Where I Stand — Mike O’Callaghan: Closer look at Medicare

Friday, Jan. 31, 2003 | 9:28 a.m.

PRESIDENT GEORGE W. BUSH, in his State of the Union address, gave Americans plenty to think about. I was especially pleased with social service ideas that included the children of parents serving time in our jails and prisons, people addicted to drugs and those suffering from AIDS.

His proposal of $450 million to train mentors for "more than a million disadvantaged junior high students and children of prisoners" also brings the problem back into every home that has a volunteer as a mentor. The need has been with us for years but little has been done to help the parent and children left behind.

Most senior citizens know about the aches and pains of Medicare and I'm sure that they paid close attention when the president talked about reform of health care. He told the nation:

"Seniors happy with the current Medicare system should be able to keep their coverage just the way it is. And just like you -- the members of Congress, and your staffs, and other federal employees -- all seniors should have the choice of a health care plan that provides prescription drugs.

"My budget will commit an additional $400 billion over the next decade to reform and strengthen Medicare. Leaders of both political parties have talked for years about strengthening Medicare. I urge the members of this new Congress to act this year."

Seniors using Medicare were left wondering just how the $400 billion will solve the high cost of drugs they are now paying. Like so many other attempts by states and the federal government to help meet these costs, the prime cause isn't solved. More money only encourages drug companies to raise their prices and the upward trend won't cease to halt. They also wonder what the trade-off will be for the drug payments.

Several writers have pointed to the most likely trade-off demanded. William M. Welch writing in the USA Today told readers: "Full details aren't expected for weeks. But leaders on all sides of the health-care debate said Bush's intention is to offer prescription-drug benefits to induce seniors to leave the traditional fee-for-service Medicare program and join a private plan. Those plans could cut costs to the government while limiting the choice of doctors and treatments.

"The proposal represents a risk for Bush and Republicans, who campaigned last year in favor of a prescription-drug benefit for seniors. Few told voters that they would have to join managed-care plans.

"Even without drug coverage, Medicare's costs have doubled in 10 years to $263 billion this year. Bush's budget would add $400 billion over the next 10 years.

"Health policy experts said the administration would herald its program as offering more choices to seniors. They could choose from an array of options: an HMO, a preferred provider plan that steers patients to a network of participating doctors, and possibly a more expensive fee-for service plan. Seniors could choose to remain in traditional Medicare. But only by choosing another option would they receive coverage for part of their prescription-drug costs."

Didn't we go through this dance just a few years ago? As I recall, several health care groups, such as HMOs, were tied into Medicare. In short order several of them cut benefits or dropped their Medicare patients. What bothers me, until I am told different, is this sounds just like one more scheme to push our health care needs back into the hands of profit-making businesses that care more about the bottom line than they care about patients.

In the meantime our nation's highest court is reviewing Maine's efforts to cut down on the cost of drugs. The drug companies are upset with the program known as Maine Rx. The state uses its buying power under Medicaid to win a reduction of drug prices for retirees and the working poor.

Americans must now watch closely to prevent its elected representatives from rubber-stamping the latest Bush Medicare proposal. It can be used as a framework if changed to cover all participants. Now is also the time for Congress to do something positive about the high cost of prescription drugs. Just adding to the budget only feeds the voracious appetites of the drug makers.