Bush proposes radical changes in healthcare

"President Bush has begun one of the most ambitious efforts to reinvent Medicare and Medicaid since the programs were created 38 years ago," today's NY Times reports.

Mr. Bush's proposals for Medicare and Medicaid, taking shape in recent weeks, would transform these pillars of the Great Society and their guarantee of health benefits to the elderly, disabled and poor.

States would have far more power to determine who receives what benefits in the Medicaid program, which covers 45 million low-income Americans. The elderly would rely more on private health plans, and less on the government, for their health benefits under Medicare, which covers 40 million elderly and disabled people.

The administration's vision for Medicare and Social Security moves away from the notion that everyone should be in the same government-managed system with the same benefits. It promises individuals more choices, including the option of picking a private health plan or investing some of their Social Security taxes in the stock market.

But critics say these proposals would also mean less security, fewer guaranteed benefits and more financial risk for beneficiaries.

The magnitude of the Bush proposals is only gradually dawning on members of Congress. Unlike President Bill Clinton and former Speaker Newt Gingrich, Mr. Bush has not boasted about the boldness of his vision for these programs, perhaps because he is mindful of the voters' anxiety about major changes in health care.

Watered down privatisation. That's what the plan amounts to.