Wednesday, March 05, 2003
Compared to people with private health plans, Medicare patients have limited choices. Medicare will pay a doctor to perform a heart bypass operation, but will not pay for drugs that could prevent the need for surgery. Medicare will pay for an amputation, but not for the insulin that could help diabetes patients avoid losing their limbs. Medicare will pay for chemotherapy and cancer surgery, but after private insurancers -- insurers made annual mammograms a standard benefit, it took ten years for Medicare to do the same, and then only because the United States Congress passed a law. Seniors should not have to wait for an act of Congress to get effective, modern health care.
Nor should Congress be setting standards of medical care, but I doubt if Medicare reform will keep them from meddling in such matters, or keep health activists from crusading for coverage of pet causes, regardless of their merits. But, I digress:
The framework for Medicare reform I'm releasing today would give seniors the freedom to select one of three broad opportunities. First, seniors who are happy with the current Medicare system should be able to stay in the system and receive help for prescription drugs. To reform the current system, I propose we issue a discount card that will reduce the cost of prescription drugs for every senior by 10 to 25 percent. We will provide an annual $600 subsidy to low-income seniors to pay for prescription drugs. And we will set annual limits on the amount seniors will have to spend out of pocket on drugs at no additional premium.
Second, seniors who want more coverage will be able to choose an enhanced form of Medicare. This option will include full coverage for preventative care, a comprehensive prescription drug benefit, protection against high out-of-pocket costs, and extra help for low-income seniors to be able to get the drug benefit. Seniors will be able to choose their specialists, their hospitals, and their primary doctors.
The fee-for-service arrangement would offer seniors similar kinds of choices now enjoyed by the members of Congress, who are given a broad choice among competing health care plans. What is good for the public servants, including members of the House and Senate, is good for America's seniors.
Third, seniors who want the kind of benefits available in managed care plans, including prescription drug coverage, will have that choice, as well. This option would place seniors in an affordable network of doctors, provide drug coverage, and allow seniors to keep their out-of-pocket costs to a minimum.
Moving toward this system will take time. And as we make these changes, all American seniors will receive a prescription drug discount card to use right away. And low-income seniors will be eligible immediately for the annual $600 Medicare prescription benefit.
Leaders of both political parties have talked for years about this issue, about adding a prescription drug benefit to Medicare. And the time for action is now. The budget I submitted will commit an additional $400 billion over that which we have already committed to, over the next decade to implement this vision of a stronger Medicare system.
I have reservations about giving discounts for drugs to every senior. Not all seniors are needy. Many are very well off. I’m all for prescription benefits for those who need it, but it seems to me if Medicare is to remain solvent as the baby boomers continue to age, there’s going to have to be some limits to the spending, and the best way to do that is to make it needs-tested rather than universal. Of course, that isn’t politically palatable, as Congress is already proving:
Republican lawmakers showed the same disdain yesterday for President Bush's latest Medicare prescription drug plan as they did his first one a month ago, promising that after two failed attempts by the White House they will write their own plan with bigger benefits for older Americans
''The way I see it, we need a universal drug benefit so seniors who want to stay in traditional Medicare get a prescription drug plan that's just as good as those who chose a new option,'' said Senate Finance Committee Chairman Chuck Grassley, Republican of Iowa.
I wish they’d give more thought to the future.
posted by Sydney on 3/05/2003 08:41:00 AM 0 comments