Meddling with Medicare

A so-called congressional “coalition of the willing” put on quite a dog-and-pony show that appears to offer senior citizens a $400 billion prescription-drug program starting in 2006. Both members of Congress and their constituents should give the mouth of this gift horse a pretty thorough examination before celebrating.

Although two Democratic senators, Max Baucus of Montana and John Breaux of Louisiana, were present at the news conference unveiling the drug plan, it is apparent that most Democrats and probably a lot of Republicans, too, were excluded from the key deliberations.

Congressional decision-making by closed-door conference committees has become the favored method of legislating by GOP lawmakers. It is worse because the doors of the meeting room are barred to the minority party whenever the majority chooses to do so. It is one of the gifts of this “compassionate conservative” administration to the American political process.

So, what are voters likely to get in this package that will be pushed hard by the GOP as a means of taking the issue of prescription drugs off the campaign agenda for 2004? If President William McKinley and his money-man, Mark Hanna, were still alive, they would understand perfectly the bait-and-switch scheme which is under way on Capitol Hill.

As envisioned by the plan unveiled with so much fanfare, seniors could, beginning in 2006, get a plan that requires them to pay 25 per cent of drug costs up to $2,200 a year, with a $275 deductible for prescription drugs and a monthly premium that would average $35 - a total cost of more than $1,000. Once drug costs reached a $3,600 threshold, 95 per cent of costs would be covered.

Most current drug-prescription plans are not anywhere near as draconian as that, but they might eventually become so if this plan is adopted. The underlying message is don t get old and, if you do, don t get sick. There are special provisions for low-income persons, and those earning more than $80,000 a year would pay more.

This is a plan billed as “not perfect,” but one which, in Rep. Billy Tauzin s words, is “a generational decision to spend $400 billion to keep mama and daddy alive” - at least as long as they have $1,000 or more to spend on drugs each year.

Better than nothing? Well, only in the sense that something, no matter how parsimonious, is better than nothing. Seniors are assured that they don t have to sign up for this plan if their own is a better one. But if it is passed, it will be interesting to watch how fast private plans are pared back to the government level.

A poison pill also is included in this plan that has nothing to do with drugs. It would set up a six-year comparison study of traditional Medicare and private health plans in six areas of the country to see which one was more efficient. With subsidies proposed to encourage seniors to enter the new program, it is plain to see that the real purpose of the bill is to change the way Medicare, a reasonably efficient program, is funded, turning it over to insurance companies. How will “mama and daddy” like those apples?

Not surprisingly, pharmaceutical companies, insurance firms, and HMOs have signed on to the program. GOP lawmakers have never met a corporate lobbyist they couldn t do business with.

Seniors, who are expected to spend $1.8 trillion on drugs in the next decade at costs that are among the highest in the world, should hang on to their wallets tightly even as they burn up the wires to congressmen in Washington.

There may be some innovation here, but the shape of this bill is ominously clear. Its passage in its present form - a race to be at the bottom of the developed world in health benefits - is too high a price to pay for getting George Bush off the hook on the prescription-drug issue in the 2004 election.