Editorial: Drug law isn’t right prescription

Wednesday, Dec. 10, 2003 | 8:39 a.m.

This week an ebullient President Bush, surrounded by elderly Americans, signed into law a bill that will provide a prescription drug benefit for the nation's 39 million Medicare recipients. "With this law, we're giving older Americans better choices and more control over their health care, so they can receive the modern medical care they deserve," Bush said of the benefit, which conservative estimates say will cost $400 billion over 10 years. The president is right that Medicare finally will offer assistance for seniors to defray the costs of drugs, but the reality is that it's a much more limited program than the president acknowledges. Granted, the program will cover 95 percent of a patient's drug costs -- but only after the senior has incurred $3,600 in out-of-pocket expenses. That gap in benefits is large and still will force many seniors to choose bet ween food and medication.

The out-of-pocket expenses also brings up another issue, which is that as time goes by and the fine print in the legislation is read, there will be unpleasant surprises ahead. As The New York Times disclosed in a story Sunday, seniors won't be allowed to buy supplemental insurance plans, known as Medigap policies, to cover those portions of the drug benefit not covered by Medicare. One of the reasons congressional Republican leaders banned Medigap policies is because they want seniors to have to bear some of the cost of their drugs. Some economists say if people don't have to assume part of the financial burden for health care, then they will opt for procedures or medications without regard for the cost. But in the case of prescription drugs, millions of seniors already have suffered long enough without coverage. Why penalize them even more?

It also is telling what the president didn't say at the bill-signing ceremony. He didn't mention that insurance companies will reap a windfall from the federal government which, instead of administering the prescription benefit itself, will pay insurers to do so. Bush also didn't note that the law bans the federal government from using its purchasing power to get much lower prices on drugs from pharmaceutical companies.

The White House and Republican congressional leaders believe they have captured from the Democrats one of their signature issues -- health care. And, conveniently for Republicans, the law doesn't kick in fully until 2006 -- well after the 2004 presidential and congressional elections. But once more Americans understand the bill's limitations, Republicans may rue how they embraced this flawed prescription drug benefit.