Bush Bilks the Elderly.

• Position: President Bush's proposals would provide a tax cut for the wealthy, and seriously damage Social Security and Medicare

Once you wade through President Bush's rhetoric about "renewing the promise made to our seniors" and "enabling individuals to build financial wealth and security," you get to the radical core of his budget proposal. After his enormous tax cut for the wealthy, the next item on Bush's agenda is the destruction of federal pension and health insurance programs for the elderly. Simply put, he wants to destroy Medicare and slash Social Security benefits. His proposal reduces tax payments for both programs by throwing beneficiaries on the tender mercies of the private market.

But, of course, the President doesn't state it so bluntly. Unlike some of his more bombastic Republican colleagues, Bush acknowledges that Medicare recipients sorely need prescription drug coverage. In his budget proposal, he touts the Immediate Helping Hand program, which gives money to the states for temporary prescription drug coverage "for those beneficiaries who need it most." Only the poorest of the poor will receive full coverage: individuals with incomes at or below $11,600 a year, and married couples with incomes at or lower than $15,700. The proposal offers to cover half the drug costs of people who make as much as $15,000 a year and couples with incomes of $20,300.

So far, there's nothing objectionable in this modest program. The trade-off comes later. Bush's long-term plan is to privatize Medicare insurance, doing away with guaranteed benefits for the elderly and the disabled. He has embraced the Frist-Breaux Medicare bill, which would institute a system in which private insurance companies compete for healthy (and more profitable) clients, and cut out those who are more expensive to insure. This system would likely leave the worst insurance policies for those who need health coverage the most.

Bush and other proponents of Medicare privatization use the argument that the system faces financial trouble and is in dire need of "reform" to remain solvent in the future. In fact, Medicare is solvent for the next twenty-five years. Meanwhile, Bush's "cure" for Medicare is far worse than the disease. Medicare has a much better record at containing costs than do the HMOs Bush wants to bring in as agents of "reform." Recent experiments that allowed HMOs to take on Medicare clients led to increased costs. The results were not that surprising, given that the United States health care system spends about twice as much per person as the health care systems in the rest of the...