Editorial: Gore, Bush spar over drug plan

Monday, Sept. 11, 2000 | 9:33 a.m.

When George W. Bush unveiled his plan to offer prescription drug benefits for the elderly, the Republican presidential nominee at least had the political savvy to acknowledge the importance of Medicare, the popular government program that provides medical benefits for 39 million Americans. Bush's plan, however, falls short of that being offered by the Democratic standard-bearer, Vice President Al Gore.

Bush places his faith in the market, relying on insurance companies to provide this benefit. Unfortunately the problem is that many of these insurance companies that already offer supplemental Medicare coverage have been pulling out of some cities and states because they're having financial difficulties. What's to make us believe that adding a costly prescription drug benefit will make them rush back to the markets they abandoned? Both plans would allow people to voluntarily use private insurance plans, but Bush's proposal would prod more beneficiaries to use HMOs instead of the traditional fee-for-service program run by Medicare.

Both Bush and Gore would ensure that seniors who have incomes less than $11,300 a year would receive free drug coverage, but that's about where the similarity ends. Bush's plan would cost $198 billion over 10 years, while Gore's would total $253 billion over the same span. There's a reason for the difference: Gore's plan would do more. Under Gore's plan, no senior would have to pay more than $4,000 in out-of-pocket prescription costs, while Bush's plan has a higher ceiling of $6,000. Gore's proposal would cover half the costs of prescription drugs -- with no deductible having to be met. Because Bush's plan would give seniors the option of using subsidies to purchase a drug plan, each private plan would establish the level of coverage.

Too many seniors now have to pick between choosing food or cutting back on their medication because of the high cost of drugs, so a stable prescription drug benefit is long overdue. But Bush's reliance on insurance companies, and the uncertainty that creates, is unnerving. Instead of gambling that competition among private insurers will create a market for prescription coverage, the better approach is that taken by Gore, which would simply incorporate a drug benefit into existing Medicare coverage.