Medicare Drug Bill Heads Toward Passage

AP | 11/24/03 | DAVID ESPO

[kattracks]

WASHINGTON (AP) - Landmark Medicare prescription drug legislation advanced toward final congressional passage Monday as Senate supporters turned back a pair of attacks launched by die-hard Democratic opponents.

The bill's supporters prevailed in the second showdown of the day on a dramatic roll call that ended at 61-39, one more than they needed.

No time was immediately set for passage of the bill, which would make the most sweeping changes in Medicare since its creation in 1965 by providing a prescription drug benefit for the program's beneficiaries and giving insurance companies broad leeway to offer private coverage to 40 million elderly and disabled Americans.

"Waiting is not going to produce a better bill. Waiting will deny seniors a benefit," said Senate Majority Leader Bill Frist, R-Tenn., rejecting Democratic calls to slow down and rewrite the bill more to their liking.

"The Senate is on trial," countered Sen. Edward M. Kennedy, D-Mass., who was present and voting 38 years ago when Democrats pushed through the bill to create the giant government health care program. "Let us not reverse the historic decision our country made in 1965. Let us not turn our back on our senior citizens so that insurance companies and pharmaceutical companies can earn even higher profits."

The legislation had cleared the House early Saturday morning on a vote of 220-215, and President Bush is eager to sign it.

While it has been clear for days that the bill commanded the support of a majority of senators, the coalition of lawmakers behind the bill worried they would fall short of the 60 votes needed to clear the second and last obstacle erected by Democrats.

With time having expired on the roll call, the vote stood at 58-39, two shy of the 60 needed for the bill to advance. Then, Sen. Lindsey Graham of South Carolina voted yes, and Sen. Trent Lott of Mississippi and Ron Wyden, D-Ore., followed suit.

Passage of the bill would mark a triumph for Bush and the GOP majority on an issue that Democrats have long used to their advantage in political campaigns.

At its heart, the legislation marked a compromise of sorts, the new drug benefit long sought by Democrats, combined with a Republican-backed plan to give private insurance companies a vast new role in health care for the program's beneficiaries.

The scope of the bill went far beyond that, though, including an additional $25 billion for rural hospitals and health care providers, a requirement for higher-income seniors to pay more for Medicare Part B coverage and billions of dollars to discourage corporations from eliminating existing coverage for their own retirees once the new government program begins.

The bill also would satisfy other goals of conservatives, including creation of tax-preferred health savings accounts, open to individuals who purchase high-deductible health insurance policies. Most controversial of all, the legislation would create a limited program of direct competition between traditional Medicare and private plans, beginning in 2010.

The measure cleared the House on a vote of 220-215 shortly before dawn on Saturday, after a roll call that was held open for three hours while Bush, Speaker Dennis Hastert and other leading Republicans lobbied furiously to avert a defeat.

White House officials said Bush was making no lobbying calls to the Senate, but HHS Secretary Tommy Thompson was in and around the Senate chamber, hoping to help redeem a pledge Bush made in his 2000 campaign and repeated in last winter's State of the Union address.

The GOP-controlled House, with Hastert making the issue a priority, has approved Medicare drug legislation in earlier years. But the Senate deadlocked twice in the recent past, once with Republicans in control, the other time when Democrats held a majority.

Bush's decision to back legislation, coupled with Frist's ascendancy to the position of majority leader, changed the political equation in the Senate. Both houses approved measures in June, the Senate version gaining bipartisan support but the House bill clearing principally on the votes of conservative Republicans.

Under the legislation, the prescription drug benefit would begin in 2006. In the interim, seniors would be eligible to purchase a Medicare-backed discount drug card, at a cost estimated at $35 a year, that the administration estimates would mean savings of between 15 percent and 25 percent off retail prices. Critics argue those estimated savings are wildly inflated.

Lower-income seniors would receive an annual $600 government subsidy for use in conjunction with their cards.

Beginning in 2006, the legislation would allow seniors to purchase coverage for their prescription drugs. GOP officials estimate the premium cost would be $35 a month, with a $250 deductible. The coverage would pay 75 percent of costs after that until a senior's drug costs reached $2,250. After that, there would be a gap in coverage until out-of-pocket expenses reach $3,600, or roughly $5,100 in overall prescription expenses. Above that level, insurance would pick up roughly 95 percent of costs.

The measure includes subsidies for low-income seniors.

[kattracks]

Myra McCoy, 76, of Cambridge, Mass., tears up her AARP card outside the organization's Boston office, Monday Nov. 24, 2003. Several dozen angry seniors gathered to criticize the group's support of a Medicare bill under debate in Congress. (AP Photo/Charles Krupa)

[jjm2111]

Yippeeee, spend money now for the promises of competition later. I'm so glad the small government party is in charge!

[Peach]

This could be one of the worst bills I've ever seen. Seniors who understand it are angry and cancelling their AARP membership.

This article seems to have its act together with regard to the facts:

http://www.timesstar.com/Stories/0,1413,125~1549~1786421,00.html

[Peach]

From the linked article above:
Article Last Updated: Sunday, November 23, 2003 - 7:25:08 AM PST

Not much of a benefit
THE latest version of the Medicare Prescription Drug and Modernization Act of 2003 was announced last weekend in Washington by the Medicare conference committee.

