'Boy Wonder' Takes on Medicare

Bobby Jindal is still years from retirement age. But the 26-year-old whiz kid now has the job of helping to save Medicare for his parents' generation and his own.

He has some experience. When Louisiana's state health care program was hemorrhaging money, he wrote a 30-page paper on how to fix it. That caught the eye of the governor, who put him in charge of the cleanup.

Now Jindal is in charge of the staff for a new federal commission that begins work Friday to keep the nation's health care program for the elderly from being overwhelmed by baby boomers.

"I think my father is part of that generation that has always wondered about Social Security and Medicare, about whether it's really going to be there for them," Jindal said in an interview Monday.

The commission, made up of lawmakers and private-sector experts, must report to Congress and President Clinton by next March, and there is consensus Congress should act swiftly on its recommendations.

"His responsibility will be enormous," said Rep. Bill Thomas, R-Calif, who recruited Jindal.

Many are surprised by his youth. People in Louisiana were, too.

But Margaret A. Dixon, president of the American Association of Retired Persons, said, "When more than one generation can be involved, we think it's a very positive thing."

Said Jindal of Medicare's benefits: "If they're only viewed as programs for the elderly, I think they're even more vulnerable."

The ambitious young man, whose parents immigrated to the United States from India, was born and raised in Baton Rouge, La., and planned to become a doctor.

But after a summer internship on Capitol Hill and a Rhodes scholarship, he ended up in Washington as a consultant helping companies navigate a health care marketplace transformed by managed care.

He was about to head to Japan on a job when new Louisiana Gov. Mike Foster asked him to come home.

Jindal had read about Louisiana's problems with its bloated health program for the poor. In his spare time, he had written an outline of possible solutions.

The paper made its way to Foster, who was impressed enough to think of offering Jindal -- then 24 -- a high-level job at Louisiana's Department of Health and Hospitals.

"If you want to offer me the head job, I'll think about it," Jindal said he told surprised Foster advisers.

Even more surprised were state lawmakers when Foster gave it to him.

"I couldn't believe my eyes. I said they're going to eat him alive," said Louisiana Sen. John Hainkel, who heads the chamber's finance committee. But, said Hainkel, "He just did a heck of a good job."

In two years, Jindal reduced the yearly cost of Medicaid per beneficiary by $325 and put the program into surplus. He did it largely by going after health care providers who were either cheating Medicaid outright or getting paid more than they deserved.

Urged on by Foster, Jindal sensationalized the crackdown, even going with a TV reporter to confront clinic operators paying parents to send healthy children in for appointments.

The public began to think of him as somebody willing to take anything on. One mother even called to complain that her son had stopped writing to her.

"I got on the phone and called him up," recalled Jindal, who got married in October.

Some advocates for the poor, however, criticized him for focusing too firmly on the bottom line.

In 1996 he eliminated a program that helped people impoverished by the expense of catastrophic illness, then touted a Medicaid budget surplus.

But Jindal also has recognized his mistakes, critics say. The catastrophic program, for example, was mostly restored.

"To his credit, I think he was surprised by the effects of some of those cutbacks and I think he did a good job of revisiting some," said Marcus Carson, former director of the Louisiana Healthcare Campaign, an organization that advocates on behalf of people served by the state's health programs.

Jindal acknowledges that Medicare, which provides health care for 38 million elderly Americans, has bigger problems barely dented by the most obvious solutions. Anti-fraud measures and cuts to hospitals, for example, were part of last year's balanced budget.

But experience has left him optimistic.

"So many times it's easy to say health care will grow by 10 percent a year and there's nothing we can do about it unless we cut rates or raise taxes," he said. "I think we need to reexamine those assumptions."

Written by Alice Ann Love
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