Copyright 2002 The Houston Chronicle Publishing Company  
The Houston Chronicle
December 22, 2002, Sunday 2 STAR EDITION
SECTION: A; Pg. 8

LENGTH: 712 words

HEADLINE: Health care back in spotlight;
Bush to address coverage, prescription issues in new year

SOURCE: Newhouse Service

BYLINE: MILES BENSON

DATELINE: WASHINGTON

BODY:
WASHINGTON - Here we go again.

Health care reform, the storm that stalled Democrat Bill Clinton in his first term, is returning as a central issue in American domestic policy - only this time, Republicans are pulling the oars.

President Bush will address the matter in the State of the Union speech he delivers in mid-January and in the budget he submits to a sympathetic new Congress in February.

Despite uncertain economic conditions, the distraction of terrorism and the prospect of war with Iraq, Bush and GOP congressional leaders say they are committed to providing prescription drug benefits for elderly Medicare beneficiaries and the disabled, as well as to helping obtain coverage for the growing numbers of Americans without private health insurance.

But the combination of drug benefits and aid to the uninsured won't be easy, and may not be enough to avert a gathering crisis. Consider:

The cost of private health insurance is going up 12 percent annually yet the insured are paying more out of pocket and getting fewer benefits.

About 41 million people, one in seven Americans, are uninsured and the number is rising.

Financially strapped state governments are cutting Medicaid and other public health programs by restricting eligibility and reducing benefit levels.

The price of all health care is rising as new drugs, tests and procedures are introduced and a labor shortage, particularly in nursing, drives up hospital costs.

Tens of thousands of people die from medical errors each year and far more are injured while beneficial services are underused and medically unnecessary procedures are widespread.

Racial and ethnic disparities mar equality and justice in access to health services.

More than one-quarter of youths under 19 are deficient in immunizations.

Heart attacks annually kill 18,000 people eligible for, but not getting, preventive medicine.

These are just some of the problems listed in a recent report prepared for the administration by the Institute of Medicine of the National Academies of Sciences.

Also looming are the steep costs that retiring baby boomers will impose on the federal budget starting in 2011, when they begin to reach 65 and become eligible for Medicare. By 2035, 82 million Americans - double the present numbers - will be enrolled in the entitlement program. By 2075, the number will be nearly 104 million. The long-range problem will force major changes if Medicare is to avert a fiscal train wreck.

"The current Medicare fee-for-service program will become unsustainable both economically and politically with escalating tax increases and reductions in other government programs to support it," said G. William Hoagland, Republican staff director of the Senate Budget Committee.

For Republicans wary of a senior backlash against attempts to change Medicare, the prescription drug benefit offers the necessary political cover to "modernize" - as Bush put it - the entire system.

White House spokesman Scott McClellan, in confirming that Bush would take up health care in the State of the Union address and in his new budget, said the president seeks "a patient-centered system, not a government-run system. One that increases access to affordable, quality health care for all Americans with more and better options." That can be accomplished, McClellan said, "if we can hold the line on spending elsewhere in the budget."

For now, McClellan said, Bush continues to believe Americans have "the best health care system in the world."

Even so, that system "is incapable of meeting the present, let alone the future needs of the American public," the national Institute of Medicine said in its report last month.

"Since there is no accepted blueprint for re-designing the health care sector," the institute's experts said, they recommended broad government efforts to test strategies to computerize health care, expand insurance coverage to those who lack it, reform medical malpractice law, better manage chronic diseases that consume most of the system's resources and improve delivery of primary care.

If the Bush administration adopts these recommendations, some improvements may appear within two years, although the bulk of reforms would take 10 years or more, the experts said.



LOAD-DATE: December 23, 2002