Supporters from organizations such as AARP see it as a compromise that would provide coverage to people with low incomes and relief to those with high drug costs.

However, a poll last week by Hart Research showed that 65 percent of AARP members want Congress to go back to the drawing board. Many members of Congress already have canceled their membership in AARP, and some grassroots organizations such as Moveon.org advocate mass membership cancellations.

Opponents, such as the Alliance for Retired Americans, are mobilizing their members to take action. Rep. Nancy Pelosi, D-San Francisco, called the overhaul "a cruel hoax that dismantles Medicare and does not provide seniors an affordable, defined, guaranteed Medicare prescription benefit."

This proposed largest overhaul in Medicare's history would have a huge impact on current beneficiaries and baby boomers for years to come. The administration is aiming for quick passage. Advocacy organizations have asked Congress to give consumers adequate time to study the roughly 1,000-page proposal.

According to a Consumers Union analysis, the proposal "not only falls embarrassingly short of giving seniors a real drug benefit, it likely will threaten Medicare's viability." The analysis finds:

The funds set aside for the drug benefit cover only 22 percent of expected costs, leaving consumers to pay the rest of the bill.

The plan takes a big step toward unregulated privatization by requiring competition between private health plans and Medicare while subsidizing the private health plans and allowing them to select the healthiest beneficiaries.

Private benefit managers determine which drugs are included in private plans. These decisions will have no transparency, methodology or public accountability.

The plan, which would not take effect until 2006, actually prohibits the government from negotiating deep prescription drug discounts for consumers. If drug costs continue their historical rates of increase, the average Medicare recipient paying $2,318 in 2003 without coverage will pay $2,911 out-of-pocket in 2007 with coverage. To calculate your drug costs under the plan, visit the Kaiser Family Foundation Web site at www.kaisernetwork.org/static/kncalc.cfm

Information provided by Rep. Pete Stark's office warns his East Bay constituents that:

The bill, if passed, will leave 2 to 3 million retirees without employer-provided prescription drug coverage; will leave up to 6 million of the poorest Medicare beneficiaries with less drug coverage than they have now; and will saddle millions of seniors with rising Medicare premiums if they refuse to join an HMO.

A cost containment provision would create a so-called "crisis" when an arbitrary cap on general revenue funding is reached, which would be used to advance radical cuts to the program, including benefit cuts.

Drug importation would be permitted only from Canada, and only if the U.S. Health and Human Services Secretary certifies that no safety risk exists.

Hopefully, Congress has not taken a vote before publication of this column and before you have had an opportunity to make your opinion known to legislators.

Visit the Center on Budget and Policy Priorities' Web site at www.cbpp.org; call your local Congressional office; contact AARP, www.aarp.org or (800) 424-3410; or the Alliance for Retired Americans, www.retiredamericans.org, (888) 373-6497.

Sandra J. Cohen, R.N., and Roger Cormier are consultants who help East Bay families plan and coordinate care of an older relative at home or in a care facility. Reach them at (510) 652-3377 or (925) 945-8855 or e-mail go@eldercaremanagers.com or visit www.ElderCareManagers.com

[Peach]

From the 10th paragraph of the article, it seems Kaiser has crunched the numbers and the facts are not favorable to retirees at all:

The plan, which would not take effect until 2006, actually prohibits the government from negotiating deep prescription drug discounts for consumers. If drug costs continue their historical rates of increase, the average Medicare recipient paying $2,318 in 2003 without coverage will pay $2,911 out-of-pocket in 2007 with coverage. To calculate your drug costs under the plan, visit the Kaiser Family Foundation Web site at www.kaisernetwork.org/static/kncalc.cfm

[newgeezer]

A good part of the reason prescription drugs are so costly is that so many people DON'T CARE about price; they're spending someone else's money, so they buy whatever the Dr. is willing (or eager) to prescribe. Watching one night's-worth of TV ads touting the latest miracle drugs is adequate proof of that. Some of them don't even mention what maladies they're supposed to cure!

The biggest joke is the "purple pill" and others like it. If Tums aren't trendy enough for you, don't bother with the over-the-counter equivalent of our "old" purple pill. Get your Dr. to prescribe our "new" (identical) purple pill. After all, you don't pay for it; someone else does. And, golly, you deserve the very best!

Any plan to put more people into that money-is-no-object category won't help, and will only serve to hasten the drive toward nationalized health care in right here the U.S.S.A. (United Socialist States of America).

[Geezerette]

You said it!!!

Those TV drug commercials are laughable. The side-effects sound scarier than whatever disease they are supposed to cure!

g

[Ganndy]

Any plan to put more people into that money-is-no-object category won't help

And besides if Pelosi and Kennedy are squeeling like pigs, I say F~** 'em!!

Out

[Ohioan]

This will set back the Conservative faction in the Republican Party for the next decade. It makes those who call themselves Conservative, but who find a rationalization for supporting this, look like a bunch of sophists and hypocrites. That does not project a very appealing image to the youth.

