Editorial: Gridlock over drugs a bitter pill

Saturday, Sept. 2, 2000 | 3:40 a.m.

Nevada, in many respects, is ground zero in this year's debate over the best way to provide prescription drug benefits for the nation's 39 million Medicare beneficiaries. Gov. Kenny Guinn's program, which would use insurance companies to offer a limited drug benefit for Nevada's seniors, has hit snags. The GOP governor's plan is similar to one advanced by Republicans in Congress, so the difficulties that Nevada is experiencing have become grist for debate not only in the nation's Capitol, but also have become fodder on the presidential campaign trail.

Earlier this year Nevada asked more than 800 insurance companies to consider bidding on its program. But only one company did -- and even that firm wasn't licensed by the state. So state officials took another run at it, asking insurance companies to reconsider. Last week Nevada state health officials announced that five insurance companies have submitted bids this time. While this is an improvement, even if the companies are able to provide a plan that offers a $40 a month benefit, it still falls short. This modest amount is dwarfed by the actual costs -- sometimes thousands of dollars a year -- that many seniors face. For that matter, not all Nevada seniors are eligible. Only those who are older than 62 and have an annual income under $21,000 would be eligible.

It shouldn't be too surprising that a market-based approach to offering prescription drug coverage would encounter problems -- the federal government itself has experienced difficulties in this area, too. Many insurance companies that once provided Medicare coverage, which include prescription drug benefits, are leaving some cities where they say they've taken huge losses. These insurers often blame it on a low reimbursement rate by the federal government. But even if the government was reimbursing them sufficiently, the insurers still can run into financial difficulties on their own that have nothing to do with government funding. Seniors shouldn't have to worry, then, that their prescription drug benefits rest upon the financial health of the insurance companies offering them the coverage.

Democratic presidential nominee Al Gore already has released his detailed proposal. Gore's common-sense plan would guarantee that Medicare beneficiaries would have access to prescription drug coverage, whether they're in the traditional Medicare program or are enrolled with insurance companies that offer Medicare coverage. Gore's plan would not charge a deductible. The proposal would cover half the costs of drugs up to $5,000 and ensure catastrophic protections after beneficiaries had paid $4,000 in out-of-pocket expenses.

Meanwhile Gov. George W. Bush only has offered vague ideas as to what he would do if elected president. Finally, after a week of Gore challenging Bush to offer his prescription drug benefit plan, Bush said he will release details this week. It's amazing that he has been able to get away so long without providing specifics. The prescription drug problem has been well-documented for years, and a Medicare coverage plan has been derailed by GOP leaders in Congress, who have been lobbied hard by the drug industry.

The bottom line is that too many seniors have been faced with a terrible choice that no one should be dealt: Either they must forgo necessities such as food to save up enough money to pay for their prescription drugs or they have to go without a full dosage of their prescription, creating a life-threatening prospect. It's time for the federal government to acknowledge, by creating a prescription drug benefit for seniors, that drugs have become an indispensable way to treat illnesses.