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Serving Up Social Security and Medicare, Without the Fixings

By Dana Milbank
Tuesday, May 2, 2006

"The job of a president," George W. Bush used to say almost daily during the 2004 campaign, "is to confront problems, not to pass them on to future presidents and future generations."

Astute observers may have noticed he's been saying that a bit less frequently these days. Yesterday showed why.

The president was over at the Washington Hilton, speaking to the American Hospital Association about his Medicare Modernization Act of 2003. "When I came into office I found a Medicare program that was outdated," he announced. Seeing this "not very cost-effective" program, he continued, "I decided to do something about it. And I worked with the Congress, and we passed critical legislation that modernizes Medicare."

An hour after Bush finished his speech, Treasury Secretary John W. Snow kicked off a news conference announcing the latest on Medicare's financial standing. The "modernized," cost-effective program is forecast to go belly-up in 2018 -- two years earlier than previously forecast.

Somebody stop us before we reform again.

Snow also announced that Social Security -- reform of which the Bush administration abandoned last year -- will become insolvent in 2040, a year earlier than previously projected.

The Treasury secretary warned of "a looming financial crisis for our nation."

Medicare and Social Security trustee Thomas Saving chimed in, "Either government is going to have to be a lot smaller, or these programs are going to have to be dramatically changed."

Bush himself, while talking about the success of his addition of prescription-drug coverage to Medicare, acknowledged that both programs are, as he put it, "going broke." He added, "It's time to set aside politics and restructure Social Security and Medicare for generations to come."

Then again, what's the hurry?

In his State of the Union address, the president called for a bipartisan commission to study Medicare and Social Security. Lawmakers immediately recognized that as a punt. Now it seems the punt is being followed by a delay-of-game penalty. More than three months after Bush proposed the commission, there is no commission and no commissioners; he has mentioned the idea only twice since January.

"Well," Snow ad-libbed yesterday when asked about the commission, "it's being worked hard." Asked to elaborate, he said, "there's outreach by the White House."

Congress Daily's Keith Koffler wasn't satisfied. "It's been three months -- why haven't you been able to get a commission together?" he pressed.

"I think it's important to get this done right," Snow ventured.

Treasury spokesman Sean Kevelighan didn't like the direction this was taking. "One more question," he called out.

Accepting the Republican presidential nomination in 2000, Bush chided Bill Clinton: "So much promise, to no great purpose." By contrast, Bush vowed to put Medicare on "firm financial ground" and said of Social Security, "I intend to fix it." Six years later, the president is floating some of the bite-size policies he once criticized Clinton for doing.

The jumbo TV screen in the Hilton ballroom before Bush entered proclaimed this "Cover the Uninsured Week" and pointed out that "Today, 45 million Americans have no health insurance."

Bush opened with a bold vow: "a comprehensive health care strategy that will make health care more affordable and available for all our citizens." Then he outlined a five-point program: medical malpractice reform, pooled insurance for small businesses, tax-free health savings accounts, better medical information technology and more "transparency" in medical pricing.

The hospital administrators liked all the ideas, particularly the malpractice bit, which prompted an enthusiastic ovation. But they didn't see Bush's proposals (a plan to have doctors display their fees just as restaurants post menus) as all that comprehensive. "It will help, but it won't solve the problem," said Thomas Nickels, the hospitals' top lobbyist, after the speech. "Not to be critical, but we need to look at this as one element of a broad package."

Broad package? At the moment, the administration and Congress can't even agree on who should be a trustee of Social Security and Medicare. The chairman and the ranking Democrat on the Senate Finance Committee wrote to Bush last week calling for the resignation of the two public trustees he recently reappointed. At yesterday's news conference at the Treasury Department, one of the trustees devoted his remarks entirely to rebutting the two senators.

Snow and his administration colleagues, for their part, sought to celebrate the prescription drug plan. "A success," pronounced Snow, in front of a money-green backdrop. "Enrollment has so far exceeded the expectations the administration put forward earlier this year."

That line fell apart when the first questioner pointed out that the trustees had, in fact, found lower enrollment in the drug plan "than was expected a year ago." Enrollment had exceeded expectations because the administration had lowered the expectations.

But not to worry: Even with yesterday's bad news, we still have a dozen years before Medicare collapses.

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