Newly hatched deficit hawks in
Congress publicly sweat at the thought of supporting personal
accounts for Social Security. But they overlook the big-ticket
elephant in the entitlement-spending room. As Washington
Post columnist Robert J. Samuelson recently noted, when
Congress approved a drug entitlement for
Medicare, it approved the largest single spending increase
since the Great Society, complete with massive deficit
financing.
Lawmakers' desperate desire to look the other way is somewhat
understandable. After 2003's two-semester push to pass a Medicare
bill, most in Congress want to pretend they're done and never have
to crack that textbook again.
But the bad news, which is becoming clearer every day, may leave
them no choice. Medicare's trustees now say that the program is in
the hole by $29.7 trillion. This represents unfunded Medicare
benefits promised to current and future retirees. It's no great
surprise that members of Congress don't want to discuss whether and
how, precisely, they will sock young taxpayers with this big
bill.
The latest Medicare trustees' report shows that the long-term cost
of Medicare's unfunded promises jumped roughly $2 trillion in just
one year. Indeed, the debt for the drug benefit alone jumped from
$8.1 trillion to $8.7 trillion. So, in just one year, the long-term
estimates of the drug entitlement increased a whopping $600
billion. At this rate, even before the benefit is in place, imagine
what that number will be next year!
For now, Congress has turned its back on this mounting problem. If
worse comes to worst, today's 20-somethings, who pay even less
attention to entitlement costs than do members of Congress, will
foot the big bills tomorrow.
Some lawmakers, however, see the Medicare drug benefit for what it
is: a ticking time bomb set to wreak havoc on the budget and shoot
future tax rates sky-high. But even among them, there seems to be
only one adult, Rep. Jeff Flake (R-Ariz.), who recognizes that the
Medicare problem is not just a matter of dollars, but major
health-care policy.
Flake sees the problem as more fundamental. He knows that tinkering
around the edges of the drug benefit -- say, by letting the
government "negotiate" (i.e., "fix") drug prices -- won't fill much
of Medicare's long-term fiscal hole and that it's dangerous to
boot. What's needed instead is a return to the drawing board. And
Flake has already sketched out a plan.
Flake's Medicare Prescription Drug COST Containment Act has three
interlocking parts, but it can be explained in one easy sentence:
Put off the hideously expensive and complicated drug benefit until
Congress can figure out a way to pay for it. Flake's bill would 1)
delay the drug benefit for one year, 2) extend the new Medicare
prescription drug-discount card program, which was slow to take off
but has proven effective at channeling aid to those who need it
most, and 3) maintain funding for seniors today receiving coverage
through Medicaid who would have been dropped into the new
program.
So far, co-sponsors for the legislation are few, but that could
change overnight. The federal and state bureaucracies have high
hurdles to jump if they're going to be ready by Jan. 1, when the
drug benefit is set to go into effect. Already, some large
companies are beginning to notify their retirees to get ready to be
dumped into the federal program, which provides poorer coverage in
almost every case.
And word of the dreaded "doughnut hole" (a large gap in coverage
that would leave many seniors with high drug bills unprotected) is
starting to spread beyond Washington to seniors, who don't like the
idea one bit. Members of Congress may soon find themselves
searching frantically for a way out. If so, Flake's solution should
meet their pressing needs.
More lawmakers need to wake up to the true cost of their
irresponsible handiwork. A year's delay could give them the chance
to avoid this mess, study the issue calmly, and -- this time -- get
it right. Flake's got the right idea.
Robert Moffit is
director of the director of the Center for Health Policy Studies at
the Heritage Foundation, where Andrew Grossman is senior Web
editor.
Distributed nationally on the Knight-Ridder Tribune wire