Medicare prescription plan is flawed

By Patrick Naeger

As I listened to the recent debate regarding the Medicare prescription drug proposal, I became enraged by the rhetoric proclaiming that it is the greatest thing for Medicare since Medicare itself.

While the prescription proposal is the biggest entitlement expansion in 40 years, it's anything but good.

This expansion is a 700-plus-page bill. Lawmakers had only four days to look at the bill, let alone understand it or investigate it. In fact, I am insulted that something this important and this costly was crafted so quickly, debated so little and shoved down the throats of the American people so that certain politicians could say they kept a promise, regardless of how bad the bill is or who is hurt as a result of it.

There is no one on this planet who believes more than I do that our senior citizens need relief from the high cost of prescription drugs. But at what price? Should they have the whole Medicare program put in jeopardy? Should their right to choose a doctor or hospital be sacrificed? Should the availability of home-care services be sacrificed? For what? So the taxpayer can hand over to the big insurance companies and drug makers the biggest subsidy of modern time? I don't think so.

Frankly, I am surprised that the AARP would settle for a plan that is far from perfect. Its members deserve better. While there is great anxiety to get something done, Congress should not have been in such a hurry to pass a bill that could undermine the Medicare program.

During the debate, Sen. John Kyle said, "We could do better ... but we don't have time." What did he mean? Oh, that's right. Our representatives and senators have to get home for the Thanksgiving break. I say they had plenty of time. Most of the provisions of this bill don't even begin until 2006.

Being a former state legislator who spent a lot of time advocating for our senior citizens and co-sponsoring and co-authoring the Missouri SenioRX legislation in 2001, I have paid close attention to the Medicare debate. I have never felt more passionate about an issue in my life. To hand a program like Medicare over to the big insurance companies and drug manufacturers will not only not provide much a benefit for most senior citizens, but it will undermine the whole Medicare program.

I continue to hear how this bill gives people a choice -- the choice of the traditional Medicare program, a health-maintenance organization, a preferred provider network or managed care plans subsidized by taxpayers. Senior citizens I talk to don't care about how many choices they have. In fact, they are more concerned about the possibility of too many confusing choices and not having the traditional Medicare choice.

Senior citizens want a strong, comprehensive plan. Most importantly, they want to be able to choose their health-care provider. This bill will not accomplish this. As a matter of fact, there is no guarantee these senior citizens will have any choice of doctor or any other health-care provider.

Is there anything in this bill that provides an incentive for quality care? No. Does the insurance company executive get paid to provide quality care? No. The insurance executive gets paid based on profitability. So there is a direct incentive to ration health care and cherry pick the healthiest senior citizens for their plans, thereby compromising the traditional Medicare program and leaving it with the sickest and costliest senior citizens to care for, undermining Medicare's viability.

Yes, the politicians want to keep their promises. All we heard in the last election was that our senior citizens deserve affordable prescription drugs and how we need to strengthen and modernize Medicare. However, there is absolutely nothing in this bill that will bring down the cost of prescription drugs. In fact, the bill has a provision that prohibits the federal government from negotiating the best price with a drug manufacturer or insurance company.

Forbidding the U.S. government from using its awesome buying power to bring down the cost of prescription drugs is unconscionable.

Under the bill, only senior citizens who spend more than $5,000 a year on prescription drugs will see any real benefit and some lower-income senior citizens could even see increases in drug costs as a result of the plan's design. In addition, there is no guarantee that senior citizens won't be forced to order their prescriptions by mail or choose their own pharmacy. There is guaranteed their pharmacy will even be allowed to participate in the plan. Is that choice?

Not only is this new proposal the possible ruination of Medicare as we know it, it also is bad for consumers. Even the Consumers Union (www.consumersunion.com) says this legislation is bad for seniors and will likely threaten Medicare's viability. Our senior citizens need prescription-drug relief, not mass confusion.

Handing Medicare over to insurance companies and pharmaceutical manufacturers is not the answer. The answer is the federal government using its buying power to bring down the cost of prescription drugs. Our senior citizens deserve a strong, viable Medicare program, not one that subsidizes the fat-cat insurance companies and pharmaceutical manufacturers.

In short, this Medicare prescription-drug program is nothing but a sloppy $400 billion kiss to the big insurance company and pharmaceutical manufacturers. It is a slap in the face not only to senior citizens, but to all Americans. Guess who's going to pay for it?

Patrick Naeger of Perryville, Mo., is a former state representative. He also is vice president of Healthcare Pharmacy and Healthcare Equipment and Supply Co. in Perryville.