Drug Coverage a Legislative Priority

Many members of Congress who traveled to their districts during the April recess were reminded once again that passing a Medicare prescription drug benefit is the most pressing legislative issue for senior citizens.

At visits to senior centers and town hall meetings with their elected representatives, seniors showed up anxious to hear about the latest proposals to help with drug expenses.

Congressional staffers were burning the midnight oil during the recess to hammer out details, with the leadership in the House of Representatives planning a vote on a Medicare bill before Memorial Day.

Medicare is the last major health plan in the country that doesn’t cover outpatient prescription drugs. Virtually every private health plan covers drugs because it is often the most economical and effective treatment available.

But Medicare is stuck in the 1960s when today’s miracle medicines to treat heart disease, arthritis, depression, and ulcers were barely imaginable.

Still, Congress and the White House know that adding a drug benefit isn’t the only fix that is needed for Medicare. The program covers only 52 percent of beneficiaries’ total health costs, and nine out of ten seniors have supplementary coverage to fill the gaps.

Further, Medicare has been cutting payments to doctors, with more and more saying that they can’t afford to take on new patients. And Medicare delays, often for years, in approving new treatments and medical innovations, forcing many seniors to get out-of-date care.

Working Americans would not tolerate such an antiquated system. But seniors have no choice; there is no private market for basic health coverage for them, so they have little choice but to tolerate Medicare’s deficiencies.

Congressional leaders like committee chairmen Bill Thomas (R-CA) and Billy Tauzin (R-LA) and House Speaker Dennis Hastert want to change that and fix other problems with Medicare in the process of adding the drug benefit.

President Bush also has proposed giving seniors the option of staying with traditional Medicare or picking a plan that mirrors one of the most successful health care arrangements in the country – the one available to nine million federal workers and retirees.

This would give seniors a choice of health plans within Medicare and allow them to decide the benefit structure that suits them best – including coverage for prescription drugs. They could pay more and join a more generous plan, but even the new basic plan would still be better than current Medicare.

While improving the Medicare program and adding a drug benefit is a legislative priority for seniors, it also is a political priority for members of Congress and the White House.

Republicans hold thin margins of power in Congress and neither they nor Mr. Bush wants to face the voters next November without having acted on their promise to provide a drug benefit.

The stakes are high and seniors are watching. The $400 billion that Congress has put in its budget for Medicare and prescription drugs won’t cover everything that seniors want, but it can start to improve the program and give seniors more choices, including coverage for modern medical treatments like prescription drugs.

Grace-Marie Turner




Grace-Marie Turner is president of the Galen Institute, a not-for-profit research organization focusing on health reform. She can be reached at P.O. Box 19080, Alexandria, VA, 22320.

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Many members of Congress who traveled to their districts during the April recess were reminded once again that passing a Medicare prescription drug benefit is the most pressing legislative issue for senior citizens.

At visits to senior centers and town hall meetings with their elected representatives, seniors showed up anxious to hear about the latest proposals to help with drug expenses.

Congressional staffers were burning the midnight oil during the recess to hammer out details, with the leadership in the House of Representatives planning a vote on a Medicare bill before Memorial Day.

Medicare is the last major health plan in the country that doesn’t cover outpatient prescription drugs. Virtually every private health plan covers drugs because it is often the most economical and effective treatment available.

But Medicare is stuck in the 1960s when today’s miracle medicines to treat heart disease, arthritis, depression, and ulcers were barely imaginable.

Still, Congress and the White House know that adding a drug benefit isn’t the only fix that is needed for Medicare. The program covers only 52 percent of beneficiaries’ total health costs, and nine out of ten seniors have supplementary coverage to fill the gaps.

Further, Medicare has been cutting payments to doctors, with more and more saying that they can’t afford to take on new patients. And Medicare delays, often for years, in approving new treatments and medical innovations, forcing many seniors to get out-of-date care.

Working Americans would not tolerate such an antiquated system. But seniors have no choice; there is no private market for basic health coverage for them, so they have little choice but to tolerate Medicare’s deficiencies.

Congressional leaders like committee chairmen Bill Thomas (R-CA) and Billy Tauzin (R-LA) and House Speaker Dennis Hastert want to change that and fix other problems with Medicare in the process of adding the drug benefit.

President Bush also has proposed giving seniors the option of staying with traditional Medicare or picking a plan that mirrors one of the most successful health care arrangements in the country – the one available to nine million federal workers and retirees.

This would give seniors a choice of health plans within Medicare and allow them to decide the benefit structure that suits them best – including coverage for prescription drugs. They could pay more and join a more generous plan, but even the new basic plan would still be better than current Medicare.

While improving the Medicare program and adding a drug benefit is a legislative priority for seniors, it also is a political priority for members of Congress and the White House.

Republicans hold thin margins of power in Congress and neither they nor Mr. Bush wants to face the voters next November without having acted on their promise to provide a drug benefit.

The stakes are high and seniors are watching. The $400 billion that Congress has put in its budget for Medicare and prescription drugs won’t cover everything that seniors want, but it can start to improve the program and give seniors more choices, including coverage for modern medical treatments like prescription drugs.

Grace-Marie Turner




Grace-Marie Turner is president of the Galen Institute, a not-for-profit research organization focusing on health reform. She can be reached at P.O. Box 19080, Alexandria, VA, 22320.

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About the author