Washington Action Expected to Cover Drugs for Seniors
Health Policy Pulse
Feb. 2, 2001 (Washington) -- What does the healthcare crystal
ball show for legislative action this year? Last year brought lots of talk
about change, but little action in Congress, so will the gridlock break?
Republicans control the White House and both houses of
Congress, albeit by very tight margins. And compared with President Clinton,
Bush is not a huge health policy fan.
Recommended Related to Health Insurance & Medicare
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The Medicare prescription drug benefit isn't perfect, by any means. But it is helping millions of people pay for medication. So, you should understand how to take advantage of it.
According to pollster Bob Blendon, PhD, no single healthcare
issue dominated voters' concerns in November, with most favoring incremental
steps in Medicare reform, managed care regulation, and helping the uninsured.
Healthcare, he says, is an important, but second-tier issue.
That said, a Medicare prescription drug benefit is especially
prime for action, pundits agreed at a health conference this week. Within his
first two weeks at the White House, President Bush already proposed to Congress
a $48 billion four-year temporary plan, termed "immediate helping
hand," that would involve grants to states to run drug subsidy programs for
Exactly what kind of drug plan might pass the tightly divided
Congress isn't too clear. Lawmakers have greeted the Bush proposal with a lack
of enthusiasm, especially Democrats who want a benefit that would be available
to all seniors and would operate as a central Medicare benefit.
According to Republican pollster Bill McInturff, covering drugs
for seniors is "the No. 1 health issue" this year.
Robert Reischauer, PhD, the executive director of the public
policy organization Urban Institute, agrees. "Some action is almost
inevitable on Medicare" by 2002. If not, he says, "then Democrats will
have been handed a huge club" with which to beat up Republicans in the 2002
McInturff says that some Republican leaders on Capitol Hill
believe that drug coverage should be passed along with the structural reforms
of Medicare -- instead of separately -- to move the program in the direction of
But Sen. Jay Rockefeller, (D-W.Va.), argues that large-scale
Medicare reform will not happen in the near future, saying the two political
parties have such fundamental differences in philosophy.
With that dynamic in play, McInturff warns, Republicans may
face disastrous 2002 congressional elections if they fail to pass a simple drug
The Medicare population will nearly double in the next 30
years, to 77 million beneficiaries, while the program's spending will skyrocket
as a proportion of the nation's gross domestic product.
But right now, all that seems very far away. Medicare's
financial stability is at an all-time high, measured by the statistic that the
program isn't projected to go broke until 2024.
Moreover, Medicare's baby steps toward the free market have
been more like stumbles. Robert Berenson, MD, who ran the Medicare+Choice
program of HMOs for President Clinton, says that HMO enrollment has fallen