Columnist David Broder: There’s no hiding anger at Clinton rhetoric

David Broder

Monday, March 15, 1999 | 11:26 a.m.

INDIGNATION IS something skillful politicians can switch on and off like a light bulb -- a useful tool in debates and negotiations. What was on display the other day at the first Senate hearing of the year on Medicare was something different -- genuine frustration and anger at the hollowness of the Clinton administration's posture on this critical issue.

The man who bore the brunt of the attack was Jack Lew, the White House budget director and leadoff witness. But the real target was Clinton himself, who has talked a good game about saving the health care program on which 39 million retirees depend but done precious little to help.

In his State of the Union speech in January, Clinton proposed setting aside 15 percent of the projected budget surpluses to extend the life of the Medicare trust fund -- now expected to be insolvent by 2010 -- until 2020. And he added, "We should ... look at new ideas, including the upcoming report of the bipartisan Medicare commission ... and cover the greatest growing need of seniors: affordable prescription drugs."

Understandably, viewers came away thinking this wonderful president has found a painless way to save a popular program from bankruptcy and is supporting a bipartisan effort to improve its benefits.

Members of the Senate Finance Committee knew better -- especially the three who serve on the commission Clinton mentioned: Democrats John Breaux of Louisiana, its chairman, Bob Kerrey of Nebraska and Republican Phil Gramm of Texas.

The committee had just received prepared testimony from two nonpartisan agencies, the Congressional Budget Office and the General Accounting Office, saying in unusually blunt language that Clinton, far from cracking the Medicare problem, may be making it worse.

Dan Crippen, the director of CBO, said that by transferring $350 billion from the anticipated budget surpluses to the Medicare trust fund in a "bookkeeping transaction," the Clinton plan would "delay the date of insolvency. But the transfer would do nothing to address the underlying problem: Rapid growth in spending for Medicare ... will still outstrip anticipated revenues."

The prescription drug benefits which Clinton touted in his speech (but did not include in his budget because he has no way to pay for them) "would be popular with beneficiaries," Crippen said, "but the additional program costs would be large."

David M. Walker, the head of GAO, was even more biting. By proposing a large-scale shift of general revenues to a program now largely financed by payroll taxes, Walker said, the Clinton proposal "could serve to undermine the remaining fiscal discipline associated with the self-financing trust fund concept."

Breaux told Lew he found the GAO analysis "pretty disturbing," and demanded, "Where is the reform?" Lew said Clinton was suggesting only "modest changes," mainly in the form of freezing reimbursement rates to hospitals and doctors.

What all of the Senate Finance Committee members know is that Clinton, while ostensibly delaying more substantive program reforms until Breaux's commission reports, has not lifted a hand to help Breaux find the 11 votes he needs for a consensus report.

All eight of the commission Republicans, plus Breaux and Kerrey, support a set of structural reforms that would require beneficiaries to pay a share of their premiums, on an income-based sliding scale, providing enough funds for prescription drugs.

Breaux aside, none of the White House appointees to the commission has endorsed the plan, apparently still awaiting a green light from the president. "If someone down there would just say to one of them, 'the president thinks it's important to get this done on a bipartisan basis,' it would happen," Breaux told me.

But with the impasse unbroken, he is less than a week away from throwing up his hands and disbanding the commission. The blame does not rest on him, any more than it does on Jack Lew. Unless Clinton acts, this failure will become another part of his legacy.