http://www.guardian.co.uk/uslatest/story/0,1282,-2834485,00.html

White House Won't Release Medicare Memo 

Wednesday June 25, 2003 11:49 PM


By LAURA MECKLER 

Associated Press Writer 

WASHINGTON (AP) - The Bush administration's top Medicare accountant has
calculated how millions of senior citizens would be affected by bringing
private managed care into the program, but the administration won't
release the information. 

An earlier analysis suggested that a Republican plan to inject market
forces into Medicare could increase premiums for those who stay in
traditional programs by as much as 25 percent. If that's still the case,
it could help Democrats who argue that the GOP plan is risky for those
who want to stay in traditional Medicare, where they can pick any doctor,
rather than move to a managed care plan. 

The administration's Medicare chief threatened to fire his top actuary,
Rick Foster, if Foster released his calculations to Capitol Hill
Democrats who requested the analysis, officials said. 

Medicare chief Tom Scully said in an interview Wednesday that Democrats
had no right to request the information from Foster in the first place. 

``They don't have the right on the Hill to call up my actuary and demand
things,'' said Scully, chief of the Centers for Medicare and Medicaid
Services. ``These people work for the executive branch, period.'' 

Scully said he would release the analysis ``if I feel like it.'' 

Medicare spokesman Peter Ashkenaz said Foster is working to update his
original memo based on changes being considered by House Republicans so
the original version is not relevant. 

Scully added that Democrats want the memo in hopes of scoring political
points, as Congress debates legislation adding prescription drugs to
Medicare and making other changes to the program. 

``We're at the end of the Medicare debate,'' Scully said. ``People are
looking for bombs to throw.'' 

Officials on Capitol Hill and at the Department of Health and Human
Services said Scully threatened to fire Foster if he released his memo.
Scully said that was an exaggeration, saying his comments were just
``heated rhetoric in middle of the night.'' 

Democrats responded by pointing to legislative language approved in 1997
that specifically requires the top Medicare actuary to answer questions
from Congress. 

``While the chief actuary is an official within the administration, this
individual and his or her office often must work with the committees of
jurisdiction in the development of legislation,'' said the legislative
report. 

Democrats suspect the information is being withheld because it will
undercut the administration's case for changes to Medicare. Democrats
object to a proposal that would set premiums for seniors through
competition between private plans and the traditional, government-run
program. 

Republicans believe it will drive down Medicare spending by directing
more seniors to cost-effective plans. Democrats worry that the sickest
seniors will wind up in the government-run program, paying more for
health coverage than they do today. 

``The administration is resisting the release of it because it's not good
news for the Republican House plan,'' said House Minority Leader Nancy
Pelosi, D-Calif. 

The earlier Foster memo, written in 2000, found that a similar proposal
would boost premiums for traditional Medicare by 47 percent. But nearly
half the increase was attributable to a provision that is no longer on
the table. The provision now being considered would increase premiums by
25 percent, Foster said in 2000. Democrats asked for an updated estimate.


Scully has repeatedly touted Foster and his colleagues as the best
actuaries anywhere. Just last week, in defending a separate Foster
analysis that supports the administration's position, Scully noted that
Foster has worked for both Democrats and Republicans and is a
professional actuary totally divorced from politics. 


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