[Mb-civic] Bush's Disastrous Drug Plan, For Seniors

[Jim Burns]

I'm always amazed when folks on the left start screaming about the
failure of government, and how government doesn't work--

Especially because that's what so many of those on the far right WANT
you to think, so that they can further dismantle benficial programs.

(New Orleans? Bush's administraion was TOLD of the needed repairs to the
infrasructure years ago--they had switched the allocated money to
another program, and wouldn't okay the work...)

Government works extraordnarily well when there's a commitment to the
common good.

Ask all those soldies who went to college after World War 2, on the G.I.
Bil, or all the kids whose only decent meal of the day, came at school,
or those who educated themselves in PUBLIC libraries...

Incredibly, Bush has made it impossible for Medicare to buy drugs in
bulk, like the V.A.

The savings to our seniors would be immense--

Over a thousand dollars a year alone on a medicine, as cited below, like
Zocor...

When did part of the Republican mantra become the flag, apple pie, and
screwing a mother's, mother....?

Bush is a false conservative.

And these pundits prey, now even more than at any other time, on our
elder Americans.

Jim Burns


" Medicare Misery"

The new Medicare bill is about to kick in, and what it offers to seniors
isn't pretty. 

By Robert Kuttner

The New Year brings with it Congressional mid-term elections. Here is an
issue that should be a real political gift to the opposition party –
the colossal Medicare drug-benefit mess. 

It was clear back in 2003, when the Bush administration rammed this bill
through the Republican Congress, that the purpose was not to devise an
affordable prescription drug program for seniors. Rather the
administration wanted to help two friendly industries, the
pharmaceutical companies and the HMO's; and to get bragging rights for
the 2004 election that Bush had helped seniors. Few voters would grasp
just how bad the law was, since its effective date was deliberately put
off until 2006. 
Now, as the year of reckoning arrives, the true cynicism of Bush's
program is becoming evident to each senior citizen (or adult child of
senior citizen) who attempts to fathom what Bush and the industry
lobbyists wrought. 
For starters, coverage is woefully inadequate. You pay a $250 deductible
and then a 25 percent co-pay on the first $2,250 of drug benefits each
year, plus roughly another $450 a year in premiums. So if your
prescriptions cost $2,250 a year, or about $190 a month, for
prescriptions, you pay $1,200 a year all told and the plan pays just
$1050. 
That's pretty shabby. But then, the truly bizarre feature of the plan
kicks in. Coverage simply disappears, until you have spent nearly $3,100
out of pocket. This is the infamous "hole in the donut." Coverage kicks
in again only after a total of $5,100 in prescription costs. 
A great many seniors will never get the coverage because the plan is a
bad bargain, and they just won't sign up. Of if they do sign up, they
will run out of the ability to pay enough out of pocket before
qualifying for needed benefits. Even with these disgracefully skimpy
benefits, the plan is expected to add over half a trillion to the
federal budget over the next decade. 
Why would anyone have designed such an insane program? 
Because the political purpose was never to deliver good benefits. One
administration goal, running the program through the private insurance
industry, conflicted with the imperative of a clear, cost-effective
plan. Seniors must evaluate innumerable competing private plans, each
with subtle differences in costs and benefits that make an impenetrable
program even less fathomable, and raise total costs because each of
these private plans tacks on a profit. This was a case of privatizing
something done far more efficiently through a direct government program. 
The second administration goal, fattening the drug industry, led to a
provision explicitly prohibiting the government from negotiating bulk
price discounts from drug companies, as the Veterans hospitals do. As a
result, according to a study by Families USA, drug prices obtained by
the VA are about 48 percent less on average than those expected to be
charged to people enrolled in the Medicare drug program. Among the
twenty most widely prescribed drugs for seniors, for instance, a year's
supply of Protonix (for ulcers) costs the VA $253, but the seniors in
the Bush Medicare program, which prohibits such bulk discounts, pay a
sticker price of $1,080. That will give you ulcers! A year of Zocor, the
cholesterol-reducing drug, costs the VA $251. Seniors in Bush's drug
plan get whacked for $1,323. 
It was these inflated costs that necessitated some gimmick to keep down
the overall cost to taxpaypers. Hence the notorious donut hole. 
If the Democrats have the moxie and the wit, they should propose a
straightforward fix, take it to the country in the 2006 elections, and
dare Republicans to oppose it: 
First, get rid of the costly crazy-quilt of private programs and bring
the "Medicare" drug program back into public Medicare. 
Second, allow Medicare to negotiate bulk discounts the way the VA does. 
Third, get rid of the donut hole, and design a simplified benefit
structure with modest co-pays and then 100 percent coverage after a set
annual cap on out-of-pocket costs. 
Finally, if the savings from the bulk price discounts are not quite
sufficient to cover costs of filling in the donut hole, take back a
little of Bush's tax cuts to the richest one percent. 
This debate will also remind voters of a useful meta-lesson. A party
whose mantra is hate-government, and that sees government mainly as a
vehicle for rewarding special-interest allies rather than serving
ordinary citizens, can never be trusted to run government competently. 
A happier New Year to all. 

Robert Kuttner is co-editor of The American Prospect.  © 2006 by The
American Prospect, Inc.  

http://www.prospect.org