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Privatizing medicare Original Source Link: (May no longer be active)
http://www.buffalonews.com/editorial/20030623/1006735.asphttp://www.buffalonews.com/editorial/20030623/1006735.asp
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Clinton sounds alert on seniors drug bill
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Sen. Hillary Rodham Clinton said her analysis shows the GOP's prescription drug legislation puts at risk or excludes about 900,000 New Yorkers, or one in three now on Medicare.
By DOUGLAS TURNER
News Washington Bureau Chief
6/23/2003
WASHINGTON - Sen. Hillary Rodham Clinton is weighing in heavily on a subject she learned a lot about in the White House: health care and prescription drug benefits for senior citizens.
With President Bush saying he will consider adding a drug benefit to Medicare, the Senate has plunged full bore into voting on a plan. Meanwhile, a House committee moved ahead on a conservative approach to the benefit.
In the process, Republicans as well as Democrats are drawing on parts of the universal health insurance plan that Clinton unsuccessfully pushed as first lady eight years ago - notably, group-buying of drugs to cut prices.
In a major floor address last week, Clinton touched on themes that drove her first effort.
Clinton said her analysis of the Senate's Republican-backed prescription drug legislation puts at risk or excludes about 900,000 New Yorkers, or one in three now on Medicare.
Among them, Clinton said, are New Yorkers who use the state's EPIC prescription drug program to defray the cost of their medicine.
One of them is an Orchard Park senior, Arlene Francis, widow of a Bethlehem Steel retiree. Under EPIC, the New York Democrat observed, Francis pays fees and co-pays of $336 for a total drug bill of $998 for her osteoporosis medicine, antibiotics and a hormone replacement patch.
"But watch her expenses change" under the GOP federal plan, Clinton said.
"She'll pay at least $420 in (government-mandated) premiums, a $276 deductible and a 50 percent co-pay.
"Her total costs for coverage of her $998 in drug expenditures: $1,157."
Francis told The Buffalo News she watched Clinton's speech on C-SPAN Friday and was pleased Clinton mentioned her case.
"But I almost fell off my chair when I heard my name," she said. "I'm just a little person from Orchard Park."
Burden on state continues
Clinton, though, pointed out the irony of Francis' situation.
"Not only is Arlene going to get nothing from this bill," Clinton said, "but New York State gets left out as well.
"The federal government isn't lifting the state's costly burden of prescription drugs, and it even adds some administrative costs on state Medicaid offices."
Adding a drug benefit to Medicare - creating the biggest entitlement program in 40 years - offers "tremendous promise and tremendous peril," Clinton warned.
Clinton said she has heard from many constituents who are "terrified" the Republican plan's benefits will be so overblown that employers will cut off coverage and the state, desperate for ways to cut costs, will take aim at EPIC.
State funding for EPIC tops $600 million a year.
Clinton said the bill excludes coverage for the lowest-income seniors who are "dual eligibles" under Medicare and Medicaid, the welfare-based health care plan. They number 219,000 New Yorkers.
To that, Clinton adds another 365,000 who might lose their benefits because their employers think they'd be covered by the new plan, and the 217,000 now receiving EPIC benefits, for a total of 900,000.
Bill also worries Pataki
Even Gov. George E. Pataki is apprehensive about the bill. He wrote to Clinton and others in the congressional delegation, urging them to make sure the bill is corrected to include the "dual eligibles" under Medicare and Medicaid.
The prospect of providing even partial coverage of seniors' drug costs - a program slated to cost $400 billion over 10 years - has drawn fire from all degrees of the political spectrum.
The budget-hawk group founded by former Sen. Warren Rudman, R-N.H., the Concord Coalition, said the plan is too expensive. Americans for Tax Reform denounced a Senate-passed amendment that will allow re-importation of drugs from Canada as "a massive market distortion."
As flawed as the Senate bill is at the moment, it is preferable to a version moving through the House Commerce Committee, said Ron Pollack, who heads the nonpartisan FamiliesUSA, which advocates expansion of health coverage.
"For a senior below the poverty line who has $3,000 in yearly drug costs, his costs under the Senate plan would be about $75," Pollack said. "Under the House bill, he would pay $1,114."
"For a senior with $5,000 or more costs, his price under the Senate bill would be $138. The House bill would cost him $3,014 a year - or a total of his annual income." Pollack said another virtue of the Senate bill is that it does no violence to the tradition of Medicare.
"It prevents the privatization of Medicare," he said.
Privatizing Medicare
By contrast, the House Committee bill would place large burdens on seniors to pay the cost of drugs, forcing them into private plans and moving toward the privatization of Medicare, long a goal of conservative Republicans.
Senate Democrats, including Dick Durbin of Illinois, warned that the Senate bill places no brakes on either the escalating price of drugs or prescription plan premiums.
The Senate has acted in two peripheral ways to discourage price increases.
The Senate, in a 99-1 vote, passed a bill sponsored by Charles E. Schumer, D-N.Y., to encourage the marketing of low-cost generic drugs, but the full effect of the bill, even if it clears the House, may not be felt for years.
And the Senate is allowing a one-year trial of re-importation of drugs from Canada. But a combination of conservative Democrats and Republicans defeated an amendment backed by Clinton and Sen. Debbie Stabenow, D-Mich., to permit the Medicare system to group-purchase drugs.
At the same time, House Republicans want to allow creation of interstate business compacts to buy drugs for seniors to help save money.
Reynolds touts House bill
There are vast differences in the way the House and Senate will draft their bills. Senate rules encourage an almost open process to amend the measure, allowing for a more bipartisan approach.
House procedure is more rigidly controlled by Republicans. Rep. Thomas M. Reynolds, R-Clarence, as a majority member of the House Rules Committee, will have a lot to say about the type and number of Democratic amendments allowed to reach the floor for a vote.
Reynolds in a prepared statement said the House committee bill "will make significant improvements in Medicare."
"The House plan would be voluntary for those who want to stay with their current coverage, and other beneficiaries would be able to choose between at least two different plans," he said.
Unions and the pharmaceutical industry are setting new spending records to lobby the Republican Congress.
In the last six months of 2002 alone, drugmakers spent $42 million to lobby Congress.
The largest spender was the Pharmaceutical Research & Manufacturers Association at $8 million in six months. Pharma says it likes the Senate bill.
Clinton urges caution
As ardently as she wants a drug benefit linked to Medicare, Clinton is urging caution. "We do not want to rush through this legislation at the expense of getting it wrong," she said. "We cannot use arbitrary deadlines and a recess as an excuse to look away from the fine print."
"If I were to take an informal poll of the (100) senators and the budget scholars who actually read this bill and asked them, "what exactly is in this bill and how does it work for our seniors,' I bet I would get 100 different answers."
Bureau Assistant Wendy Eichorst contributed to this report.
e-mail: dturner@buffnews.com
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