I'm told that very few (if any) of the congressmen and women who voted on it had even read the full 681 densely packaged pages of mind-numbing prose that made up the latest Medicare Reform legislation when they acted on it last Fall.
If that's the case, it should not be surprising that our lawmakers now have precious few answers to questions posed about it. A piece of legislation this expensive, far-reaching and complicated ought to have had full scrutiny in the public arena long before it was enacted.
In a scathing analysis of the new law in the current issue of Harper's magazine, Lewis Lapham notes that none of this occurred. Instead, the primary author of the bill, a bureaucrat named Thomas Scully, closeted himself with key lobbyists for the pharmaceutical industry, the HMO and health insurance industries and that faithless, sightless guardian of the welfare of the nation's elderly, the AARP, and after several months produced a turkey of incredible proportions.
Then Scully resigned his post with Health and Human Services and marketed himself to the private sector where he will no doubt find great success in uncovering loopholes, mining troves of hidden goodies and generally assisting Corporate Medicine to get fat at the trough.
Lapham wrote in December that this measure could become the biggest federal give-away since the transcontinental railroad boondoggles of the 1870's, with a tab expected to cost taxpayers a cool $400 billion (yes, with a "b") over the next 10 years. In January we found out the estimated size of the giveaway has already grown by an estimated $120 billion—now its cost is pegged at $520 billion--and the bill won't even take effect for another 20 months.
The worst of it is that what Scully and company have foisted on us could also undermine the fiscal stability of Medicare. At least if Lapham and other writers who've raised questions about it are to be believed, there are major areas of concern that ought to be addressed in clean-up legislation before the massive reform kicks in.
But when Congresswoman Heather Wilson brought the U.S. Surgeon General to Albuquerque in January for an open-mic discussion of this new bill at the Palo Duro Senior Center, the press coverage of the event in our daily fish wraps and on the evening news was so inept and misleading that it leads me to despair of the public ever getting anything close to the information that we need to be able to push our elected representatives into doing the right thing.
The meeting involved brief statements from Rep. Wilson and the Surgeon General about the bill and then was essentially open to questions from the audience. And there were lots of questions asked by the 150 or so in attendance—angry questions about provisions of the bill that seemed unfair; fearful questions about parts of the measure that need to be improved. And there were a lot of creative suggestions offered as well for how to correct it.
But in reading the coverage of the meeting in the following morning's Albuquerque Journal, I would never have been able to recognize the meeting that had actually taken place. All the Journal did was paraphrase the press release that had been passed out at the meeting. Not surprisingly, that press release, prepared by Wilson's staff, emphasized how wonderful it is that now seniors have a way to pay for medicines.
Anyone reading the Journal's article would have concluded that not only is Medicare Reform the best thing to come down the pike since sliced cheese, but America's seniors are solidly enthusiastic about the new approach. Not a word about the concerns expressed. No suggestion that maybe, just maybe, there might be trouble down the road with some major parts of the bill. No hint that many of our seniors are thoroughly pissed.
If the press fumbles something as major as this, our system breaks down totally. At least in England the opposition can raise Cain in parliamentary debate. The pointed questions certainly get asked there. In the United States, however, we've relied on an independent, suspicious, hard-to-convince press as our first line of defense against bad legislation.
When they don't ask questions (worse: when they don't even manage to report that other people are asking questions) we have lost our only true check and balance against bad legislation. And this is bad legislation!
So what could be wrong with finally offering seniors prescription benefits? For starters, here are two glaring trouble spots.
First, it adopts the most expensive approach imaginable in providing medications. The pharmaceutical industry will lap up hundreds of billions in profits from this measure ... and there is no way to finance it included in the bill itself. Instead, it's left up to the future. Bought on credit, these medicines represent a huge debt that will have to be paid by our children someday.
Second, it leaves many observers suspicious of permitting HMO's to exercise "maximum flexibility" in deciding whether or not to enroll seniors. It is to the HMO's benefit to cream the potential enrollees, leaving to Medicare those seniors most in need of medicine. That could bankrupt Medicare and lead to bigger problems in years ahead.