Bush’s variant of health insurance system

George Bush wants to create an ownership society -- a place where informed citizens take responsibility for their &to=http:// english.pravda.ru/cis/2001/05/09/4935.html ' target=_blank>economic affairs with an assist from the free market. The president hopes to use that formula to overhaul Social Security and maybe Medicare, the health insurer for the elderly. If he succeeds, government will be transformed and Washington will get out from under some huge financial liabilities. But when it comes to the third big entitlement program, Medicaid, which provides healthcare to the poor, the ownership formula may not work. Government is stuck with the Medicaid problem, in large measure, because the private sector can't or won't shoulder the responsibilities Medicaid has to bear. Congress last week struggled to trim the Medicaid budget, with the House and Senate failing to reach agreement. It is clear why Medicaid is a target. It is an expensive program (annual price tag $300 billion) and its costs rise inexorably with the cost of medical care. In the coming decades, spending on Medicaid will grow dramatically faster than spending on Social Security, according to the &to=http:// english.pravda.ru/usa/2002/02/07/26273.html ' target=_blank>Congressional Budget Office. Medicaid provides health coverage to about one in six Americans, more than 50 million in all, a number that has climbed by 10 million since 1999. The weak economy explains some of the rise in enrollment. The deterioration of the private health insurance market explains the rest. Between 2000 and 2003, the percentage of Americans with employer-sponsored medical insurance fell from about 63 to 60, according to the US Census Bureau. There are two reasons fewer Americans get insurance where they work: their companies don't offer insurance, or if it is offered, it is not affordable, reports the Boston Globe. According to the Christian Science Monitor, Congress is deliberating whether to punch another hole in the biggest safety net of all for those with little income - Medicaid and the related &to=http:// english.pravda.ru/society/2003/04/03/45536.html ' target=_blank>State Children's Health Insurance Program (SCHIP). Next to Social Security and Medicare, which serve all income brackets, Medicaid and SCHIP stand as Uncle Sam's biggest social program. They support 1 in 6 Americans and cover 1 in 4 children. Among low-income children and parents, they provide health insurance for more than 38 million Americans. Medicaid is a critical source of acute and long-term care coverage for 12 million elderly and disabled individuals, including 6 million low-income beneficiaries of Medicare with medical problems not paid for by that health program. Medicaid costs have soared in recent years. It will cost the states and the federal government about $322 billion this year, with Washington picking up $182 billion of that amount. One factor behind the soaring cost is the rapid rise in the price of medical services. Another factor is corporate America's many cuts in healthcare provisions for their employees and their retirees. So more people have sought Medicaid help. As a result, Medicaid has become a significant target for cutting federal spending. NR

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