FOR IMMEDIATE RELEASE July 21, 2003

CONTACT: Brendan Daly/Jennifer Crider 202-225-0100

'Prescription for Disaster?'

The following op-ed by House Democratic Leader Nancy Pelosi ran today in the San Francisco Chronicle.

Prescription for Disaster?

Let's do the right thing on Medicare drug benefit

By Nancy Pelosi

If the faces of the health-care fight 10 years ago were the fictional characters Harry and Louise, the ones for the 2003 Medicare prescription drug debate may well be real seniors Anne and Lucille.

Anne Green, a retired adult educator and longtime San Francisco resident, is on Medicare. Since her stroke last year, Anne takes preventative stroke medications in addition to those for hypertension and high cholesterol. Her prescription drug costs are $2,400 a year. She has supplemental insurance to pick up some of the costs, but still has to pay $1,400 in out-of-pocket expenses. Anne worries about her health, along with her financial well-being.

Lucille Bryson of Washington has drug costs averaging about $3,600 a year. Also on Medicare, Lucille has heart disease, lung troubles and arthritis, but no prescription drug coverage. The price of her medication already takes more than one-third of her monthly Social Security check and seriously impacts her quality of life in our nation's capital.

Anne, Lucille and millions of seniors across the country need and deserve a defined, guaranteed prescription drug benefit under Medicare. Unfortunately, Congressional Republicans (at the urging of President Bush) rushed last month to pass a deeply flawed prescription drug benefit that would leave most of the 40 million seniors and people with disabilities in Medicare worse off than they are today.

There should be no mistake: Republicans "Medicare reform" plans will begin the unraveling of the Medicare program seniors know and trust. A recent study by the nonprofit Consumers Union underscores the meager benefits of the GOP plans. According to the report, beneficiaries with average drug costs and no private coverage will spend around $2,300 this year, about what Anne Green pays. By 2007, if either the House or the Senate bill takes effect, seniors will pay at least $2,500. In other words, the average Medicare beneficiaries would spend more, not less, on prescription drugs.

Both the House and Senate bills contain a "coverage gap" so wide that nearly half of the elderly would fall into it, leaving millions of seniors to bear 100 percent of whatever an HMO sees fit to charge for drugs -- even as they continue to pay premiums. After years of waiting for help with the skyrocketing cost of prescription drugs, America's seniors deserve better.

As House and Senate negotiators work out the differences between the two bills, House Democrats insist that a responsible prescription drug benefit, such as the plan we put forward, meet several critical standards:

-- First, any prescription drug benefit must be affordable. Premiums and deductibles should be reasonably priced and the plan must be designed to reduce significantly the high cost of drugs, and seniors should not be subjected to huge gaps in coverage. Backed by 40 million seniors, Medicare should have the collective bargaining clout to negotiate lower drug prices. The Republican plans, however, would explicitly prohibit the government from negotiating lower drug prices.

-- Second, it must offer a defined, guaranteed benefit under Medicare. Prescription drugs must be covered as other Medicare benefits are, with guaranteed coverage for drugs prescribed by doctors. The Republican schemes do not define any drug benefit. Instead, insurance companies and HMOs -- with their checkered past toward Medicare enrollees -- would decide which drugs to cover and how much to charge.

-- Third, a prescription drug benefit should be within the Medicare program that seniors have known and trusted for nearly four decades. After intense Democratic pressure, Republicans made a major concession by rejecting President Bush's radical proposal to force seniors out of Medicare and into HMOs to get any drug benefit at all. Yet under the House Republican plan, by 2010, seniors would simply be offered a voucher for all Medicare services, including doctor visits and hospital stays, for which private plans and the traditional fee-for-service Medicare program would compete.

-- Finally, the same drug benefit and premiums must be available to all seniors and disabled Americans in Medicare no matter where they live or what their incomes are. Under the Republican plans, seniors in rural areas would likely have to pay higher premiums for less coverage than seniors in well- served urban areas. Rural areas are typically underserved or not served at all by HMOs. In Kentucky, for example, HMOs have dropped 90 percent of Medicare enrollees.

Some argue that shortcomings in today's bills can be fixed tomorrow. But once a drug benefit -- any benefit -- is passed, Republicans will no doubt insist: "mission accomplished." Seniors will be left to live with the consequences for years to come.

There is still time for House and Senate negotiators to do this right and give America's seniors the help they expect and need. Anne Green, Lucille Bryson and millions like them deserve no less.

“ Democrats are united in presenting a New Direction for America, one that will make our nation as strong as its people, one that brings opportunity, security, and prosperity to all Americans. ”

Democratic Leader Nancy Pelosi