Daschle Becoming ‘Concerned’ About Fate of House and Senate Medicare Bills
Senate Minority Leader Tom Daschle (D-S.D.) yesterday said he is "becoming increasingly concerned" about whether negotiators working to reconcile the House and Senate Medicare bills (HR 1 and S 1) will be able to reach a compromise, the New Orleans Times-Picayune reports. He suggested that lawmakers approve a "more modest approach" than called for in the bills, such as a drug discount card or allowing U.S.-made drugs to be reimported from Canada, saying, "We don't have to finish it all before the end of the session" (Walsh, New Orleans Times-Picayune, 9/17). "It would please me greatly if we agreed to pass reimportation this year and continued to work on the other issues until we've resolved them," he said (Rovner, CongressDaily/AM, 9/17). However, Sen. John Breaux (D-La.), a member of the Medicare conference committee, said he disagreed with such a "piecemeal approach," according to the Times-Picayune. He added, "It's far too early to throw in the towel to say we should just do a discount card or something like that. I think it would be a huge failure." Rep. Bill Thomas (R-Calif.), co-chair of the conference committee, said last week that conferees are not yet considering abandoning negotiations. "Plan A is very much alive," he said (New Orleans Times-Picayune, 9/17). House Majority Leader Tom DeLay (R-Texas) said, "It's more important to get the package right than to get the package right now" (CongressDaily/AM, 9/17). Negotiators are scheduled to meet today, the Times-Picayune reports (New Orleans Times-Picayune, 9/17).
A "small but crucial" group of 15 House Republicans is expected to hold a news conference today to outline several provisions a final Medicare bill must include to gain their support, the Los Angeles Times reports (Kemper, Los Angeles Times, 9/17). According to a draft of a letter sent last week to House Speaker Dennis Hastert (R-Ill.), the group, led by Reps. Trent Franks (R-Ariz.), Sue Myrick (R-N.C.), Joseph Pitts (R-Pa.) and Patrick Toomey (R-Pa.), a final Medicare bill cannot include price controls on prescription drugs; must include a provision that would require traditional fee-for-service Medicare to compete with private health insurers beginning in 2010; must include a "generous expansion of health savings accounts"; and must include provisions to ensure that the cost of the bill would not exceed $400 billion over 10 years. "If the final bill does not meet each of these criteria, we believe that it would be contrary to the interests of current and future generations of taxpayers to vote for the bill," the letter says (California Healthline, 9/11). The Times reports that although there have been other "vote-withholding threats" by other lawmakers, the demands of the 15 House GOP members "highlights deep divisions" within the Republican party regarding Medicare and "adds new uncertainty" to the fate of a final Medicare bill. Toomey said, "There is a growing concern that we can't do this [legislation]. A strong case can be made for going back to the drawing board on this" (Los Angeles Times, 9/17).
The New York Times is incorrect to imply that "Medicare gives away health care 'for free,'" Uwe Reinhardt, a professor of political economy at Princeton University, writes in a letter to the editor in response to a Sept. 13 Times article that examined Medicare usage in Florida (Reinhardt, New York Times, 9/17). According to the Times, Boca Raton, Fla., has become a "case study" of what happens when people "are given free rein to have all the medical care they could imagine." In Boca Raton doctor appointments have become a "social activity" for beneficiaries, many of whom have between eight and 12 specialists and visit "one or more of them most days of the week," and "every visit, every procedure is covered by Medicare," the Times reported (California Healthline, 9/15). In the letter, Reinhardt says that Medicare requires more out-of-pocket contributions from beneficiaries than does the typical employer-sponsored health insurance plan. He writes that Medicare covers 80% of the cost of doctor and outpatient hospital visits and requires beneficiaries to pay an $840 deductible for each hospital stay. Medicare generally covers about 52% of the average total health spending of its beneficiaries, according to Reinhardt. He notes that if seniors in Boca Raton are getting their care "for free" it is because they have additional coverage through their former employers or through a Medigap plan (New York Times, 9/17).
KQED's "Forum" today in the first hour of the program included a discussion of how Medicare reform will affect how consumers purchase prescription drugs. Guests on the program included Robert Goldberg, senior research fellow of the Center for Medical Progress at the Manhattan Institute and Bruce Livingston, executive director of the Senior Action Network (Nelson, "Forum, KQED, 9/17). The full segment will be available online in RealPlayer after the broadcast.
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