Bush’s Medicare Reform Plan ‘Skips’ Harder Questions, Washington Post Writes
Although President Bush's "new 'principles' for strengthening Medicare are a little more specific than the fuzzy generalities that got him through last year's campaign," a Washington Post editorial says that Bush "continues to skip past the harder questions, the answers to which would require him to say that sooner or later some people are bound to pay more or benefit less." While Bush maintains that Medicare needs to be "financially secure," the editorial says that "like the Democrats, he does not say how he would achieve the necessary soundness." The editorial says that "to avert a major benefit cut as the baby boomers retire, Medicare will require a significant tax increase," something Bush "will not say." While Democrats continue to push for a Medicare prescription drug benefit, the editorial notes that Bush and the Republicans say "they, too, are in favor, but only in conjunction with broader programmatic reform -- modernization, the president calls it." The editorial notes that Bush "envisions a program" that relies on private competition, which, Bush maintains, will "produce a more efficient use of the health care dollar then does government regulation." However, the editorial says that such a system "entails great risk unless accompanied by a heavy dose of precisely the regulation that it mainly seeks to avoid." Although Democrats, and some Republicans, are "pushing for a drug benefit in a hurry," the editorial says that there is "no way Congress is going to work its way through [Medicare reform] in a hurry, nor should it." The editorial says that Bush's recent proposal to give Medicare beneficiaries cards allowing them to access drug discounts negotiated by pharmacy benefit managers, while it might "do a little good," is designed to "buy time." The editorial concludes: "At bottom, the president's position is to oppose a drug benefit until Medicare is made to look a lot more like private insurance. But that's a hard one to take into next year's election. On Medicare, the White House at this stage is playing a lot more defense than it sounds" (Washington Post, 7/17).
A New York Times editorial says that Bush's proposal to allow Medicare beneficiaries to join "for-profit discount clubs that will negotiate with drug companies and pharmacies for low rates" is the "most minimal way to follow through on his campaign promise of immediate relief for the elderly," and it "makes Congress's task -- instituting a permanent benefit -- all the more urgent." The proposal's "obvious weakness" is that it allows pharmaceutical companies to "set their own prices for wholesale medications," according to the Times, but the editorial also says that the problem "could be avoided if the federal government required discount clubs to bargain with drug companies and pharmacists to set prices prospectively" -- a "crucial element" lacking in Bush's plan. In addition, the plan "does not require the federal government to help people pay for prescription drugs," and the editorial says that the "supposed savings" will likely come from "pharmacists' razor-thin share" of profits The editorial says that "Bush could have avoided these complications by truly committing himself to the principle of volume discounts and setting up a federal discount club for all Medicare enrollees." The editorial maintains that such a club "could reap the deepest discounts by dealing directly with wholesalers." The editorial says that the smaller discount clubs proposed by Bush "might help some Medicare enrollees save small amounts on drugs in the near future because it typically takes some time for drug companies or pharmacies to change prices." But the editorial argues that in the long run, "the real payoff will come only if Congress can assemble a prescription drug plan that provides a permanent, equitably determined benefit while controlling costs." The editorial concludes: "Overall Medicare reform may have to wait for years. But because the president's discount club plan does so little now, Congress should get to work on a prescription drug benefit without delay" (New York Times, 7/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.