June 12th, 2003

By Eric Krol

Daily Herald

President Bush sought to break through years of political gridlock on providing better prescription drug coverage for seniors during a Chicago speech Wednesday, with Democratic critics saying the Republican plan falls short but acknowledging its momentum.

"We have an unprecedented opportunity to give America's seniors an up-to-date Medicare system that includes more choices and better benefits like prescription drug coverage," Bush told the Illinois State Medical Society in an ornate ballroom at the Chicago Hilton. "I'm here to urge Congress not to miss the opportunity."

If Congress can reach consensus, the addition of prescription drug coverage and the option to join lower-cost, managed-care insurance plans would be the biggest changes to Medicare since the nation's health-care plan for seniors was begun nearly four decades ago.

The changes also would require seniors to navigate a new maze of health and drug insurance options to determine whether the Republican plan working its way through the U.S. Senate is right for them.

When help kicks in

The plan would require seniors to pay for $275 worth of drugs before insurance kicked in. The government then would pay for half of drug costs up to $3,450, but put the entire burden on seniors until their prescription tab reached $5,300. At that point, the government would pay 90 percent of any other drug costs. Seniors making $19,766 or less as a couple would get more aid.

Bush illustrated the problem of no Medicare drug coverage this way: the government won't pay the $500 a year required for ulcer medicine, but will pay the $28,000 for an extended hospital stay to treat an ulcer.

The president also wants the carrot of the government picking up a greater share of prescription costs if seniors join managed-care plans like PPOs and HMOs. But that incentive isn't in the Senate plan.

The Senate plan also does not include a House provision to charge wealthier seniors more.

U.S. Rep. Jan Schakowsky, an Evanston Democrat who represents Des Plaines, argues the Republican plan has a huge flaw: It doesn't require the drug companies to negotiate lower prices with the federal government, meaning seniors still will be paying inflated prices.

Schakowsky also said the GOP version doesn't cover enough of the cost of prescription drugs, a statement echoed by Gay Lee Andrews. The 74-year-old Elk Grove Village woman and her husband, Ray, pay more than $10,000 a year for prescription drugs.

The seniors retired, only to each return to two jobs after three HMOs they were in went belly-up and drug costs mounted. Andrews said she and her husband would have to continue to work because the Republican plan leaves a 100 percent gap for prescriptions between $3,450 and $5,300.

"I never thought I'd see the day when we'd have to scrimp and save to buy groceries," said Andrews, who attended a small rally outside the hotel protesting the Bush plan.

Moving to approval

Other suburban seniors will be watching to see what ultimately wins approval. Allen Goodridge, an 85-year-old resident of Friendship Village in Schaumburg, said he would be interested in a prescription drug benefit -- if it beats the $40 per month he now pays.

Walter Paquet of St. Charles said he probably wouldn't be interested in managed care if it meant he couldn't see his current doctor.

"I'd have to see something showing how it'd benefit me," Paquet said.

Meanwhile, the Senate Medicare plan continued to gather steam, with Senate Democratic Leader Tom Daschle of South Dakota saying Wednesday he thinks it will pass. A Senate panel is scheduled to vote on it Friday, and Bush hopes for a conclusion by July 4.

Bush, however, drew the biggest applause from the room full of Illinois doctors when he called for a $250,000 cap on pain-and-suffering lawsuit awards in medical malpractice cases.

Congressman Philip M. Crane, a Wauconda Republican, applauded the call, saying "we're going to keep our doctors in this state by keeping their (malpractice) insurance down."

But Schakowsky, who doubts the measure will get through the Senate, called the plan "mean spirited" because it penalizes victims of doctor's mistakes.

Still, if Bush succeeds in providing prescription drug coverage for seniors, he takes away a key issue from Democrats in next year's re-election bid.

"I think it dramatically enhances his re-election. It's a key campaign promise. It's a big reform for Medicare. So for America's seniors, who increasingly rely on prescription drugs for their health care, this is a big deal," said Congressman Mark Kirk, a Highland Park Republican.