Reprinted from The Washington Times , 5am -- April 16, 1998
Parties observe health care truce
By John Godfrey
THE WASHINGTON TIMES
KANSAS CITY, Mo.R.T. Reza, 85, sat in the Penn Valley Community College gymnasium, sharing a box lunch with his wife, Ernestine. The retired minister and his wife, a former nurse, came to hear President Clinton tell them about his plans for Social Security.
They know they will be taken care of, but they worry about their children and their grandchildren.
"It's about time we begin doing something," Mr. Reza said. "They have a right also to a good life."
Mr. Reza said he is tired of politicians always talking about these issues but never fixing anything.
"I believe they all personally have a desire to do something," he said. "The trouble is that in our type of democracy, politics always enters in."
The Rezas are part of a growing tide of voters concerned about the nation's ill and aged, seeking solutions, not slogans. Having been savaged in the past for touching the so-called "third rail of American politics," both Republicans and Democrats are cautiously testing which ideas will play on the campaign trail this fall.
So far, though, the proposals from both sides are just a bag of parts with no instructions attached.
A few politicians have drafted proposals. Many more have latched onto popular ideas such as creating private retirement accounts to supplement Social Security. But it is not clear how the two parties will line up on the issues or how they will use them in the elections.
Rep. Jennifer Dunn, Washington Republican, says she hopes the various independent commissions created to solve the looming financial problems of major entitlement programs such as Social Security and Medicare can reduce rancor and stop politicians from exploiting voter fears unfairly in the fall.
"We tried to solve the Medicare problem in 1995 ... and [Democrats] turned it around on us. It very nearly cost us the majority," Mrs. Dunn said. This time Republicans are including voters in discussions and working with Democrats, she said.
"It is a more mature approach. Moving fast frightens people," she said.
Sen. John B. Breaux, Louisiana Democrat, agreed. "I think these are all positive issues from a political position. We are talking about saving health care for seniors."
Mr. Breaux is running for re-election this year and co-chairs two separate commissions on reforming Medicare and Social Security, a situation that would have been political suicide just a few years ago.
The problems likely to be discussed in the elections are well known.
Payroll tax dollars intended to fill Social Security trust fund coffers are being used to pay for the federal government's general expenditures. As the baby boomers begin to retire, the cost of Social Security benefits going out will exceed the flow of payroll taxes coming in.
The same dilemma faces Medicare, but the crunch will come even sooner.
As for health care, widespread unhappiness with the quality of care at health maintenance organizations and other managed care companies could play a major role in the fall elections. Large majorities in polls say HMOs can too easily delay or deny treatment.
So far, the big push in Washington has been to resolve or defuse these issues. Party strategists are leery of trying to exploit patient HMO gripes until the political landscape becomes clearer.
Taking on the huge national pension and health care programs has always carried political risks. Members of the 1994 Bipartisan Commission on Entitlement and Tax Reform, headed by Sens. Bob Kerrey, Nebraska Democrat, and John C. Danforth, Missouri Republican, joked about having targets printed on their backs.
Things have changed since then. A persistent effort by ideologically diverse groups to warn people about the upcoming crises over funding for Social Security and Medicare has won many converts in the media and among voters. Coupled with a strong economy that has Americans feeling sanguine about most issues, "it is much more difficult to demagogue this issue than in the past," Mr. Breaux said.
Sen. Rick Santorum, Pennsylvania Republican, who chairs a Senate GOP task force on Social Security reform, said, "As a matter of fact, I think the third rail of politics is not talking about Social Security."
Gene Sperling, top White House economic adviser, said a number of outside groups have asked President Clinton to keep his "powder dry" on Social Security. "It would be a a lot more fun for most of us to have a plan" to save Social Security, Mr. Sperling said, "but it would become an election issue."
The Social Security "town meeting" attended by the Rezas is the first of a series planned by Mr. Clinton during the year, with any proposed changes reserved until the November election is safely in the books.
But the political cease-fire might not last, Mr. Sperling said. If a candidate is "suddenly down eight points in August, a lot of things get thrown on the table. ... People on both sides could say things that will make this more inflammatory," he said.
To that end, members of both parties are already testing battle lines.
With his State of the Union address and his 1999 budget, President Clinton tried to pre-empt Republicans from using budget surpluses for tax cuts by saying the government should "save Social Security first." Even though Mr. Clinton simultaneously outlined new spending programs that would have increased federal government spending by about $70 billion over the next five years, the argument of "every penny of the surplus" for Social Security still resonates and is a potent political tool.
