Kennedy Angers Allies Supports GOP Drug Bill

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Kennedy Angers Allies Supports GOP Drug Bill

 

 

June 23, 2003

Senator Edward M. Kennedy (D-Mass.) is normally the scourge of Senate

Republicans. But this week, it's Democrats in the Senate and elsewhere who are

miffed at the Massachusetts liberal for throwing his support behind the

Republican plan to add prescription drug coverage to Medicare.

 

Both houses of Congress are poised to approve their versions of a Medicare drug

benefit this week. While the plans differ sharply, they have one thing in

common: both are mind-numbingly complex and will be difficult for seniors, their

physicians and insurance companies to interpret.

 

Democrats and their liberal and labor union supporters say the Republican plan

is inadequate and is the first phase of a GOP maneuver to turn Medicare over to

private insurance companies.

 

Kennedy begs to differ. As he sees it, the current bill is a $400 billion down

payment that can be improved and broadened as time goes by. Kennedy calls it " an

opening " and says it is the only chance to enact a prescription drug benefit in

this Congress.

 

Besides, said Kennedy in several weekend interviews, if Democrats block the

measure Republicans will paint the Democrats as obstructionists and will have a

stronger chance of winning more seats in the upcoming Congressional elections.

By supporting the measure, Kennedy says Democrats can tell voters that they

should send more Democrats to Congress to continue the fight for improved

Medicare coverage.

 

Sen. Barbara Boxer (D-Calif.) denounced the plan during Democrats' weekend radio

address. She said the measure would require too many senior to sign with private

insurance companies to get the drug benefit. She charged those companies " put

their dollar signs ahead of your vital signs. "

Complexity

The House and Senate versions are nothing if not complex. Sen. Hillary Rodham

Clinton (D-N.Y.), no stranger to complex, large-scale health care legislation,

says the measure will create " a Medicare maze, a whole new bureaucracy. "

 

For starters, seniors will face a number of decisions -- whether to stay with

traditional fee-for-service Medicare or join a private plan. If they decide to

join a private plan, they will have to choose among an array of companies and

types of plans, including health maintenance organizations (HMO), preferred

provider organizations (PPO) and hybrid plans.

 

Those who stay with traditional Medicare will have to buy " drug only " insurance,

something that doesn't now exist on a large scale. If fewer than two private

plans are offered in a given area, the government would provide a " fallback

plan, " under the Senate bill.

 

For the first time ever, different beneficiaries will pay different premiums and

have different levels of coverage. Currently, most Medicare beneficiaries pay

$58.70 a month and get virtually identical benefits. Under all of the measures

now pending in Congress, premiums and benefits will vary widely.

 

Each year, just like musical chairs, everything will change, as companies revise

their plans, drop some offerings or pull out of a region altogether.

 

There are still many competing provisions to be hammered out and each party has

its sacred cows. The Republicans have agreed that the government can pay for

prescription drugs but are determined that it must not control prices.

Democrats, on the other hand, want Medicare to use its huge purchasing power to

drive prices down.

 

The Republicans want to encourage PPOs to participate in Medicare, thinking they

will provide services more effectively. But most PPOs have not yet been able to

figure out whether they would be able to operate in the Medicare market because

of the complexity of the legislation and the huge uncertainties entailed in

serving a vast population of seniors, nearly all of whom have at least some

chronic health conditions.

 

Whatever is finally enacted will, be tinkered with by Congresses and by the new

federal bureaucracy that will be created to run it. Or as Drew Altman, president

of the Kaiser Family Foundation put it in a New York Times interview: " The

history of most great social legislation in our country ... is ready, fire,

aim. "

 

 

 

 

 

 

 

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