|5/24/2011 11:37:00 AM|
Notion of privatizing government programs worries agency heads
Congressional Republicans have abandoned a plan to retool Medicare and are seeking to cut spending in other ways.
Catholic News Service photo
A senior citizen reads the label of her prescription medication in her home.
Catholic News Service photo
Lyndon Johnson signs Medicare bill in presence of Harry Truman in 1965.
|Federal health aid took time to pass|
|Franklin Roosevelt and Harry Truman both proposed government-funded health insurance. Truman's National Health Insurance would have covered every American and would have included doctors, hospitals, nursing, lab work and dental services.|
But the ideas met fierce opposition in Congress and from the American Medical Association, which warned of the perils of "socialized medicine."
John F. Kennedy urged lawmakers to create health insurance for elders after a survey found that 44 percent of those age 65 or older had no coverage.
It was not until 1965 that Lyndon Johnson and his new Democratic majorities in Congress passed revisions to the Social Security Act, establishing both Medicare and Medicaid to insure people who are elderly or poor. The package passed the House 313-115 and the Senate 68-21.
Johnson signed the legislation in the presence of Truman, who was given the first Medicare card.
Johnson remarked, "We marvel not simply at the passage of this Bill but that it took so many years to pass it."
In 1972, amendments extended Medicare to people with disabilities. In 2003, a prescription drug benefit was added for seniors and people who are disabled.
The shift came in part because constituents pilloried House members who voted for a bill to replace guaranteed Medicare benefits with vouchers.
But GOP leaders say they'll take another run at the big entitlements in the future, probably with intent to privatize them. The targets include Medicare, the nation's health insurance for elders, and Medicaid, a program for people with low income.
Privatization could have adverse effects on patients with limited means, say Catholic social service leaders in Oregon.
"Low income people have very low access to capital. Shifting to a voucher system basically is depriving them of access to insurance because the voucher is not enough to cover all the insurance," says Terry McDonald, executive director of St. Vincent de Paul of Lane County.
Co-payments and other health plan costs that would come with privatization would further burden patients, he predicts.
"We need to stop thinking about how we make everyone individually responsible and get back to thinking about how we have a common responsibility," McDonald says.
Catholic Charities workers across the state serve Medicare and Medicaid recipients daily. Doug Alles, director of social services for Catholic Charities of the Archdiocese of Portland, says a reduction in the safety net, plus increasing costs of health care, raise nightmarish fears of rationing; it's imaginable that only wealthy patients will have access to expensive technology, for example.
"It's a scenario almost out of science fiction," Alles says.
Both McDonald and Alles say the privatization would mean increased pressure on Catholic hospital emergency rooms, the last resort for people without enough health care access. Emergency room visits, highly expensive, tend to increase health care costs for everyone.
Neither Providence Health and Services nor PeaceHealth would offer a comment for this story because the issue is so new.
But in a letter sent to House members April 6, Sister Carol Keehan, president of the Catholic Health Association, called proposed Medicaid cuts "draconian." She urged lawmakers to vote against the reductions as a way to "stand with us in defense of the poor, most vulnerable and middle class."
Sister Carol warned that restructuring programs into block grants and vouchers vouchers "fundamentally alters their mission and purpose in ways that greatly undermine their ability to serve beneficiaries."
Critics of the Republican plan, including a handful of governors, say it would shift health costs to patients who cannot afford it.
The plan passed by the House would have affected only those now younger than 55. But across the country, today's seniors still lit into their representatives out of concern for descendants.
Rep. Paul Ryan, the Wisconsin Republican who formed the now-spurned Medicare idea, has defended it, saying it would require higher-earning Americans to pay more of the costs. He rejected the criticism that he had proposed a voucher program at all, instead saying it created a menu of options for which the government would pay.
Rejecting what he characterizes as spurious predictions of doom, Ryan told the New York Times that the budget he proposed would put the debt on a downward track and help create a debt-free nation, in his view a vital move for future generations.
Meanwhile, Paul Krugman, the Nobel-prize-winning economist who writes for the Times, says privatizing Medicare and creating the menu plan would do nothing to control costs.