"The top priority for Democrats will be 'save Social Security,'" said Michael Tucker, spokesman for the Senate Democratic Campaign Committee. Democrats, he said, will argue that "if Social Security were to be voted on today, none of the Republicans would vote for it."
Republicans are planning their counteroffensive.
"President Clinton's plan to box us in on Social Security vs. taxes is smart and effective politics, but we have an opportunity to flip the box by making the issue Social Security vs. new spending," notes a memorandum being circulated among House Republican leaders.
"Our policy and rhetoric ought to be: 'Not another dime of the Social Security trust fund should go to finance more Washington spending,'" according to the memorandum.
Survey results included in that memo indicated that voters would rather use the overall budget surplus to shore up Social Security than to cut taxes, pay down the debt or increase spending on federal programs.
The survey also found, however, that the willingness to spend on federal programs increases when those programs are listed by subject. Just 6 percent of voters said they wanted to spend more on "federal programs," but when asked whether they wanted to spend more on "federal programs like education, health care and the environment," the level of support quadrupled.
On Medicare, both Republicans and Democrats have begun to set up issues that could be used in an election. In 1996 the Medicare battle left many scars, but many analysts say this time around politicians may be hard pressed to turn complicated policy proposals into easy vote-getting slogans.
For example, President Clinton has offered a plan that would allow people from age 50 to 65 to buy into Medicare, arguing it would provide health care to people with no other alternatives.
Republicans call it a backdoor effort to revive the Clinton administration's failed national health program of 1994. And even Democrats see it as "attempting to work the Medicare issue again," according to a Democratic senator speaking on the condition of anonymity.
Republicans too are trying to lay the groundwork for issues they hope will play this fall.
For example, a dispute has broken out over Republican claims that current law precludes seniors from getting doctors to perform medical procedures not otherwise provided by the federal health care program. The Health Care Finance Administration, which administers the Medicare program, says Republicans are wrong. Political observers say the issue may appeal to some seniors but is too arcane to hit in the polls.
One health care issue that has touched a broader nerve -- and which could explode this fall -- is the treatment of patients by HMOs.
Rep. Charlie Norwood, Georgia Republican, has co-authored a bill with Sen. Alfonse M. D'Amato, New York Republican, that would give patients more rights when dealing with their health care providers and make it possible for them to seek redress through state government channels. The latter is currently precluded under federal law.
The bill has more than 218 co-sponsors in the House and Mr. Norwood says at least 300 members have said they would vote for it.
"This is sponsored by everyone from [Georgia Republican] Bob Barr to [Vermont independent] Bernie Sanders," said John Stone, Mr. Norwood's spokesman.
The problem is that health care providers hate the bill and are pressuring House and Senate Republican leaders to oppose it.
"Republican leadership is now engaged on this issue and is issuing strong directives to all players in the insurance and employer community to get activated," said an Oct. 22, 1997, internal memorandum from the Health Insurance Association of America leaked by Democrats. "The message we are getting ... is that we are in a war and need to start fighting like we're in a war."
Mr. Stone and Democratic and Republican analysts say that for now, HMO reform is a bipartisan issue.
House Republican leaders have formed a task force headed by Rep. Dennis Hastert, Illinois Republican, to draft a more palatable compromise. If a bill is produced and passed, how the HMO question plays will depend on the candidate and the district, not the party, Mr. Stone and others said.
But if the legislation dies, that could change.
"This could become a partisan issue," Rep. Robert T. Matsui, California Democrat, said. If they push too far, Democrats risk being painted as supporting a government takeover of health care.
One House leadership aide said it actually matters little what the final bill does, so long as a member can tell voters he backs a plan. Mr. Stone contended voters will know the difference between real legislation and a pale substitute. The question, he said, is whether the GOP will be "the party of Wall Street or Main Street."
Seventy-one percent of voters say they are more likely to vote for a candidate who supports federal action to protect the rights of patients, said the aide. Therefore, the risk for Republicans is that Wall Street prevails and the voters revolt.
- Congressional reporter John Godfrey will be tracking health and aging issues on the campaign trail through the 1998 election cycle. He can be reached by e-mail (godfrey@twtmail.com).
Copyright 1998 News World Communications, Inc.
Reprinted with permission of
The Washington Times.
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