Published in the Wall Street Journal, Wednesday, November 5, 1997, page A22.

"Sen. Jon Kyle (R., Ariz.) has vowed to hold up President Clinton's nominee to head Medicare's funding agency, Nancy-Ann Min DeParle, until Congress repeals a particularly socialist provision of this summer's federal budget pact: As it stands now, no Medicare patient - that is, almost no American over 65 - will be allowed to use his own money to pay the doctor of his choice.

How is it that the federal government can enforce such a law in the land of the free? Easy: Participation in Medicare Part A - the part that pays for hospital care - is mandatory if you receive Social Security benefits. That means many Americans automatically become subject to Medicare regulations whether or not they want to participate. Additionally, the federal government enrolls all seniors into Medicare Part B - the part that pays for doctor visits - unless they actively opt out. Some Americans decline to join Part B because it does not cover most self-administered prescription drugs.

Starting Jan. 1, however, seniors will be coerced into joining Part B. The reason is that the budget act enacted this year contains a provision which requires any doctor who sees private patients to agree to stop seeing all Medicare patients for two years. Most doctors are not going to drop all of their Medicare patients in order to treat a few private-paying patients. That means seniors will have to join Medicare Part B if they want to see the doctor of their choice - and thus it will be nearly impossible for seniors to contract privately for medical services.

This coercive provision was so important to the White House that President Clinton threatened to veto the entire federal budget bill this past summer unless it was included. How ironic. Just two years ago Mr. Clinton wrote to the Coalition for Patient Rights to assert that "I do not advocate prohibiting an individual from puchasing outpatient mental health services directly from a practitioner, even if those services are also provided by the individual's health plan. Neither the Health Security Act nor my current health care proposals are meant to curtail this prerogative."

Now Sen. Kyl and Rep. Bill Archer (R., Texas) are pushing bills that would restore American seniors' legal right to spend their own money on the doctor of their choice. Don't be surprised if President Clinton threatens another veto - that isn't the kind of choice he supports."