MEDICARE: Lack of Drug Coverage Hits Many Elderly
Today's Wall Street Journal takes a look at the lack of prescription drug coverage under Medicare, a "glaring hole in the safety net." According to the Congressional Budget Office, some 19 million elderly adults have "little or no drug coverage at all." At the same time, seniors "consume almost 35% of all prescription drugs," which now account for 34% of the average senior's yearly health care bill. And, "one in five elderly people takes at least five prescriptions a day." Approximately half of all seniors receive prescription drug coverage, either from former employers, HMOs or Medicaid. But the other half are increasingly struggling with the rising costs of drugs, and have resorted to "rack[ing] up big credit card debts, plead[ing] with their doctors for free samples and forgo[ing] basic necessities" or crossing the boarder into Mexico or Canada for drugs. Others go without medication or skip dosages, "often resulting in medical complications that can send them to the hospital." The Journal notes that this group is particularly hard hit because those who pay for drugs in cash don't receive the same discounts as HMOs and other large purchasers. Seniors' groups have been advocating for expanded coverage, but, the Journal reports such a move is unlikely to come from a budget-conscious Congress that has been heavily lobbied by the pharmaceutical industry to resist an expansion. The Journal notes that the drug industry fears that such an expansion might open the way for government price controls. Frank Larkin, president of Good Samaritan Hospital in Brockton, MA, said, "The system makes no bloody sense. Does it make sense that we give people costly surgeries but we can't give them prescriptions?" Steven Soumerai, chair of Harvard University's Drug Policy Research Institute, notes, "Drugs are the glue that holds the medical system together. We can't afford not to cover people with chronic illnesses, or [those] whose independence rests on access to medications" (Lagnado 1, 11/17).
The Time Is Now
In an accompanying article, the Journal assesses the chance that Medicare drug benefits will be one of the recommendations made by the National Bipartisan Commission on the Future of Medicare. While commission member Bruce Vladeck, former head of the Health Care Financing Administration, says the "push for coverage has 'gained momentum,'" he notes that it's "still a long shot." Others on the commission, like lawyer and drug industry lobbyist Deborah Steelman, say such a benefit would be a "dinosaur" that could cost up to $40 billion annually. However, the Journal notes that the drug industry's longstanding, monolithic opposition to Medicare drug benefits may be crumbling, as the aging of the baby boom generation swells "the potential market for prescription drugs" (Lagnado 2, 11/17).