Despite abundant evidence of its success, Democrats are still on the warpath against President Bush?s 2004 Medicare prescription-drug plan ? and they threaten to undermine future success if they take control of Congress.
At an Oct. 4 campaign event in Sunrise, Fla., House Minority Leader Nancy Pelosi, D-Calif., declared, “This is a bill borne of corruption at the expense of America?s seniors, and we can do something about it.”
She promised that one of the top priorities of a Democratic Congress would be to authorize the federal government to directly negotiate with drug companies to lower their prices instead of relying onprivate insurance companies.
The savings, she said, would be used to close the “doughnut hole,” the gap between the first $2,250 in a beneficiary?s annual drug expenditures, of which the government pays 75 percent of the cost, and $5,100, above which it pays 100 percent.
To save money, Congress required seniors to cover the $2,850 hole themselves, either by buying insurance or paying out of their own pockets ? which Democrats denounced at the time, even as they assailed the administration for underestimating the total cost of program.
According to Mark McClellan, who is leaving this week as head of the Centers for Medicare and Medicaid Services, competition among private insurance companies and their negotiations with drug companies have lowered the estimated 10-year cost of the program by nearly 20 percent, to $516 billion, and may reduce it by another 10 percent next year.
That was just one of the successes he cited at a reporters? breakfast sponsored by the Christian Science Monitor, as well as in a subsequent interview. Others include the fact that the average prescription drug-insurance premium paid by seniors is $27 per month, not $34, as originally estimated.
And polls show consistently that 75 percent to 85 percent of participants in the program are happy with it. J.D. Power and Associates recently gave the program, known as Medicare Part D, a 75 percent approval rating. A forthcoming AARP study shows that only 11 percent of seniors disapprove.
Democrats predicted that few private insurance plans would participate in the program. Then, when dozens of companies offered competing plans, they charged that the program was “chaotic” and that seniors were so confused that few would sign up.
In fact, 16 million seniors who previously lacked drug coverage did sign up. According to the CMS, 90 percent of all the nation?s 43 million Medicare beneficiaries now have coverage.Their average savings for drug purchases is $1,200 a year. About 9 million low-income seniors pay nothing for their drugs.
McClellan pointed out that the original Democratic plan for eliminating the doughnut hole would have cost $1 trillion. As the program has developed, according to America?s Health Insurance Plans, the health insurance lobby, 15 percent to 25 percent of seniors have been able to find plans that cover all their drug outlays, thus closing the hole.
If Democrats do take over either the House or Senate, or both, they should strive to improve the Medicare reform record set by McClellan and the Bush administration ? not undermine it with top-heavy government regulation.
Congress should see to it that the reform agenda advances and that doctors, health plans, drug companies and hospitals have incentives to compete on the basis of their ability to keep people healthy ? not just treat sick people at government-set prices. If they do take control, Democrats need to reform not only health care but their own thinking.
Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill.
