REP. ADAM SCHIFF FIGHTING FOR A PRESCRIPTION DRUG BENEFIT
By Congressman Adam Schiff
Nearly four decades ago, President Lyndon B. Johnson signed the Medicare Act of 1965 into law, extending health coverage to almost every American aged 65 or older. Since then, our nation's seniors have benefited from a comprehensive health benefits plan that covers everything from routine physical examinations to open heart surgery with one major exception: prescription medicine.
Last November, Congress debated and adopted - during the longest roll-call vote in the history of the House of Representatives - the Medicare Prescription Drug and Modernization Act, a bill that sought to close this yawning gap in America's health care coverage for our seniors by adding a prescription drug benefit to Medicare.
Despite the promises of the bill's proponents and an inappropriate, tax-payer funded television campaign that the Administration is running to promote the new law, this legislation fails to fulfill the promise we made to our nation's seniors: to build a solid, well-constructed prescription drug benefit into Medicare. It provides an inadequate prescription drug benefit, contains a large gap in coverage and weakens Medicare by moving the venerable program toward privatization.
First, the bill does little to help address the soaring costs of prescription drugs. It explicitly prohibits the Secretary of Health and Human Services from negotiating lower drug prices on behalf of America's 40 million Medicare beneficiaries. Negotiated pricing is one of the most important means by which private insurers contain costs and there is no reason why Medicare should not be allowed and encouraged to do the same. The bill also expressly forbade the Medicare program from saving money by re-importing drugs from Canada and other countries, an idea that I strongly support.
Second, the prescription drug benefit provided in the legislation is too small to be meaningful. As we all know, the cost of prescription drugs is skyrocketing. According to a 2003 study done by the Kaiser Family Foundation, retail prices for prescription drugs rose at a rate more than double that of inflation from 1992-2002. Currently, the average senior's drug costs total approximately $1,350 a year. Under the new law, the average senior will have to pay $946 in out-of-pocket expenses - that's 70% of their prescription drug costs. We must do better than that.
The legislation also contains a large coverage gap for seniors who spend more than $2250 a year - or $187 per month - on medication. The seniors who fall into this gap will be required to pay 100% of their drug costs from $2,250-$5,100 before the federal government will step in again. That's $2,850 in out of pocket spending for those seniors who are most in need of prescription drugs. At the same time, the bill gives almost $80 billion to employers in the hope that they will continue to provide health benefits to their retirees - but even with this subsidy, it is estimated employers will drop 2 million seniors from coverage.
Third, and most regrettable, the bill weakens Medicare by putting it on the road towards privatization. It pushes seniors out of traditional Medicare and into private plans. Under the new law, seniors will only be eligible for drug coverage through private insurance companies that will have wide latitude in setting premiums. Seniors will eventually be urged to join Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPO) for all their health care coverage. Seniors who choose to remain in the traditional fee-for-service program will face the prospect of rapidly rising premiums and no prescription drug benefit. This is a serious mistake, one that will ultimately create fewer choices and result in higher premiums.
More than 185 senior advocacy groups opposed this bill, including the National Committee to Preserve Social Security and Medicare, Center for Medicare Advocacy, Alliance for Retired Americans, Medicare Rights Center and Center for Medicare Advocacy.
I voted against this legislation in November because I am committed to providing seniors with a defined, guaranteed, affordable prescription drug benefit under Medicare and this legislation fails to accomplish this goal. Congress should immediately work to replace H.R. 1 with a truly comprehensive bill that uses the combined bargaining power of Medicare's 40 million beneficiaries to lower drug costs, that allows the safe re-importation of drugs from other countries like Canada and Australia, that does not lead to the privatization of the Medicare program and that offers all seniors a meaningful prescription drug benefit.
During last fall's debate in the House, many of my colleagues who supported the bill proclaimed that it would eliminate the need for America's senior citizens, our parents and grandparents, to choose between food and medicine. Unfortunately, that horrible choice still confronts too many of our elderly and we have an obligation as a Congress and as a society to take up this issue anew.
|
