01 July 2004

Prescription drug lottery makes losers of us all

Last week the Bush administration announced it had established a lottery to decide which 10 percent of chronically ill patients would get their expensive prescription drugs paid for. For 50,000 winners, whose prescriptions cost thousands of dollars per year, this was good news. But 450,000 other seniors who need help just as badly will have to wait two years for help.

This is the most literal and unseemly example of how the administration has created a health-care system of winners and losers. While some do very well by the new rules ó mostly the HMOs and big drug companies ó most Americans are worse off.

The drug coverage lottery was created by the Medicare prescription drug bill. That bill was narrowly enacted last year despite the warnings of many in Congress who felt the new law would create a windfall for HMOs at beneficiaries' expense.

Last week, Wall Street analysts confirmed those concerns, concluding that the HMOs will gain the most from the new legislation. One expert gushed, "The profit opportunity in Medicare Advantage, the HMO program, is extraordinary."

They confirmed that the legislation is designed to force seniors into HMOs. And they predicted that seniors who choose to stay in traditional Medicare and purchase a stand-alone drug plan could see their premiums skyrocket.

The Medicare bill's discount drug card promised to lower drug costs, but has been a failure for most seniors. Since the cards were made available on May 1, only 500,000 of the 15.5 million eligible beneficiaries ó about 3 percent ó have chosen to enroll. The cards are hopelessly confusing and offer little real savings. In fact, the discounts offered to seniors are less than either the cost of drugs from Canada or the cost of those same drugs here three years ago, before the drug companies raised prices on the 30 most popular drugs by 22 percent.

We're not doing right by America's seniors when we force them to pay more, while profits for HMOs and drug companies skyrocket.

But seniors aren't the only ones being squeezed by our broken health care system. The Supreme Court ruled last week that no American has the right to force his or her HMO to cover a medical treatment, even when a doctor says it is necessary. This means that HMOs ó not doctors and patients ó get the final word when making health-care decisions.

But we don't have to allow seniors to be forced into HMOs. We don't have to keep paying the highest prescription drug costs in the world. We don't have to lose our right to hold HMOs accountable. And we don't have to have a health-care system of winners and
losers.

It's time we started doing right by America.

The Medicare drug bill has so far been a failure. We need to go back to the drawing board and design a bill that will provide affordable prescriptions to all seniors, including those who don't want to join an HMO or don't have that option.

Second, to lower drug costs, we can pass bipartisan legislation supported by Republicans John McCain and Olympia Snowe and Democrats Byron Dorgan and myself that allows for the safe importation of lower-cost drugs from Canada and other countries.

Finally, we must pass a Patients' Bill of Rights that guarantees patients can hold their HMOs accountable for denying necessary medical care.

Americans are proud that we have the best doctors, hospitals and medical researchers in the world. But the delivery, access to and cost of health care have been slanted in favor of the HMOs and big drug companies at the expense of regular Americans.

Last week's prescription drug lottery was a troubling metaphor for the new rules for health care in this country. It's time to take a new direction before it's too late.

Daschle, of South Dakota, is Democratic leader in the U.S. Senate.

By U.S. SEN. TOM DASCHLE

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