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 people's welfare.

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 issues.

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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