WASHINGTON, March 4 (UPI) -- President George W. Bush on Tuesday presented a framework for revamping Medicare that would preserve the traditional form of the healthcare plan while encouraging membership in enhanced and managed-care plans that offer a subsidized prescription drug benefit.
"Our vision, our goal is a system in which all Americans have got a good insurance policy, in which all Americans can choose their own doctor, in which seniors and low-income citizens receive the help they need, in which -- the system is one in which the patient-doctor relationship is the center of good medical care," Bush said.
The president made his comments before the American Medical Association, a standards and lobbying group representing doctors. Bush offered his proposal that would usher the nation's Medicare beneficiaries -- some 40 million seniors -- into one of three types of plans, leaving Congress to hammer out the details of the plan such as the level of prescription drug coverage.
As a nod to physicians who have faced skyrocketing malpractice insurance premiums, Bush promised a 1.6-percent increase in Medicare reimbursements.
The Bush administration has estimated 77 million Americans would be in Medicare by 2030. It also estimated the fund for hospital insurance -- the Part A Trust Fund -- will face cash-flow deficits beginning in 2016, and Medicare's fund for its other benefits under Part B, which includes doctor visits and other non-hospital healthcare costs, likely would require a doubling of its premiums to remain solvent over the next 10 years.
Bush wants to set aside $400 billion over 10 years for the reforms.
Bush said medicine in 1965 meant physician care inside a hospital. Modern medicine, he said, offers drug therapies, new medical devices, disease screening and preventative care -- choices that not all seniors have access to.
"Compared to people with private health plans, Medicare patients have limited choices. Medicare will pay a doctor to perform a heart bypass operation, but will not pay for drugs that could prevent the need for surgery. Medicare will pay for an amputation, but not for the insulin that could help diabetes patients avoid losing their limbs," Bush said.
Meanwhile on Capitol Hill, Democrats lobbed criticisms at the Bush plan and countered by rolling out their own prescription drug program.
"I am concerned that once again the president will coerce seniors out of Medicare and into HMOs. They're going to force seniors to give up the doctor they choose for the drugs they need. That is a false choice. That is wrong, and that ought not be the direction we take prescription drug benefits in this country today," said Senate Minority Leader Tom Daschle, D-S.D.
"The meager benefit he is proposing, even with its coverage gaps and high out-of-pocket costs, won't be available to the 89 percent of Medicare beneficiaries who are enrolled in the existing fee-for-service program," said Rep. Nancy Pelosi, D-Calif.
Under the House Democrats' plan, Medicare beneficiaries would pay a $25 monthly premium and a $100 deductible. Medicare would pick up 80 percent of drug costs, with a $2,000-a-year out-of-pocket limit. Low-income recipients with incomes up to 150 percent of the federal poverty level would pay no premium.
"Democrats are offering seniors the prescription drug benefit they deserve -- one that is comprehensive and affordable, without any gaps or gimmicks. Under our plan, meaningful help would be available for all Medicare beneficiaries, including those who choose to stay in the same Medicare program they have trusted for nearly 40 years," said Pelosi.
"And our plan maintains the choices that matter most to the elderly and disabled -- which doctor to go to and what pharmacy to use."
Democrats have balked at the prospect of tampering with Medicare and vowed to preserve the entitlement program.
Rep. John Spratt, D-S.C., said the Bush proposal fails to provide a meaningful benefit to any senior, particularly those who stay in traditional Medicare.
"The president now says that seniors who stay in the traditional Medicare program can get prescription drugs under his proposal, but the main thing he is giving them is a prescription drug discount card," Spratt said.
"This drug card isn't true insurance and this latest proposal still provides preferential treatment for seniors who move into private health plans, giving second-class treatment to seniors who stay in traditional Medicare."
