In Whose Name?

Barely a year after Congress enacted catastrophic health care for older Americans, the House of Representatives voted 360-66 to repeal the program. There is some maneuvering in the Senate to preserve parts of the plan, such as the federal subsidy for prescription drugs.

But catastrophic health care and the surtax on the elderly that paid for it seem doomed to repeal—killed by a nationwide outcry by the supposed beneficiaries of the program. The elderly, or at least a vocal group of them, didn't want the program if they were going to be socked with new taxes to pay for it.

If the catastrophic care debacle has demonstrated anything, it is that large groups such as the elderly have diverse needs that cannot be met by any grand one-size-fits-all federal program. And the lobbyists who purport to speak for millions often have no idea what these people really want and need.

Catastrophic care's chief proponent, the American Association of Retired Persons, alternately represents its constituency as upscale, affluent consumers (to advertisers in its slick bimonthly magazine Modern Maturity—the largest circulation magazine in the country) and as impoverished little old ladies forced to eat dog food. There is some truth to both images.

There are 62 million people over the age of 55, 26 percent of the population. The AARP itself has about 30 million members. As with any group of this size, there is tremendous diversity. Some are rich, some poor, most middle class. Some seniors continue to work and pay taxes; others are retired, living off pensions and Social Security. Some seniors live in nursing homes and require medical care. Most have some measure of mobility and independence. Some are Democrats, some Republicans. Some liberal, some conservative.

It would seem obvious that no single program could adequately meet the needs of every one of these people. It would seem obvious to anyone except the elderly's chief lobbying group, the AARP.

The AARP pushed for catastrophic health care despite the fact that 85 percent of the elderly already have private insurance that provides most or all of the benefits in the program. These seniors resented paying up to $800 apiece annually in new taxes for a program they didn't need.

The AARP might have anticipated this resentment if it had polled its members. But, reports syndicated columnist Leonard J.Hansen, AARP local chapters say they were barely consulted.

Granted, the AARP probably has many members who would benefit from the catastrophic care program. But it also obviously has many members who don't need the plan and don't want to pay to support it.

The AARP might have better served its members by exploring ways for that 15 percent of seniors who need catastrophic care to obtain private insurance. Some analysts have proposed various combinations of tax credits and deregulation that promise to promote greater private care for the elderly.

Instead, the AARP pushed for a massive new federal program. The group probably never even considered finding a private solution to the problem of long-term health care for the elderly. The Wall Street Journal quotes former AARP executive director Jack Carlson as saying that the group's staff, many of whom have worked or hope to work in the federal government, "tend to think of a federal solution to any problem. But I think many members would prefer to see a private or a state solution."

But the AARP isn't the only organization wedded to the Washington bureaucracy. On every issue from homelessness to child care to education, groups that purport to speak for millions of people are advocating new federal programs.

The next time these people march on Washington and demand that something be done to solve their pet problem, we should ask ourselves three simple questions: Is there really a problem? If so, is more federal spending the best solution to the problem? And, Do these individuals really speak for all the people they claim to represent? Often, the answer to all three questions will be no.