Posted on 06/29/2002 12:29:40 PM PDT by sarcasm
ASHINGTON, June 28 — When the House voted early today to help elderly people buy prescription medicines, it was a major moment in the history of American health care and politics. The vote foreshadows a deepening federal commitment to the elderly and the aging baby boom generation, as well as a significant expansion in the role of government.
Both parties laid claim to the title of being the best protectors of the elderly. Republicans hope to impose fiscal discipline on the proposed new program, but that will not be easy.
The Republican bill, to add drug benefits to Medicare, was passed by a vote of 221 to 208 at 2:30 a.m. after five and a half hours of debate.
Conventional wisdom holds that the bill is going nowhere this year and that the debate was just politics, an effort by Republicans to secure political cover in the November elections as Democrats exploit the issue in a bid to regain control of the House.
Predictions of an impasse may be borne out. Asked today about prospects for enacting Medicare drug legislation this year, Senator Tom Daschle, Democrat of South Dakota and the majority leader, said, "The odds are against us."
But the House debate suggested that expansion of Medicare to cover prescription drugs was becoming inevitable. Democrats were eager to pour $800 billion to $1 trillion more into Medicare over the next decade.
The move to expand Medicare seems inconsistent with the conservative Republican philosophy of limited government. But most Republicans voted enthusiastically for a $320 billion prescription drug program — much bigger than the one they pushed through the House on June 28, 2000. Reviled by Democrats as cheapskates, House Republicans boasted — yes, boasted — that they were creating a new entitlement program.
The cost of adding drug benefits to Medicare rises each year Congress defers action. Public expectations, drug prices and the number of prescriptions dispensed to the elderly are continually increasing.
Pharmaceuticals, one of the most promising tools of modern medicine, prolong life and improve its quality. A huge increase in federal spending on biomedical research, combined with investment by drug and biotechnology companies, is producing new drugs to treat cancer, heart disease, Alzheimer's, osteoporosis, arthritis and other diseases of aging.
Medicare would help pay for these drugs under all the major Republican and Democratic proposals pending in Congress.
Congressional decisions will affect the economy because drug companies, by their own account, have been one of the nation's most innovative and profitable industries. Elderly people account for more than one-third of prescription drugs sold in the United States.
Carl B. Feldbaum, president of the Biotechnology Industry Organization, a trade group, said: "In the context of dismal financial markets, today's vote was a positive development. The House and Senate are unlikely to agree this year, but eventually some legislation will have to pass because of pressure from seniors for relief.
"That prospect should help restore the confidence of investors who want to know how biotech products, many of them still in development, will be reimbursed."
Medicare, the federal health insurance program for 40 million elderly and disabled people, generally does not cover outpatient drugs. One-third of beneficiaries have no coverage for such costs. Others have spotty or unreliable coverage. So there is almost surely pent-up demand, or unmet need.
In analyzing the House bill this week, the Congressional Budget Office said, "Adding or expanding insurance coverage for prescription drugs is expected to increase both the use and price of drugs."
With House action completed, the focus shifts now to the Senate, where Mr. Daschle plans to call up a Democratic bill for floor debate next month. The debate will be not just about money, how much to spend on drug benefits, but also about the proper role of government in managing benefits and controlling costs.
Mr. Daschle did not mince words in assessing the House measure today. "The bill is a terrible bill," he said. "It's a sham. It is awful." The bill, he asserted, "was written by drug companies and will be administered by insurance companies."
In providing drug benefits, Republicans are determined to avoid what they consider the mistakes of Medicare's traditional fee-for-service program, which regulates the prices paid for heart surgery, bedpans, wheelchairs and other coverages.
Under the House bill, the government would pay subsidies to insurance companies to encourage them to provide drug coverage for the elderly. Democrats say drug benefits are too important to be left to the vagaries of the insurance market.
Representative Jay Inslee, Democrat of Washington, said the Republican plan was "a big gamble" because "no insurance companies exist on the face of this planet today to provide the service." Representative Sherrod Brown, Democrat of Ohio, said, "The Republican bill begins the process of privatizing Medicare."
Republicans say insurance companies and market forces can control costs better than the government.
The House Republican bill says the government may not set drug prices or "interfere in any way with negotiations" between insurers and drug manufacturers or suppliers. That ban could fade with time, just like a section of the original 1965 Medicare law, which said the federal government must not "exercise any supervision or control over the practice of medicine or the manner in which medical services are provided."
Democrats and some Republicans say it is absurd for the government to establish a program of benefits without taking steps to limit drug costs. Without such limits, they say, the program will be unsustainable.
Senate Democrats will push two plans House Republican leaders avoided. One would alter patent laws, making it easier for low-cost generic drugs to compete with brand-name medicines. The other would allow pharmacists and wholesalers to import drugs from Canada and Europe, where prices are held down by government regulation. Both ideas are anathema to brand-name drug makers.
Clearly, Mr. Daschle can engineer votes that help Democrats running for Congress this year. Whether he can get a bill through the Senate is unclear. He has not divulged his strategy even to other Democratic senators.
And everyone else will see tax increases to pay for this boondoggle.
And drug prices will shoot up.
--Boris
The cost of drugs will rise due to the government regulation and seniors will be used to further sales by physicians over-prescribing as in our school children. The excuse will be heard, why worry, the government pays for it.
I thought Medicare was on life support and due to go broke in 2013 and now no mention of this possibility by the authorities. Maybe the government has cooked the books enough to eliminate this possibility, but I would like to know the truth for a change.
With Washington stalled on a plan to provide a Medicare prescription-drug benefit,
patients...are taking matters into their own hands. It's technically illegal to import
drugs from other countries, but U.S. authorities have made exceptions for "personal
use." Nearby Canada makes an inviting shopping ground.[...] Yankees typically
save 30 percent to 50 percent.
[...] Patients visit unitedhealthalliance.com, fill out a brief medical history and an
order form, and fax them --along with a doctor's prescription -- to the Canadian
pharmacy. A Canadian doctor reviews the paperwork and writes a Canadian
prescription. The drugs are then shipped directly to the patient's house in the
States. The savings can be huge. [...] The first 145 people who used the program
would have spend $81,000; through MedicineAssist, they paid just more
than $22,000.
Newsweek June 24, 2002
Back in the 60's, when Medicare was born, the AMA could have taken the position that it would not participate, that it was a bad idea for government to be involved. Instead, it offered its own 'Medicare-lite' version called "eldercare', thereby accepting the premise of government medicine. The battle was lost at that point and today we continue to see the results.
The AMA did what it did for "practical political reasons". That is a point worth remembering when GWB and co. make their political calculations (I need not repeat the list) because it is so 'important' for the 'next election'.
I very much doubt the government reduced spending in the Medicare program. They did attempt to reduce fraud and some doctors and hospitals have paid in some very big fines but I doubt spending got cut at all. I read recently that the Medicaid program is in financial crisis ----somehow they expected that program would top out at some point but of course it didn't.
Maybe that's the program that should be expanding, not Medicare. The government should get out of healthcare completely ---the Constitution never gave it that authority in the first place and it doesn't do the job well at all.
That's not your opinion friend, it's a hardcore fact of life.
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