Health Care

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The Race is ON: Prescription Drug Benefits as Campaign Strategy

Everyone agrees that older Americans need help paying for their prescription drugs. The Bush administration has moved from their campaign pledge to change the Medicare system. Responding to the Democrats challenge to leave Medicare alone, but add a prescription drug benefit, the President has signaled that he also wants to add a prescription drug benefit to Medicare. However, there is much disagreement on just how to do this.

Once again, WomenMatter reminds us that whoever gets to frame the question for the debate, has the most clout. Is prescription drug coverage a question of quality, cost, or risk? Notice how the arguments shift among these three as each of us decides for herself, which of the three is the most important.

President Bush is in favor of moving seniors from traditional Medicare which is an entitlement to anyone over 65 (no matter how much money he/she has) to Preferred Provider Organizations (PPOs), private health plans in which the patient gets to choose the doctor. The Bush plan offers prescription drug benefits to those who enroll in PPOs, thereby leaving Medicare, the entitlement. PPO’s can drop people and change benefits without government protections or standards. The advantage is that PPO’s would compete with each other and drive down the price from either the pharmaceutical manufacturers or the intermediary private Pharmacy Benefit Management companies.

The Senate’s Finance Committee’s plan (remember all committees have a majority of Republicans since the November 2002 election) offers such benefits to all: to seniors who get Medicare coverage and to seniors who purchase PPO coverage. President Bush supports this plan as well because he is more concerned with passing some sort of prescription drug benefit than the details of the legislation.

What’s the plan?

The Senate Finance Committee’s proposal has two main themes: private versus public, and the inclusion of prescription drug benefits. First, we have private versus public. The plan gives people on Medicare the option of switching to a PPO, which is a privately-owned business. Or, Medicare beneficiaries can stay with traditional Medicare, which is paid for by our taxes, and, therefore, government regulated.

The committee says that both the PPOs and Medicare will offer the same prescription drug benefits. Either way, patients would pay a monthly prescription drug premium of $35. They would also pay the first $275 of drug costs. After they spend that $275, the government will pay half of drug costs UNTIL they reach $3450. Once they get to $3450, they go back to paying all drug costs. If they get as high as $5300, then they only pay 10% of costs from there on out.

So, patients who pay more than $3450 for prescription drugs need to pay close attention. Critics of the proposal cite this gap between $3450-$5300 as a major problem. People who spend that much on drugs may be quite ill, and would receive even less support than those who already happen to spend less on medicine.

Is privatization good or bad?

Those who dislike government participation in healthcare think that privatization is a good idea. Many say that if left up to the free market, healthcare will improve in quality and diminish in cost.

Others believe that the government should provide and manage healthcare. They say that it is the government’s job to make sure that everyone gets good healthcare. Many people cannot afford the most talented doctors and the technology necessary for diagnosis and treatment. Under Medicare, all individuals are entitled to the same services, no matter what income they have. Medicare takes the responsibility for risk for all the elderly, because they are citizens.

Bipartisan support

The committee’s plan has the support of most Republicans and some Democrats, and it is likely to be approved by June 13, 2003. The proposal would then move to the Senate floor for debate. Republicans hope this debate will be short. They want to pass the bill by the July 4th weekend, 2003. Republicans may want to pass the bill quickly so that they can claim prescription drug benefits a victory for the 2004 campaign.

What’s the rush?

Republicans claim that seniors have waited long enough for prescription drug benefits and that the sooner this legislation goes through Congress, the better. Democrats are also in favor of an expedient process, but fear that if the bill moves too quickly, important details may be overlooked. Democrats want to discuss the pros and cons of privatizing Medicare, before taking a step towards privatization. No one has actually stated where the money would come from, given the budget deficits which rely now on borrowing from Medicare and Social Security. When the baby boomers retire and are eligible for Medicare (by 2013), the demand for prescription medicines will be huge. Older people need more medicines.

Democrats want to keep it Public

Some Democrats, like minority leader Tom Daschle, are opposed to the Senate Finance Committee’s proposal. Daschle warns that the privatization of Medicare will harm poorer seniors, who won’t be able to afford complete healthcare without government help.

Campaign Strategy in the minds of all

Republicans aren’t the only ones worrying about the 2004 elections. Some Democrats fear that if they hold up this legislation, they will be seen as naysayers, which is not a good image on Election Day. So, many Democrats have agreed to pass the proposal and fight for broader drug benefits for seniors later. This is a well known way to get legislation passed. A bit at a time, that is incrementally. The direction of those bits and the timing of them in a campaign are important to watch.

Stay Alert

Since the prescription drug benefit proposal is still in committee, a lot could change with this issue over the next few weeks and months. Check in with Womenmatter to find out the latest information on this issue. To find out how your representative votes, click here.

Posted on: 6/14/2003

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