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USA Today Questions Pressing Need
for Drug Bill
Oct. 14, 2003 - The national newspaper, USA Today, ran an editorial
today questioning the importance being given of adding drug coverage
to medicare, when millions of poor Americans need basic health
insurance. They also published a view by William Novelli, CEO of the
AARP. Both are reprinted below.
USA Today Editorial
Focus on seniors' drug needs
shortchanges other worries
When Congress tackles national
problems, its tendency is to take the course of least resistance or
greatest pressure. From its refusal to touch Social Security to its
eagerness to create new corporate tax breaks, Congress has shown
repeatedly that it listens to those groups that speak the loudest.
Senior citizens are plenty vocal, both
through their muscular lobbies, such as the AARP, and their voting
clout. This helps explain lawmakers' preoccupation with crafting an
expensive Medicare drug benefit to ease the health care burdens faced
by a slice of seniors. But it doesn't excuse it.
The singular focus on expanding the
benefits for the 38.5 million individuals who already are covered by
one of the nation's most affordable and dependable health plans is
dangerous in two respects. It diverts political capital and precious
taxpayer resources from more pressing national health-coverage
concerns.
In 2002, 43.6 million people lacked
health insurance for the entire year, an increase of more than 2
million from 2001, according to a Census Bureau study released last
month. The reason for the jump is clearly documented. Faced with
double-digit increases in health insurance premiums for a third year
in a row, private companies with coverage are dropping it, and others
are refusing to offer it. The increase in the number of uninsured
would have been even greater had government programs such as the
Medicaid health plan for the poor not picked up more than 1 million
people.
The same study shows a stark contrast
between the growing ranks of people without insurance and the
guaranteed benefits for people in Medicare. Those 65 and older are
covered for just $57.80 per month. While the plan doesn't cover
prescription drugs, its price is considerably less than individuals
pay for comparable private plans if they are fortunate enough to
have one.
Yet Congress is concentrating its
energies on further enhancing benefits for seniors. The Senate and
House each have passed Medicare drug plans and are trying to work out
a compromise measure by the year's end. In spite of pronouncements of
concern about the rise in health care costs and number of uninsured,
lawmakers have failed to put broader solutions on the calendar.
In fact, the push for a $400 billion
Medicare drug plan during the next decade reduces the chances for more
far-reaching legislation. Among the reasons:
Lost time. Debate on the drug bill
has prevented Congress from completing work on other pressing health
issues. Last spring, it set aside $50 billion to address the problems
of the uninsured. Yet the money remains unspent because lawmakers have
not agreed on what to do with it, if anything. Also stalled is
President Bush's proposal to revamp Medicaid coverage for the poor. He
wants to cap spending on the rapidly growing program in the future,
but for now give cash-strapped states more federal aid and discretion
in allocating the money. Congressional leaders see little chance of
taking up those or other politically contentious issues on health
coverage now that a presidential election is approaching.
Lost money. The $400 billion
reserved for the Medicare drug bill takes away funding that could go
toward broader health coverage. In fact, lawmakers are under pressure
to cut spending elsewhere because the drug benefit's steep price would
increase a yawning budget deficit already projected to approach an
unprecedented $500 billion.
Supporters of the drug bill say it is
necessary to halt price increases that are overwhelming for seniors.
Yes, drug prices are shooting up. Prescriptions for popular medicines
such as Zocor, a high-cholesterol treatment, or Norvasc, for
hypertension, cost more than $100 per month, nearly twice Medicare's
premium. And the outdated Medicare program is in need of revamping to
match reforms common in private plans, from drug coverage to cost
efficiencies. That not only leaves seniors on limited incomes liable
for huge drug bills, but also ignores the potential savings that could
come with an overhaul of the program.
Even so, the drug bill would address
only part of that problem. And it wouldn't even do that very well.
Some seniors who exchange the new Medicare plan for the drug coverage
they now get through former employers or separate health policies
would see their out-of-pocket expenses rise, the Senate Budget
Committee reports. And as many as 37% of seniors who now get a drug
benefit from former employers could lose it, according to the
Congressional Budget Office. The reason: Companies could use the new
plan to justify dropping their benefit for retirees. The $400 billion
drug benefit also relies on accounting gimmicks that underestimate the
huge cost taxpayers likely would bear.
Addressing the issue of the uninsured
will be expensive and complicated. Just extending coverage to children
and young adults up to age 25 would cost $53.4 billion a year,
according to an Emory University study.
Ignoring the problem won't make it go
away, which is why a national conversation about it is long overdue.
That conversation can't be heard, however, when it's drowned out by
all of the noise generated by a flawed senior drug bill.
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Original editorial in USA Today online can be found here
Opposing View
Issue is not 'us vs. them'
By William D. Novelli, CEO AARP
Pitting the uninsured against the
underinsured reminds me of the biblical story of King Solomon, who
settled a dispute between two women claiming the same child with the
sly suggestion that they cut the baby in half. Health care in America
is also a baby that cannot be cut in half. We can't turn away from the
immediate opportunity and pressing need to add prescription drug
coverage in Medicare. At the same time, we must also face up to the
challenge of finding ways to ensure that every American has access to
affordable health insurance. It is the ultimate false choice to pit
one deserving cause against the other.
It is true that in 2002, more than 2
million people joined the ranks of the uninsured, raising the number
of Americans with no health-insurance coverage to 43.6 million. Many
of them are working men and women. But the case is every bit as
compelling for adding a prescription drug benefit to Medicare.
Forty-one million people including 2.5 million people under age 65
whose disabilities qualify them for Medicare are without this vital
coverage. Some of them do not have access to drug therapies that they
desperately need.
Americans ages 65 and older represent
just 13% of our population, but they account for more than 40% of
spending on prescription drugs. When older Americans can't pay for the
drugs they need, their families, charities and all American taxpayers
are the ones who have to pick up the often-hefty tab on their behalf.
We've reached a point where
individuals of all ages, businesses of all sizes and governments at
the local, state and federal levels all are struggling with the
complexities and spiraling costs of health care and insurance.
America no longer can afford to look
at our serious health care problems in terms of "us vs. them" or
"older Americans vs. current workers." Absent more fundamental reform,
AARP strongly supports incremental steps to address our nation's
health-coverage needs. Programs such as Medicaid, Medicare and the
State Children's Health Insurance Program, which expands health
coverage to uninsured children, are proof of what we can accomplish
when we take it step by step.
We can do more. We can open existing
public health-insurance programs to more people. We can expand
coverage to more people such as low-income adults without children,
people between jobs, and workers whose employers don't offer coverage.
And, as a vital first step, we can take advantage of what may be our
last opportunity for years to add prescription drug coverage for the
41 million Americans in Medicare.
What we dare not do is offer a false
choice between two groups of deserving citizens or, worse yet, cut the
baby in half.
William D. Novelli
is chief executive officer of the AARP, the senior lobbying
organization formerly known as the American Association of Retired
Persons.
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