Saturday, February 23, 2002

Prescription benefit pushed

U.S. Medicare administrator visits city

By Tim Bonfield
The Cincinnati Enquirer

        The nation's top Medicare administrator assured Tristate seniors Friday that the Bush administration is serious about launching a prescription drug benefit.

        But whether Congress will pass the president's 10-year, $190 billion proposal — or reach a compromise on any other proposal — remains a guessing game.

[photo] Rep. Steve Chabot (left) and Medicare administrator Tom Scully surprise Jean Harrison while she visits her mother, Irene Hartmann, 89, (right) at West Park.
(Glenn Hartong photo)
| ZOOM |
        “We are very, very committed to creating a drug benefit for Medicare,” said Tom Scully, administrator of the Centers for Medicare and Medicaid Services. “If it doesn't happen, the biggest reason it won't is political, sadly.”

        During a Cincinnati visit Friday, Mr. Scully met with Republican Reps. Rob Portman and Steve Chabot, talked with health care executives at the Greater Cincinnati Health Council, toured Mercy Franciscan Hospital-Western Hills, and spoke with seniors at the West Park retirement community in Westwood.

        Mr. Scully's main point: The Medicare system is at least 20 years out-of-date and needs reforms that go well beyond adding a prescription drug benefit.

        Medicare is the federal health plan for seniors and the disabled. Nationally, as Baby Boomers begin retiring, Medicare spending is expected to rise from $254.8 billion this year to $428.6 billion by 2012, Mr. Scully said. In Ohio, Medicare spends nearly $7 billion a year for care in a system that covers 1.7 million residents.

        “Nobody would design a program like this today,” Mr. Scully said.

        The lack of coverage for Medicare prescription drugs, an awkward set of deductibles for hospital and doctor care, hard-to-justify geographical differences in payment rates, and a lack of ways to measure the cost-effectiveness of covered services are just some of the Medicare problems that need to be addressed, Mr. Scully said.

        However, seniors struggling with constantly rising medication bills want a lot less study and a lot more action.

        At the Clifton Senior Center, a government-subsidized residence for lower income seniors, residents told the Enquirer they spend large parts of their days searching for ways to obtain medications that Medicare won't cover but they can't afford.

        They share tips about which doctors give away free samples, and which drug makers offer discounts. They discuss mail-order deals, Internet offers, even whether it's worth taking trips to Canada or Mexico to get cheaper medications. Every day, seniors take partial doses or leave prescribed pills at the pharmacy for lack of money to pay the bill.

        The situation is an outrage to Audrey Buehler, a 73-year-old resident of the Clifton center.

        “We're the richest, most powerful country in the world. All the other civilized nations of the world take care of their senior citizens. Why can't we?” Mrs. Buehler said.

        So how much Medicare reform has a chance of passing in 2002? Mr. Portman and Mr. Chabot offered partly-cloudy, partly-sunny predictions.

        “There's no guarantee in life, but there is a bipartisan consensus that prescription drugs should be in Medicare. We're closer to agreement on that than we have been in years,” Mr. Portman said.

        The president's plan emphasizes a phased-in approach, starting with a prescription drug discount card and medication subsidies for the poorest seniors. That plan — or one close to it — has a good chance of passing in the Republican-dominated House, but faces tougher odds in the divided Senate, Mr. Portman said.

        Democrats, along with some senior groups, have contended that the Bush proposal doesn't go nearly far enough. Meanwhile, hospitals and other health service providers have worried they could be hurt if Medicare shifts funds into prescription drugs.

        Mr. Chabot said cost concerns will be the big stumbling block as Congress debates budget issues during the next six months, especially with the recession and the increased defense spending after Sept. 11.

        “Unfortunately, it's going to be a little tougher this year to actually implement a prescription drug benefit than we'd like to see,” Mr. Chabot said.



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