Hopping Mad About Medicare

COMMENTARY Health Care Reform

Hopping Mad About Medicare

Apr 10th, 1998 2 min read
Edwin J. Feulner, Ph.D.


Edwin J. Feulner is the founder and president of The Heritage Foundation.

If you bring a pan of water to a boil first and then try to drop a frog in, the frog will immediately hop out-burned and understandably angry. But, if you place the frog in cold water and gradually turn up the heat, the frog will boil to death.

Four years ago, President Clinton turned the burner on high by pushing for an entirely government-run national health-care system. But before he could get us into real hot water, we wisely hopped out.

Having learned his lesson, the president has since been attempting the slow-cook method, by implementing his government-run system piece by piece. First it was "Kidcare," which established the same sort of government-sponsored "purchasing alliances" envisioned in the president's health-care plan. Then there was the "Patients' Bill of Rights," which proposed a slew of new government mandates on insurance providers.

Now there is a new law that makes it all but impossible for senior citizens and doctors to do private business outside of Medicare's rules and regulations.

If you're already covered by Medicare, you are effectively barred-by a provision that President Clinton insisted on including in the 1997 budget agreement-from paying directly for medical services covered by Medicare with your own money. You are effectively barred because any doctor who enters into such a private "contract" cannot accept any Medicare payments on behalf of any other Medicare beneficiaries for two years. Of course, very few doctors can or will make such a sacrifice, leaving seniors with no alternative to Medicare.

Essentially, this new restriction (known as Section 4507) tells the elderly that their concerns-and freedoms-are less important than the dictates of the bureaucracy. Contrary to what the bureaucrats and their allies in Congress are now saying, there are few exceptions to section 4507. Your mother or grandmother might like a particular doctor and want to take advantage of his special skills. She may want to receive special medical care (such as psychiatric help) and keep the treatment confidential. Or she may simply cherish the convenience of dealing directly with a doctor outside of Medicare's maze of rules and regulations. Too bad.

Why do President Clinton and the nanny bureaucracy want to prevent Medicare patients from contracting with private doctors? Because like "Kidcare," the "Patients' Bill of Rights" and similar initiatives, it establishes a precedent. Today, it's the kids and the elderly; next year, maybe the entire public.

Fortunately, lawmakers are fighting back. On April 1, Sen. Jon Kyl, R-Ariz., won passage of a "sense of the Congress" resolution that seniors have the right to see any physician of their choice, and to not be limited in that right by the imposition of "unreasonable conditions" on the doctors. While 51 senators agreed to the resolution, a shocking 47 did not. Sen. Kyl also has introduced a bill in the Senate to overturn Section 4507. A companion bill has been introduced by Rep. Bill Archer, R-Texas, in the House. The issue is also being fought in court with a lawsuit brought by United Seniors Association and several Medicare patients.

If allowed to stay on the books, Section 4507 is likely to have some unintended consequences. Forcing doctors to choose between staying in or getting out of Medicare could cause some of the best doctors to leave, restricting their practices to wealthy seniors who don't need Medicare in the first place. The result: Medical freedom for seniors will become the exclusive preserve of the wealthy, creating the kind of "two tiered" health-care system liberals say they oppose.

The water in the pan is getting warmer, and it's time we all got hopping mad. The longer we sit, the more our freedom is slowly boiled away.

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