Medi-Scare Tactics

To listen to the current campaign rhetoric, you'd think the future of Medicare, the federal health insurance program for the elderly, poses irreconcilable differences between Democrats and Republicans.

Proposed cuts in Medicare, after all, are exhibit A when the Clinton campaign is attempting to prove "Dole-Gingrich" heartlessness. The Dole camp fires back that the Clinton charge is proof of the president's inclination to shade the truth.

But before getting into the truth in that point-counterpoint, let's recall a few basics about Medicare.

The now $200 billion-a-year program is growing explosively. In June its trustees warned that the program's hospital insurance trust fund is projected to run out of money by 2001. Their findings confirmed figures released by the Congressional Budget Office earlier this year.

The unsustainable pace of Medicare spending is recognized on both sides of the aisle in Washington. In 1995, the Republicans' budget-balancing plan included a seven-year, $270 billion reduction in the growth of spending. That plan was vetoed by President Clinton. By early 1996, both the administration and congressional Republicans had fielded new plans. Overall reductions proposed by both sides aren't that far apart: $168 billion for the new GOP plan; $124 billion for the administration's.

There are, of course, some differences on how to achieve these reductions. Republicans, for instance, would demand higher premiums from some recipients. Mr. Clinton would rely heavily on moving $55 billion in expenses out of the troubled hospital trust fund into other government funds. That accounting maneuver lies behind his promise to give the trust fund an added 10 years of solvency - allowing time, he says, for a real solution.

In fact, a real solution is practically at hand, given the common ground between current Democratic and Republican plans. But it is purposefully obscured by campaign politics.

Mr. Dole has a point when he accuses his opponent of blurring the facts on Medicare in order to frighten older voters into the Democratic fold. The Republicans have never proposed "cuts" per se, only reductions in the rate of growth. (Though actual cuts, in term of coverage for future recipients, would seem likely no matter whose plan is adopted.) The $270 billion figure pushed last year by the GOP and vetoed by Clinton was a campaign ace for the Democrats. But if that hand is overplayed now, it could undermine the spirit of consensus needed to rein in the program.

Entitlement reform, led by an overhaul of Medicare, is going to become even more urgent in the years ahead. Honest candidates will remind voters of that as they try to grab the mantle as Medicare's savior.