The Magazine


Mar 22, 1999, Vol. 4, No. 26 • By ROBERT M. GOLDBERG
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For Republicans, the right response is not a watered-down version of a Democratic entitlement. Instead, what is required is to improve coverage for the neediest. In 1997, almost 60 percent of Medicare beneficiaries with incomes below the federal poverty threshold (about 1.5 million seniors) were eligible for Medicaid but were not enrolled in the program. Local councils on aging and Social Security offices should be enlisted to step up efforts to enroll these people. Medicaid would meet most of their prescription-drug needs. Second, Medicare should provide the seniors who are in poorest health with vouchers, adjusted by income and severity of illness, to use to buy care that includes coverage for drugs. These reforms would require minimal outlay and no new regulations. Best of all, they would solve the real -- as opposed to the politically invented -- problem of helping the truly needy elderly pay for medicine.

Robert M. Goldberg is senior research fellow with the Program on Medical Science and Society at the Ethics and Public Policy Center in Washington, D.C.