Shopping smarter

February 10, 2005

UP AND UP and up it goes, where it stops nobody knows. Yep, that's the cost of Medicare's new prescription drug benefit we're speaking of. And it's not like the benefit itself is going to be any more generous.

Ten-year cost estimates for the benefit program scheduled to begin next year are now more than double what they were in 2003 when President Bush had to rough up some tight-fisted Republican House members to get the legislation passed.

The administration's explanation that some of that $1.2 trillion will come back to the government in the form of premiums from elderly Medicare beneficiaries is not at all consoling.

Here's our suggestion, Mr. President: Get a better deal from the drug companies. Using the purchasing power of 41 million customers, Medicare could strike a heck of bargain. State and local governments are already moving in this direction, as have other nations, notably Canada. Soon, only the U.S. government and people with no insurance will be paying retail. How dumb is that?

In the past, the obstacle to smarter shopping by Uncle Sam has been Republicans who get all hinky about price-fixing. But the pharmaceutical market is already distorted by patent protections and research grants. Americans are now subsidizing drug costs for the whole rest of the world - paying as much as three times more than they should be. The highly profitable pharmaceutical industry should not continue to be allowed to charge whatever price it wants to the federal government.

Coping with medical costs is perhaps the greatest challenge facing the nation today - bigger than terrorism, bigger than Social Security - because everybody needs care at some point, and usually more as they age. Technology as well as pharmaceutical breakthroughs improve the quality of care even while driving up the costs.

Both Medicare and Medicaid, which combines federal and state funds to provide health care for the poor, are wildly over budget. There aren't many easy answers to bringing these budgets under control. But one of them surely is that the drug industry's very best customer ought to be getting its very best price.

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