William Flax Return Of The Gods Web Site.

[marajade]

How many seniors are cancelling their membership? Has AARP reported a number?

[marajade]

your post #3 article: Did you see where moveon.org is at the heart of the supposed mass AARP defections? You should go take a look at moveon.org

[SierraWasp]

Pete Stark and Moveon.org, the Anti-Clinton-Impeachment Website and the Stark-Raving-Mad-SuperSocialist from the Bay Area? Come on Peach, this is totally transparent!!! Kaiser has also been taken over by Socialistas and I thought the staff of AARP had been also, until now. They probably still are, but realized they better get on board with the most successful tactic of "incrementalism" in use for the last 40 years!!!

[SierraWasp]

Didn't anyone watch what Hastert said on the Sunday "Talking Head Shows?" Unless he's lying through his eye teeth, this nit-picking is BOGUS!!! (can anyone get that transcript?)

[Peach]

I'd seen that. There are other article that have been on FR that AARP admits they are receiving cancellations.

I personally know two people in my neighborhood who have cancelled their membership.

[woodyinscc]

Here you go

http://www.foxnews.com/story/0,2933,103935,00.html

[Grampa Dave]

Before all conservatives blow gaskets on this, there three major factors working to bring the costs of medicare RX drugs down.

1. A large % of the good RX drugs on the market now will be losing their patents in a very short time. Generic manufacturers will come in and this will become an agressive bidding process to get the business. Drugs selling for $100 for a month's supply will sell for the copay. That will still be a good deal for the MediCare patients.

2. FDA is moving quietly and surely to remove drugs from the Rx category to over the counter. Claritin and the purple pill were the biggies this year. FDA is working to make a couple of the lipid reducers over the counter. When these drugs go from RX to over the counter, the patient pays not the hmo or Medi Care.

3. We will probably see Mexico go back to actively making retirement in Mexico cheap and good for Americans. To help induce Americans to make this decision, the Mexican stock market will start selling QQQ and SPY stocks. This was just recently announce and got little play in the American press.

"All stocks purchased on the Mexican stock exchange, by Mexicans or foreigners, are exempt from capital gains. Also, dividends on stocks bought in Mexico are taxed at a lower rate than in the United States."

That will be a hell of an incentive for retirees to flee the US and go to Mexico to live. Once down there basically every RX drug in America is over the counter. So there will be no rx drug expense for Medicare. Medicare will probably work out some arrangement to pay doctors/hospitals in America to treat US retirees at a cheaper rate than treatment in the States.

When Mexico does this, watch other countries fight to get American retirees to move to their country with even better deals.

[reformedliberal]

Wow, Grampa!!!!!!!!!!!!!!!!!!!!!!!!

Thanx for the info on the Mexican stock market and the coming bidding war for all of us.

I know a lot of FReepers who can't wait to get rid of greedy geezers (tm).

Your drug scenario is also spot on, IMO.

[NittanyLion]

I'm a 25 year old who will be paying for this bill for the next 40 years. With friends like this, who needs enemies?

[SierraWasp]

But, But, But... Grampa!!! I don't wanna be exiled to Mexico or Canada or Belize or even Managua Nicaragua when I gits old!!! I wants my Amureca back like it used ta be!!!

You know, like even 50 years ago when people died when they got old? What? I should keep livin an achin and painin till I'm outta my friggen mind and havta be watched 24/7 in an alzheimer's facility on my Long-Term Care Insurance??? (assuming I'm able to hang onto it with the humongous rate increases due to everybody scared to let theirs lapse and hopelessly low rates of interest on insurer reserves)

Geeze, Grampa, they don't even speak my language and if ya hires 'em they'll steal ya blind! (If'n you're not blind already) I was born here and I intend to be planted here if publick policy doesn't make that impossible. My financial planner told me my check to the undertaker should bounce! (only trouble is, neither of us knows the date of my obit)

My indigent brother-in-law gits his meds from the HMO doc-in-a-box fer nuthin as "samples!" Them drug salesmens are just givin 'em to them doctors to git their patients hooked, I think!!! What's up with that? (you know, addicted to pain killers, like Rush)

Finally, do you think if alla us "retired" movin ta Mexico and hirin them good peeple as servants is gonna slow down them e-leegal's swarmin our borders? I ain'ta arguin, I'm justa thinkin bout alla this here guvermental "help" we're gonna be gittin. I do like the medickle scraping and savings accounts. I just wish they included barter arrangements so's I could pay the medickle high priest with gourds!!! [/smartaleckyness]

[Grampa Dave]

Actually Cabo sounds good to me from November to about March/April. Then, back to California/Oregon for the rest of the year.

This way we can hire the locals down there, and they don't have to come here illegally.

Soon, they will not be able to get driver's licenses in California. When other benefits are cut, they will just stay at home and take care of Senor and Senorita Wasp.

If Mexico gets wise they will make a lot of retiring boomers and those of us a little older think about retiring down there.

Then Canada can attract all of the liberals. That will the states to people like my children and grand children until they can retire to Cabo. My oldest son would move tonight if he could.