Medicare reforms held captive

Drug prices: Despite clamor for changes, White House and Congress play politics.

November 11, 1999

THERE wont be any big changes in the current congressional session on Medicare or other aspects of this nations struggling health-care system.

Congress and the White House would rather jockey for political advantage than hammer out fundamental reforms.

Other than a bill undoing a tiny fraction of the damage done to teaching hospitals, nursing homes and home-health programs through budget cuts two years ago, congressional leaders are content to spout platitudes on health care.

A patients bill of rights? Its dead for this year, as House Republicans maneuver to make sure no sweeping changes are approved in a conference committee.

A financial bailout of the struggling Medicare program? Even in an era of huge surpluses, neither the Democratic White House nor the Republican majority in Congress wants to push hard for a practical solution. Its too expensive and controversial.

Curbing the high cost of prescription drugs? President Clintons proposal was recently declared DOA by Republicans, who are loathe to expand governments reach into the drug industry, which is a major lobbying force in Washington.

The fight over helping Medicare recipients with prescription drug costs symbolizes this gridlock.

Every politician decries elderly constituents who must choose between paying for food or prescription drugs. But few in Congress want to take the heat for approving a drug-subsidy plan.

The 39 million Americans who qualify for Medicare get no prescription drug coverage, except during hospital stays. More than 9 million of them run up drug bills that top $500 a year; 1.3 million of them run up drug bills topping $2,000 a year.

Even modest, first-step efforts to give seniors some help in paying these drug bills have gotten nowhere. Baltimore Rep. Benjamin L. Cardins plan for Medicare to help pay most of the cost for drugs that combat five common diseases of the elderly is stalled, despite its modest costs compared with more ambitious proposals.

Theres no easy answer. Drug companies can spend billions and a decade or more bringing new drugs to market. That, plus the cost of liability insurance for these new drugs, explains some of the high prices people pay. But large-volume purchasers, such as managed-care companies, demand and receive big discounts from drug companies.

For example, a leading ulcer drug, Prilosec, is sold to consumers at a regular price of $112, but favored customers get it for $56 a bottle. Drug companies fear any federal intrusion into the pricing arena. And no group has stepped forward with a feasible political plan on how to pay for a government drug subsidy.

Congress is supposed to resolve such tough questions. Instead, Republicans try to make the Democrats look like big spenders out to crush free enterprise, and Democrats try to make Republicans look like heartless captives of the drug industry. Its a risky strategy for both parties.

Constituent anger over the deteriorating state of health care is sure to be a big issue in next years election campaigns. But will either party stop playing partisan politics long enough to find ways to fix the nations health care system?

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