Wednesday, July 7, 1999 | 9:49 a.m.
Grasping a microphone, Health and Human Services Secretary Donna Shalala walked among a crowd of about 250 senior citizens at the Howard Cannon Senior Center Tuesday, fielding questions about Medicare and touting President Clinton's plan to pump billions of dollars into the federal program.
Shalala said the president has a three-pronged approach to revamping Medicare. First, she said, he wants to extend the solvency of the Medicare trust by transferring money into it from a projected government surplus. Last week, Clinton said he intended to divert $794 billion into the federal program.
"If young people today had to write a check to cover your medical expenses, they couldn't do it," Shalala said in defense of Medicare. "The surplus will be there because we will set it aside. We are being conservative in our estimates (of the surplus)."
Some critics of Clinton's proposal, such as former Rep. Timothy Penny, D-Minn., think the projected surplus could change if unemployment or interest rates go up.
Shalala said that won't happen because the administration and its economic team have a good track record and wouldn't pour money into a program if they don't have it.
Secondly, Shalala said the federal government is overpaying in Medicare fee-for-service billings. She said the program needs to be more competitive in obtaining price quotes from the medical community.
The secretary received the biggest round of applause when she touted Clinton's third proposal to include prescription drugs in Medicare. She explained that for $24 a month the government would pay half the price of a senior citizen's prescriptions up to $1,000 a year. That payment would rise to $44 a month by 2008 with a maximum government payment of $5,000. Currently, prescription drugs aren't covered under Medicare.
"If Lyndon Johnson was here, he would say we couldn't design a Medicare program without prescription drug coverage," Shalala said of the president who was the primary force behind Medicare in 1964.
As an added feature of Clinton's proposed "modern benefit program," Shalala said Clinton planned to eliminate co-payments or fees for preventative medicine procedures such as prostate screening and mammograms. The services would be free, she said, under the new Medicare program.
Rep. Shelley Berkley, D-Nev., also spoke at Tuesday's event. She cited a recent survey conducted of 20 congressional districts around the nation. Nevada came out on top for uninsured senior citizens who pay for prescription drugs out of their own pockets. The study showed, she said, that uninsured seniors pay 126 percent more than the best price health maintenance organizations pay for prescription drugs.
The state Division for Aging Services said Nevada had 238,055 people 65 and older as of July 1. This represents 12 percent of the state's population, the state demographer reported.
The Division of Aging Services concluded that 190,444 Medicare beneficiaries are in need of some form of prescription medications.
"We discussed a lot of stuff that doesn't matter much to a lot of people in this country," Berkley said of her short time in Congress. "This Medicare stuff matters."
Sen. Harry Reid, D-Nev., said the average senior citizen fills 18 prescriptions a year. He said because seniors live on a fixed income, they should not have to choose between paying their rent or buying prescription medicines. He said the president's proposal would protect seniors who can't afford the high price of prescription drugs.
Sen. Richard Bryan, D-Nev., pointed out that debate will resume in the Senate Finance Committee on July 22 over the Patient's Bill of Rights. Like Nevada's Assembly Bill 156, Medicare beneficiaries and federal employees would be protected in disputes with HMOs if the bill is passed.
"Only foreign diplomats and HMOs can't be sued today," Reid said. "We should change that -- don't you think?"
During a question-and-answer session, Ken Mahal, president of the Nevada Seniors Coalition, asked Shalala why the federal government didn't set up five or more programs where seniors could buy into them for a monthly premium.
She said having the federal government manage any more than one program would cause confusion.
"The more options you give government, they more they screw it up," she said.
William Petrak, first vice president of the National Council of Senior Citizens, thought Shalala was well informed about seniors' problems. He agreed that prescription drugs should be included in Medicare. He said something needed to be done to revamp the federal program.
"I think it's a fight between the HMOs and the almighty dollar," Petrak said. "HMOs are not thinking about the people. It's all about their budgets."
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