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Guest Commentary: August 27, 2001
A Prescription for Medicare
The Honorable Kay Bailey Hutchison
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Thirty-six years ago, when Medicare was created to provide health coverage for elderly Americans, hospital stays and doctors' treatments were the most costly portion of the care that was to be provided. Prescription drugs represented only a small percentage of medical expenditures.
Today, that picture is very different. Nearly 400 new drugs have been developed in the last decade alone to fight diseases such as cancer, heart disease, diabetes and arthritis. While the drugs themselves are expensive, their use has proven to save health-care dollars in the long run.
Take, for example, anticoagulants: A year's worth of these blood-thinning agents, which help prevent the recurrence of strokes, costs $1,000. Compare that to $100,000 in lifetime costs for taking care of an individual who has suffered a stroke. Similarly, the new "H2 antagonist" drugs are used to treat ulcers in patients who otherwise would need surgery costing $28,000 or more. A year's worth of such drugs can cost $900.
Medicare would pay for the ulcer surgery. But Medicare does not provide prescription drug coverage. Although two-thirds of seniors have private, supplementary coverage that helps with the cost of prescription drugs, the other third are paying 100 percent of their escalating drug costs. It is unfortunate that while more than 98 percent of employer-sponsored health plans pay for prescription drugs, Medicare's benefit package has yet to be updated to include this benefit.
Congress and the Bush administration are trying to figure out the best way to address this situation. We are looking for a way to provide prescription drugs to those who need them but are unable to afford them. We must be careful to design a plan that is responsible, and tailored to those who truly need the help. Seniors who are happy with their existing coverage should not be forced into a more costly, one-size-fits-all government program.
Nor should the elderly be handed a government program that decides which drugs they may and may not have. Such decisions are best made by doctors and patients, not an anonymous bureaucrat in Washington.
An effective prescription drug benefit proposal has to meet certain criteria for common sense and effectiveness. Government should not set up a plan that would duplicate coverage that already exists in the private sector. Nor should we have to wait five or 10 years for a plan to take effect.
The approach I favor would have two main components:
- It has to provide immediate assistance to the states to expand or initiate their prescription drug support programs for moderate to low-income seniors. In many states these programs have put needed drugs within the reach of many elderly individuals who otherwise were going without. We should provide immediate and ongoing relief to the millions of seniors currently forced to pay full retail prices for prescription drugs.
- There should be a Medicare prescription drug benefit as part of a broader Medicare modernization plan that gives seniors more choice and control over their health care.
To accomplish this, the President has proposed making available to Medicare beneficiaries a prescription drug discount card, either free of charge or for a nominal fee, sponsored and administered by private entities.
Medicare would then require the card sponsors to publish the discounted prices for most prescription drugs purchased by seniors, to encourage competition. Ultimately, well-informed buyers will push the market toward more competitive pricing for everyone, whether on Medicare or covered by other insurance.
Today, medical advances mean patients can be treated at home or in the doctor's office, and the emphasis has shifted to preventative care. Still more effective prescription drugs are expected to be available to the elderly in the years ahead to help treat breast and prostate cancer, Alzheimer's disease and diabetes. We need to strengthen the system and make it as modern and effective as 21st century medicine.
Note: Senator Hutchison issues a weekly column; the above is adapted from her column of August 22, 2001.
 How to contact Senator Kay Bailey Hutchison (R-TX)
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