43 million Americans still uninsured, and many
of them "working poor," progressives should move to expand Medicare
to provide universal coverage.
Robert Kuttner noted in a March 14 Boston Globe column that we could
stabilize Medicare's financing and protect the elderly by expanding coverage
to all Americans. The government already covers one child in four through
a patchwork of programs that includes Medicaid (the health program for low-income
families) and the new Childrens' Health Insurance Program (CHIP). Legislatures
are quibbling over how poor families have to be to qualify their children
for health care.
Edith Rassell of the Economic Policy Institute calculates that it would
take $60 billion a year to extend Medicare, with free choice of doctors
and hospitals, to every child in America. Rassell calculates that the cost
of extending Medicare to all children could be financed by an additional
1.54 points on the employer share of the payroll tax. Since kids tend to
stay well, adding children would supplement Medicare's financial reserves
(and employers who now responsibly offer family coverage would see their
health insurance costs drop).
The next step would be to extend Medicare to people aged 55 to 65. These
people are most likely to be priced out of private insurance when they lose
their jobs. Picking them up would cost Medicare about $100 billion a year,
less the money they already are spending on insurance. This could be financed
by new employer payroll taxes or by general revenues.
After that, Medicare could absorb the other half of the population--those
between 21 and 55. This group is, on the average, a lot healthier and cheaper
to insure than the elderly. And everybody would still have their choice
of doctor and hospital that Medicare offers.
See? It's not so difficult to reform Medicare and provide health care for
everybody ... if you're not already indebted to a Star Wars antimissile
program or other costly boondoggles that put corporate welfare ahead of
Steel Beats Bananas
While the Clinton Administration girds for economic war with Europe over
bananas, slapping punitive tariffs on European imports such as cheese and
sweaters [see our cover story], the U.S. House of Representatives bucked
the White House and its own Republican leadership March 17 when it voted
decisively to protect the domestic steel industry.
This first major trade measure of the new Congress should encourage populists
who are fighting the "free trade" movement that benefits multinational
conglomerates. The House voted 289 to 141 to limit steel imports from other
nations to their average monthly volume for the three-year period ending
in July 1997. All but 13 House Democrats broke with the Clinton Administration
while 91 Republicans defied their party leadership, which also supports
the free-trade position. (The protectionist "fair traders" gained
20 GOP votes since last September, when 71 Republicans voted with 172 Democrats
to defeat the proposal to give "fast track" authority that would
limit congressional review of trade deals.
The steel imports bill, sponsored by Peter J. Visclosky, D-Indiana, faces
a threatened veto if it makes it through the Senate. The House vote was
one short of the two-thirds needed to override a veto.
United Steelworkers President George Becker noted that more than 10,000
American steelworkers already have been laid off due to the dumping of foreign
steel in the United States and tens of thousands more are on the edge. "Steelworkers
in Ohio, Indiana, Pennsylvania, Illinois, Alabama and in every other state
where there are steel facilities have felt the effect of these imports either
through layoffs or reduced hours of work and consequently reduced incomes,"
he wrote March 11 in a letter to Clinton asking for help. "Mr. President,
how much more must we bleed?"
Rep. Dick Gephardt, the Minority Leader from St. Louis, was among the bill's
supporters and spoke out about the need to put a plan in place that would
combat unfair imports. As Alison Mitchell wrote in the New York Times,
Gephardt gave a hint of "the debaste that might have been" in
the 2000 Democratic Presidential campaign. That debate apparently will be
ceded to Al Gore, who has been a reliable ally of Wall Street as Vice President,
and Bill Bradley, who had a pro-labor voting record as senator from New
Jersey but voted for NAFTA and has yet to clarify his position on trade
Urge your senator to support the Visclosky bill. In another bill that is
expected to get a House vote soon, tell your representative to support Jesse
Jackson Jr.'s African HOPE Act, which would focus on debt relief for African
nations but also would protect American workers by requiring businesses
doing business in Africa and planning to export to the United States to
adhere to environmental, worker safety and labor rights standards similar
to those required of companies operating in the United States.
Clinton Embraces Debt Relief
President Clinton wants to expand an international program to relieve the
debt burden of the world's poorest countries. Clinton would more than triple,
to about $100 billion, the amount of debt that could qualify for forgiveness
under the "Highly Indebted Poor Countries" initiative, known as
HIPC, but he would continue to offer debt relief only to countries that
open their markets to multinational corporations and embrace economic reforms,
such as the dismantling of state-owned industries and termination of subsidies
for food and energy.
A more sweeping and unconditional debt-relief plan is promoted by Jubilee
2000, which is calling for a no-strings-attached cancellation of poor countries'
foreign debts at the start of the new millennium. Reps. James A. Leach (R-Iowa)
and John LaFalce (D-NY) have introduced H.R. 1095, the Debt Relief for Poverty
Reduction Act, which "will enable the poorest countries in the world
to better provide for the needs of the most vulnerable people in their societies--the
young, the elderly and the sick," said Leach, chairman of the House
Banking and Financial Services Committee.
Debt relief could help American farmers and industry because governments
in debtor nations are forced to divert resources from economic development,
health and education to pay international bankers. H.R. 1095 would cancel
most of the debt owed to the U.S. government and reduce the debt owed to
international financial institutions. The measure requires debt relief to
be targeted to reduce poverty and provide basic social services.
To make your voice heard, contact the White House at 202-456-1414 or Congress
at 202-224-3121. Write your congressmember c/o U.S. House, Washington, DC
20515; U.S. Senate, Washington, DC 20510; or the President, White House,
Washington DC 20500. -- Jim Cullen
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