That lovin' feeling

February 24, 2005

THE NEWS JUST keeps getting worse for those House Republicans who, against their better instincts, voted to add prescription coverage to Medicare. First they learn the new benefit will cost almost twice the original price. Now it turns out some of those bucks will pay for recreational drugs as well.

That's right: Viagra, and its competitors.

Impotence treatment apparently won't be limited to the diseased or surgically incapacitated. Folks hooked by advertisements promising to rekindle cooled passions can buy little blue pills with their Medicare cards as well.

In the scheme of things, the "lifestyle drug" issue is incidental. Had the Medicare drug benefit been well-designed, competitive pricing and negotiated discounts could cut the cost of those little blue pills in half. A case could be made that money spent there might be saved on antidepressants. Maybe those seeking help to fulfill romantic ambitions could be charged a higher co-pay than patients in need of life-saving potions.

But the budding erectile controversy in Congress simply puts a sexy angle on the far more complicated question of how the government should ration medical care. The laissez-faire approach simply isn't working.

America spends more for health care than any other industrialized nation, yet ranks 37th out of 191 countries in value for the dollar, according to the World Health Organization. Experts blame the inefficiency of a hybrid public/private financing system that distributes resources unevenly and lets many fall through the cracks.

The new Medicare benefit is a case in point. Lawmakers complaining now about Viagra coverage bought a pig in a poke. They enacted a program that demands insurers who get Medicare subsidies cover "drugs in all therapeutic categories and classes," yet forbids Medicare from negotiating with pharmaceutical companies for discounts. Now they wonder why it costs so much.

There's little appetite in Congress this year for reorganizing the entire health care financing structure; President Bush wants to tackle Social Security instead.

But with perhaps a few more embarrassing revelations, lawmakers will reopen the Medicare drug law for much-needed rewrites. President Bush has threatened to veto any changes before the new benefit goes into effect next year, but applying more fiscal discipline to the program won't get easier as time goes on.

The temptation posed by those little blue pills will make it pretty tough to just say no.

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.