Sen. Jon Kyl (R., Ariz.) has vowed to hold up President
Clinton's nominee to head Medicare's funding agency, Nancy-Ann
Min DeParle, until Congress repeals a particularly socialist
provision of this past summer's federal budget pact: As
it stands now, no Medicare patient -- that is, almost
no American over 65 -- will be allowed to use his own
money to pay the doctor of his choice.
How is it that the federal government can enforce such
a law in the land of the free? Easy: Participation in
Medicare part A -- the part that pays for hospital care
-- is mandatory if you receive Social Security benefits.
That means many Americans automatically become subject
to Medicare regulations whether or not they want to participate.
Additionally, the federal government enrolls all seniors
into Medicare Part B -- the part that pays for doctor
visits -- unless they actively opt out. Some Americans
decline to join Part B because it does not cover most
self-administered prescription drugs.
Starting Jan. 1, however, seniors will be coerced into
joining Part B. The reason is that the budget act enacted
this year contains a provision which requires any doctor
who sees private patients to agree to stop seeing all
Medicare patients for two years. Most doctors are not
going to drop all of their Medicare patients in order
to treat a few private-paying patients. That means seniors
will have to join Medicare Part B if they want to see
the doctor of their choice -- and thus it will be nearly
impossible for seniors to contract privately for medical
This coercive provision was so important to the White
House that President Clinton threatened to veto the entire
federal budget bill this past summer unless it was included.
How ironic. Just two years ago Mr. Clinton wrote to the
Coalition for Patient Rights to assert that "I do not
advocate prohibiting any individual from purchasing outpatient
mental health services directly from a practitioner, even
if those services are also provided by the individual's
health plan. Neither the Health Security Act nor may current
health care proposal are meant to curtail this prerogative."
Now Sen. Kyl and Rep. Bill Archer (R., Texas) are pushing
bills that would restore American seniors' legal right
to spend their own money on the doctor of their choice.
Don't be surprised if President Clinton threatens another
veto -- that isn't the kind of choice he supports.
Ms. Blevins is president of the Institute for Health
Freedom in Washington, D.C.