Washington Seniors Deserve a Real Drug Benefit

Seniors and the disabled deserve a real prescription-drug benefit. Unfortunately, the bill President Bush signed into law fails our seniors and is bad for Washington state, which is why we voted against it.

The bill has been criticized as a giveaway to the private insurers and big drug companies. But rather than focusing on how the bill was written, we would like to address the substance of the bill and what it means for seniors in Washington state.

Most seniors are satisfied with the health care they receive through Medicare and it is a program they trust. They simply wanted Congress to add a drug benefit to the coverage they already receive.

Seniors need access to life-saving prescription drugs. Medicine has changed over the past 38 years and Medicare should be updated to reflect this new reality.

That’s why we co-sponsored a bill that would have added a real drug benefit to Medicare, without dismantling the popular program.

Instead, Republican leadership developed legislation that provides a meager drug benefit and completely overhauls the Medicare system, forcing seniors to pay higher premiums if they want to stay in the traditional Medicare program.

The bottom line for this bill is that many seniors will see increased costs, higher premiums and dizzying choices. This bill will cause at least 3 million seniors to lose their current employer-sponsored drug coverage, in exchange for a new plan, which may be less generous. The bill also fails to address the imbalance in reimbursement rates that penalizes Washington state doctors, hospitals and seniors.

Costs

The administration’s own data show that average Medicare premiums could initially jump 25 percent. Over time, the increase will grow higher and higher. Millions of Medicare beneficiaries will be worse off — including many people with retiree prescription benefits and those with lower incomes.

Furthermore, drug prices will stay high, because this law forbids Medicare from negotiating with drug companies for better prices. Ironically, the government already negotiates for better prices under the Veterans Affairs health-care system.

Premiums

The bill forces seniors to pay higher premiums to stay in the traditional Medicare program. The only way seniors can avoid higher premiums is by switching from Medicare to private insurance. Instead of adding a drug benefit and allowing seniors to continue to see the doctors they know and trust under Medicare, this new law will coerce seniors into private plans.

Confusion

This bill will also create problems we can’t predict, since seniors won’t even know until late 2005 what types of drug-benefit plans will be available where they live. Seniors will have to sort through an array of plans to find one that covers their medicines, and then will have to enroll — for a full year — with that particular plan. While the private plans can change the list of drugs they cover at any time, seniors can change plans only once a year. Seniors who don’t sign up immediately will pay a financial penalty for enrolling later.

Changes to Medicare

This bill could have a devastating effect on cancer patients and how they are treated. It alters the reimbursement formulas for drugs and cancer care, potentially cutting $11.5 billion for treating cancer patients.

Also, while the law makes fundamental changes to Medicare, it does not make the changes needed in Washington state. The problem in our state is that our doctors and hospitals are reimbursed at a rate lower than most states.

This means that a doctor in Washington is paid less by Medicare for the same procedure than a doctor in Florida, or Texas, or any of the 40 states that get higher reimbursement rates than we do. Low Medicare reimbursement rates have contributed to doctors either leaving Washington state or choosing not to practice here in the first place. In many cases, doctors cannot afford to treat new Medicare patients.

We introduced legislation to correct our state’s low reimbursement rate. But, the Medicare law signed by the president only makes this problem worse. Under the new law, Washington state will fall to 45th from 41st in the nation for Medicare reimbursement rates, compounding the hardship for doctors, hospitals and patients.

There is nothing we want more, and nothing seniors deserve more, than a comprehensive Medicare prescription-drug benefit. Unfortunately, the bill that was rushed through Congress is a prescription for higher costs, more confusion and bigger problems for seniors in our state.

We will continue to work with seniors in Washington state to fix the problems in this new law. We must continue to lower drug costs for seniors, ensure that drug coverage is seamless and strengthen the Medicare program. Our seniors deserve no less.