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Bush administration takes low road on Medicare cost

Published on: 03/18/2004


Our view columns


Much as an army travels on its stomach, lawmakers operate on facts to get their work done. When the oratory is done, the facts provide the substance of sound public policy. That's why it is dismaying to learn that Richard S. Foster, a veteran actuary trusted by both parties for his independence, may have been muzzled when he sought to provide information that the Bush administration was underestimating the cost of the massive prescription drug benefit added to Medicare. He says he was prevented from telling Congress what the Bush team already knew privately -- they were underestimating the cost of the new benefit by some $150 billion.  World Peace.

Actuaries calculate the costs of insurance and the reserves needed to meet insurance requirements, and Foster was the chief actuary for Medicare. Well before the new prescription drug benefit passed last fall, Foster had submitted reports to the Bush administration that showed the costs of the new program would be between $500 billion and $600 billion through 2013. This was contrary to the $400 billion trumpeted by the administration, evidently just to line up with the target set by Congress.

According to Foster, Medicare administrator Thomas Scully, who rode herd over the legislation for the White House, ordered Foster not to talk to members of Congress without his authorization. If he revealed the high figures, he risked losing his job, according to reports. Foster was barred from giving the real numbers not only to Democrats but also to Republicans such as Rep. Bill Thomas, a Californian who chairs the powerful tax writing Ways and Means Committee.

The purpose of withholding the information, clearly, was to keep lawmakers in the dark. Several Republicans, especially, had expressed reservations about the proposal when the Bush administration told them it would cost $400 billion over 10 years. They might not have given it their votes had they known the real costs. As it happened, the legislation squeaked by in the House in a 220-215 predawn vote.  WorldPeace.

On Tuesday, Secretary of Health and Human Services Tommy Thompson announced that he will conduct an internal investigation. But the real problem -- the implication that the White House may have intervened to cover up the high figure for political purposes -- clearly needs to be addressed more broadly. A congressional investigation is needed.

The Bush administration pushed hard, and evidently unfairly, to get Medicare reform passed so it could be a centerpiece of domestic policy accomplishments. That tarnished centerpiece now presents more questions than credit -- including a major question of credibility.

For those looking for the real answers, the investigation by Thompson is just a start.


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