The Current Crisis

Drug Fix

If it's not broke, Medicare sure will be once the new prescription drug bills become law.

By 8.21.03

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Before attending to this week's business I should like to defend myself from the machotypes who fell on me for saying in last week's column that a .30 caliber Weatherby magnum was capable of reaching a bird at 1200 yards. Allow me to quote from a memo to AmSpec's expert on the subject, my friend Chuck Fowler.

Quoth: "A 165-grain bullet from a 30-378 Weatherby drops nineteen and a half inches at 500 yards. It screams out of the barrel at a blistering 3500 feet per second. I'm sure at 1200 yards it may drop twice again as much as at 500 yards and maybe even more. But once a scoped gun is zeroed for 1200 yards, a person of modest ability can easily hit a human-sized target. A person with some skill could hit a bird, and no one with good sense would bet his life on it not being possible to hit him."

I stand by my statement but remain a bird lover, particularly Wild Turkey.

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Washington -- I write as a confirmed hypochondriac. I have more medicines in my medicine cabinet than Arianna Huffington. In fact, I have more medicine cabinets than Arianna Huffington, and I did not even have to divorce a multimillionaire to afford my multitudes of medicine cabinets. I have a half dozen personal physicians. The only docs I avoid are plastic surgeons, and that is because they would have me looking like Senator John Pierre Kerry.

Thus you might think I am exultant over the advance of the new prescription drug bills through Congress that our solons plan to append to Medicare. Actually, I am not. As these bills approach the conference committee where they will be reconciled, I reach for the Prozac. They are unfunded. They are likely to lack market-based reforms. They will force all of us into a healthcare straitjacket. We hypochondriacs need to be able to make choices. What strikes me as an unendurable affliction might strike you as a hangnail. Yet I might want to take my hangnail to a doctor and I ought to be able to, assuming I pay for it. With a proper array of healthcare programs available to me I just might be able to get insurance for my hangnails.

The basic thing that all of us, hypochondriacs and the physically fit alike, need to remember about health policy is a condition that the great economist Milton Friedman recognized a generation or more ago, to wit: healthcare demand is elastic. The cheaper and more available it is the more it will be in demand. If it were free, we hypochondriacs would be in the doctor's office all the time. At least we would be in the doctor's office if the doc's fees were paid by government -- and if government did not regulate care, thus restricting procedures.

The restriction of procedures is just one of the problems with Medicare. The other is that it is underfunded and will go bust someday. Scholars at the American Enterprise Institute calculate that Medicare's long-term shortfall is more than $30 trillion. If the contemplated prescription drug coverage is thrown in, add another $6 trillion to $12 trillion. And still I cannot get my hangnails treated. As the shortfall mounts ordinary Americans will not be able to get some genuinely urgent procedures covered. In fact, services are being cut back even now. In the years to come there will be more cutbacks in Medicare and a huge tax increase.

The government cannot run unfunded programs forever. Yet with the present prescription drug bills now headed for conference that is about what the politicians are contemplating. To repeat, the unspoken truth of these prescription-care bills is that they are not even funded.

The Bush Administration until recently included market-based reforms in its plans for prescription-drug legislation. Now it has apparently thrown in the towel. Senator Edward Kennedy is opposed to such measures. Of course, any market-based reforms can be expected to rouse Kennedy's ire. He wants to move towards a single-payer health system whose proper name is socialism. Any policy that further damages Medicare he believes will put further pressure on the government for his quaint 1930s goal.

Actually the government already has a solution to the healthcare muddle, but it is only available to members of Congress and government employees, namely, Federal Employees Health Benefits Program (FEHBP). In its 28 years, FEHBP's costs have been no greater than Medicare's and its benefits are more extensive. Even a hypochondriac can admire it.

Under FEHBP the government's Office of Personnel Management annually sends out a memo to health insurance providers, outlining goals and soliciting each company to put together plans consistent with those goals. The plans that meet the government's minimum standards are offered to government employees who can then select the policy of their choice. Furthermore, employees can negotiate with the companies as to which options are included in their personal policy. I would want the hangnail option. Thus my policy might cost a bit more than Senator Kennedy's though he ought to take the weight-watcher's option. The government then agrees to pay between 72% and 75% of the policy premium.

FEHBP has wide acceptance among health specialists and healthcare providers. Frankly I cannot understand why Republicans and Democrats cannot agree on extending it beyond government employees to the rest of us. The only reasons I can ascertain are that A) Republicans are not up to the political fight, and B) Democrats are holding out so as to move national healthcare towards socialism and away from market reforms. By now it is pretty clear that today's reactionaries are with Senator Kennedy.

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About the Author
R. Emmett Tyrrell, Jr. is the founder and editor in chief of The American Spectator. He is the author of The Death of Liberalism, published by Thomas Nelson Inc. His previous books include the New York Times bestseller Boy Clinton: the Political Biography; The Impeachment of William Jefferson Clinton; The Liberal Crack-Up; The Conservative Crack-Up; Public Nuisances; The Future that Doesn't Work: Social Democracy's Failure in Britain; Madame Hillary: The Dark Road to the White House; The Clinton Crack-Up; and After the Hangover: The Conservatives' Road to Recovery.