MEDICARE RATIONING AT STAKE IN CONGRESSIONAL CONFERENCE COMMITTEE.

Five years after the pro-life movement won the ability of senior citizens to avoid rationing of lifesaving medical treatment, food, and fluids under Medicare, this right is again at stake in critical negotiations being conducted by a Senate-House conference committee dealing with bills to add a prescription drug benefit to Medicare. The fundamental question is whether seniors will be prevented from using their own money, if they wish, to gain access to insurance that will not ration prescription drugs - - or medical treatment.

President Bush has been pushing Congress to enact legislation adding a prescription drug bene-fit to Medicare, the mandatory government health insurance program for older Americans. On June 26, 2003, the Senate by a vote of 76 to 21 and the House by the very close vote of 216 to 215 adopted their separate versions of such a bill. Their differences leave critically important rationing issues unresolved.

Since its inception, the National Right to Life Committee has been as concerned about protecting older people and those with disabilities from euthanasia as about protecting the unborn from abortion. In the words of NRLC Executive Director David N. O'Steen, Ph.D., "Government-imposed rationing is a form of involuntary euthanasia. It is outrageous when, by law, the federal government prevents people from using their own money to save their own lives."

Then in 1997 the pro-life movement succeeded in creating an option in Medicare under which senior citizens can choose to add their own money, on top of the limited government payment, in order to select health insurance plans that are less likely to deny needed lifesaving treatment - - called "private fee-for-service" plans.

The economic reality is that in order to provide Medicare coverage for the baby boom generation as it retires without massive tax increases (which are highly improbable), government payments per beneficiary will not be able to keep up with medical inflation. If the funds available for health care for senior citizens from all sources are so limited, the only possible result will be rationing. Since senior citizens are required to participate in Medicare, this would amount to government-imposed involuntary euthanasia.

Private fee-for-service Medicare plans created an escape valve - - one alternative to rationing that does not either break the budget or require new taxes. That alternative permits those eligible for Medicare voluntarily to supplement government payments for health insurance premiums with their own funds, if they wish, in order to obtain unrationed, unmanaged, private fee-for-service insurance. This is comparable to the way in which most retirees supplement government Social Security payments for living expenses with their own funds. Now the question is whether the private fee-for-service alternative will be preserved, with ambiguity in the current law clarified, and whether the same model will be applied to the prescription drug benefit.

The House bill allows the new prescription drug benefit to be offered by these plans with unmanaged access to drugs, and allows senior citizens to add their own money on top of the government contribution to get such unrationed drug insurance.