Providing prescription drug benefits in Medicare

By Staff
Chip Pickering / U.S. Representative
June 22, 2003
Our nation has a moral responsibility to fulfill our Medicare promise. Many well meaning people on all sides of the health care debate have important points to make; and we can agree that promises made should be promises kept.
Our mandate must be to preserve Medicare to fulfill that promise and do so in a manner that meets the needs of seniors and disabled people while providing the highest quality service for the best price.
President George Bush has asked Congress to prepare legislation that preserves and modernizes Medicare. Last week my colleagues and I moved a measure out of the Energy and Commerce Committee that will fulfill that request.
The legislation moves soon to a vote by the full House will guarantee all senior citizens an affordable prescription drug benefit under Medicare, protect senior citizens right to choose a benefits package that's best for them and strengthen Medicare for all senior citizens and future generations.
Currently eight out of 10 American retirees use a prescription every day. Those without prescription drug coverage pay an average of 34 percent of their after-tax income on health care. Between 1998 and 2000 the average retail prescription price increased more than three times the rate of general inflation.
American seniors require 21st century medicine but are stuck in a 20th century Medicare system. If we want to make prescription medication affordable to our seniors, we must improve the system.
Improvements
President Bush's and our congressional budget provides for $400 billion over 10 years to modernize and improve Medicare and to add a prescription drug benefit. The plan will make sure that low-income seniors receive additional financial assistance so they will not have to pay more to receive better benefits than they currently do under Medicare.
The prescription drug benefit for seniors should be affordable to both the taxpayers paying the bills and the seniors paying the premiums. The long-term answer to the cost of prescription drugs for low income seniors can not be solved by simply increasing the budget. We must introduce the innovations in delivery and service from the market sector into the Medicare system.
New drugs commonly substitute for more expensive treatments such as surgery and hospitalization. Treating stroke patients with new clot-busting drugs has saved $4,400 per patient by cutting hospitalization and rehabilitation costs, according to a study sponsored by the National Institutes of Health.
Humana Hospitals found that while new drugs for congestive heart failure increased pharmacy costs 60 percent, they cut hospital costs 78 percent, saving $9,000 per patient. Not incidentally, the same drugs also cut mortality rates from 25 percent to 10 percent.
This measure modernizes the 40 year old program by adding a voluntary prescription drug benefit to all Medicare beneficiaries. It also brings Medicare reimbursement stability to health care providers and provides the largest rural health package ever contemplated by the House of Representatives.
Amendment
During the debate and discussion in the committee last week, I offered an amendment to provide immediate Medicare Part B coverage for self-injectable biologics that are prescribed as replacements for physician-administered drugs already covered by Medicare. The amendment would provide the option to seniors with chronic diseases, such as rheumatoid arthritis and multiple sclerosis, to seek equally effective and less expensive home based treatments. The Medicare program would also save expenses from hospital facilities, doctor payments and other medications.
This particular Medicare solution has been championed in Mississippi by former First Lady Pat Fordice.
Medicare reform also includes the largest rural health package ever contemplated by the House and strengthens the role of the local pharmacist as they counsel seniors in the proper way to take their medications.
Increasing the efficient delivery and accessibility of modern prescription drugs will expand the medication market, driving down the retail costs of the medicine, making health care move affordable to seniors, increasing the return for drug producers, spurring additional medical research which replaces more costly and less effective treatments and surgeries of the past.
A reasonable and well applied prescription drug plan will ensure seniors have good affordable medicine while maintaining the competitive free market medical system that has made the American arrangement work while the rest of the world fumbles.
Modernization and the prescription drug benefit are not just the right things to do for Medicare, they make common sense.
America has the best quality health care system in the world. By expanding the medical market, offering choice, and providing fair benefits at affordable prices, our system will be even more successful and our seniors will get the medication they need.