Bitter Medicine

The Bush Medicare overhaul seemed too good to be true. Guess what? It was.


The Bush administration declared its sweeping Medicare reform law a triumph of compassionate conservatism, and a success where Clinton’s team had notoriously flopped.

If it seemed too good to be true, it was — at least at the advertised price. The bill squeaked by last November at dawn, after final, grueling hours of flesh-pressing and arm-twisting won round lawmakers, many of whom balked at the law’s $400 billion price tag. It turns out the overhaul will in fact cost more than $500 billion — and, according to Medicare’s top accountant, the administration knew this all along.

Meanwhile, the White House is spending $100 million on media blitz to sell the law — a particularly bald-faced piece of politicking on the taxpayer’s dime. A large chunk of the money is going on “video news releases” sent to network journalists and often dropped unedited into
newscasts. In the footage, distributed nationwide in English and
Spanish versions, actors masquerade as reporters saying good things about the new, improved Medicare.

Lawyers from the General Accounting Office, investigating charges that the ads are “illegal propaganda,” last week declared
them legal despite “notable omissions and other weaknesses.”

Livid editorials, from The New York Times to the San
Francisco Chronicle,
have blasted the Bush team for concealing the costs and spinning the law. The Times railed
against the “Orwellian taint” of the administration:

This sleight of hand only deepens doubts about White
House credibility on a complex issue. The public deserves
straightforward information about the changes in Medicare, and
federal agencies should not be engaging in political spin. This is no
way to run a democracy nourished by information and taxpayers’
money.

Will the 41 million people who rely on Medicare to stay healthy
into retirement agree? Well, first they have to understand the law, which isn’t easy. The new Medicare enrolls seniors in HMOs and will experiment with letting them choose between private and public insurance. Many
members of AARP, the nations’
largest senior-citizen membership organization, accused the group’s
leadership of selling out. AARP maintained that the law’s
compromise prescription price cuts were better than nothing, but
only 8 percent of seniors polled recently by the New York
Times
and CBS News thought the law would shrink their medical
costs.

An Associated Press survey recently found that 55 percent
of respondents trusted Democrats with health care, against 33 percent
trusting Republicans–roughly the same results as an ABC News poll
four years ago.

Which is bad news for Republicans, who thought they had a winner here. James Harding of the Financial Times
explains that:

Republican leaders are deeply frustrated by the
party’s failure to make political inroads on traditional Democrat
territory. A senior Republican acknowledged recently that the
Republic and were losing the “public relations battle”.

At issue is whether the biggest Medicare reform in 38 years chiefly benefits consumers or corporations. It covers
three-quarters of drug expenses up to$1,250 and then 95 percent above
$5,100. The government will rule out some 1.8 million people from
the low-income category that would exempt them from paying premiums.
The system also prevents people from buying supplemental insurance to
cover gaps in the federal plan.

As Harding puts it, people over 75, who comprise some 7 percent of
voters, “are generally staunch New Deal supporters and see the
Medicare legislation as a treacherous lurch towards
privatization.”

This impression could shift in summer, once Medicare beneficiaries
receive new drug discount cards — if, that is, they prove to be helpful. Yet
the benefits are so complicated that people are likely to remain
confused through the election season. Meanwhile, some 10,000 seniors
and retirement centers are receiving Washington-sponsored videotapes
that try to explain the law. The nonprofit Families USA is
countering with a videotape narrated by Walter Cronkite.

A Health and Human Services spokesman said of the government tapes that there was “no expectation that a TV station will use
this word for word,” according to Reuters. There’s nothing unusual
about this, or even about the suggested news anchor scripts sent with the film clips.
European journalists must label pre-packaged footage as such, but the
U.S. lacks such regulation.

President Reagan’s media relations gurus were the first to master
feeding pre-prepared news reels to the media, and every
administration since the 1980s has done it. The ploy is a common tool for
corporations, such as pharmaceutical giants who laud their drugs’
“medical breakthroughs” by cutting images of pills rolling off a
conveyer belt with a real doctor’s beaming testimony. Cash- and
time-strapped local newscasts often use the samples without
explaining their origin or countering the message. You don’t need to be a medical ethicist to see the problem with that.

In the meantime, presidential hopeful John Kerry is using the
opportunity to accuse Republicans of catering to special interests.
Pushing the bill last year, lobbyists from AARP spent more than $20
million, and those Pharmaceutical Research and Manufacturers of
America (PhRMA) spent some $16 million, according to The Hill.

Knight-Ridder quotes another Massachusetts liberal, Sen. Edward
Kennedy, asking the question “What did
the president know and when did he know it?” (Watergate, anyone?)

The White House is now backing an investigation, called for by
Democrats and by the Health and Human Services head, into the charges that at the time the bill was working its way through Congress, the top Medicare accountant, Richard Foster, was threatened with losing his job if he revealed his own cost estimate of
up to $600 million.