Dangerous Remedy.

• Author: Postrel, Virginia
• Position: The other problem with extending Medicare - Prescription drugs

The other problem with extending Medicare

Bill Clinton has done some incredibly reckless, irresponsible things as president. But his campaign to expand Medicare entitlements has to rank among the worst.

Unexpectedly large tax revenues are burning a hole in Clinton's pocket. He doesn't want to return the overcharge to taxpayers - that would be "irresponsible," since we might spend the money on the wrong things. But neither is Clinton content to do the sort of one-time spending that might qualify as "responsible": fixing some roads and bridges, replacing the cruise missiles he's depleted over the past few years, sending a $1,000 check to every American baby born in 2000, buying everyone in Mississippi a computer, offering a $15 billion prize to anyone who can take people back and forth to Mars. You may find such ideas wasteful, but they have one big advantage: They're finite.

Not so Clinton's Medicare plan. Imagining that Washington will be awash in extra tax dollars for at least the next 15 years, he plans to stick a new entitlement into the budget bill: coverage of prescription drugs for Medicare recipients. This plan is not the sort of one-time discretionary expenditure that matches windfall revenue with windfall spending. It is an open-ended obligation designed to keep expanding federal spending well into Chelsea and Monica's middle age.

Clinton's drug entitlement would cover half of up to $5,000 in annual prescription expenses, with no deductible. To get the coverage, retirees would pay a monthly premium of $44. The plan also includes price controls by the back door, stipulating that Medicare recipients must get their drugs at the best prices negotiated by private insurers or large public employers.

The administration fantasizes that this open-ended commitment will be "responsibly" financed "mostly by savings from competition and efficiency," plus $45.5 billion in presumed budget surplus over the next 10 years. The wonks in the White House couldn't possibly believe this nonsense - while we're at it, let's add a few Army divisions financed by cutting back on Pentagon "waste, fraud, and abuse" - but they know that once an entitlement is law, money will be found, one way or another, to keep funding it.

Anyone who thinks the plan will stay even this modest hasn't boned up on the history of Medicare. Back in 1965, when the program was new, expert projections were that it would cost $12 billion in 1990, after adjusting for inflation. It...