The goal of a serious prescription drug plan under Medicare would be to provide strong benefits for seniors and lower drug costs for all Americans. The program should also be cost effective in terms of taxpayer dollars and should be non-complicated for the people who use it. Unfortunately, the Republican plan, which passed the House on June 26th, does none of that. The benefits provided to seniors are minimal, there are no serious cost containment provisions and the plan is enormously complicated. The following are just a few of the reasons why I voted against the House Republican plan:

The House GOP plan creates an insurance company run plan – outside of Medicare. The most basic problem with the House Republican Medicare prescription drug plan is that it does not create a Medicare prescription drug plan. Instead, the Republican plan relies on private health insurers and HMOs to create prescription drug insurance plans for seniors. That means different seniors will have different plans depending on where they live and what plans the private insurers are interested in offering.

The House GOP plan has no guaranteed benefit and no caps on premiums. By creating different regions with different rules and by relying on private insurance plans to offer coverage, the House Republican plan does not guarantee any set benefit package. The House Republicans provide seniors with estimates but no guarantees. They estimate, for example, that the monthly premium for their plan will be $35, but there's no guarantee. Premiums could be higher.

The House GOP plan provides totally inadequate benefits for seniors. A senior who spends $4,000 a year on medicines would have to pay 100 percent of the cost of the second $2,000 of his or her needed medicines. Under the House GOP Plan, many seniors would have to pay $420 in premiums and, because of the deductible, purchase their first $250 worth of drugs without any federal help. They would then pay 20 percent of all of their drug costs from $251 to $2,000 a year. Then the Republican plan would offer no help at all until a senior's annual drug costs reached $4,900 (the bill's $3,500 out-of-pocket cap translates into $4,900 in total drug costs). Nearly half of the Medicare beneficiaries would fall into this "coverage gap" every year, while still paying the monthly premium. Under this plan over a third of Medicare beneficiaries would pay more than they would get under the House GOP plan. For example, if a Senior needed $500 worth of prescription drugs in a year, that senior would pay $720 because of the premium's deductible and co-payment. The average senior spending $1000 a year would pay $820, 82 percent of the total cost. This is totally inadequate.

The House GOP Plan does nothing to effectively lower the cost of prescription medicines. One of the reasons that American seniors (and others) are having a difficult time paying for their prescription medicines is that American consumers are forced to pay, by far, the highest prices in the world for their medicine. This is true even though many profitable medicines have been developed in part with U.S. taxpayer funding. The Republican plan fails to address this problem. Instead of standing up to the enormously powerful pharmaceutical industry, the most profitable industry in the country, and lowering the cost of medicines, the House Republicans instead chose to provide an inadequate benefit package. Even worse, the House GOP plan specifically prohibits the Secretary of HHS from negotiating lower prices.

The House GOP plan will lead to the privatization of Medicare. The House Republicans require that in 2010 the Medicare program start "competing" with private plans to cover all health care for seniors, not just prescription drugs. The result will be that private insurers will take all the healthy Medicare recipients. That means those in the government plan will by definition be those seniors who are sicker. This will drive up the cost of the government plan on a per person basis relative to the private plans. This means the destruction of Medicare as we know it and greater cost for the taxpayers. Of course, the insurance industry will make out very well. The House GOP bill also contains, for the first time under Medicare, a "means-testing" provision. This is the beginning of a slippery slope which could eventually convert Medicare into a welfare program for low income seniors.

The House GOP Plan raises the cost for beneficiaries of the non-drug portion of Medicare. Instead of lowering traditional Medicare costs for seniors, the House GOP bill would raise them by more than $8 billion. In a provision completely unrelated to creating a prescription drug benefit, the House GOP bill would increase seniors' costs for doctor's visits by raising the Part B premium and indexing it to inflation.

Copyright © 2003 Rutland Herald and Barre-Montpelier Times Argus

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