The new health care entitlement drew scathing reviews. Outrageously expensive and unfunded. Infuriatingly complex. Even though it was years in the making, the rules were still changing just before launch. Pleas to extend sign-up deadlines multiplied.
This wasn’t Obamacare. It was Medicare Part D, the prescription drug add-on benefit. A George W. Bush administration rollout in 2006 was heavily criticized and came with a shocking price tag.
Then, and today, Republicans and plenty of Democrats loved it. Seniors are loving it now, even with complexities that require shoppers to evaluate plans with prescriptions in hand. And it still needs fixes.
Last Sunday, that love extended to a full-page ad in The Star, thanking Sen. Pat Roberts of Kansas for protecting Part D, brought by MedicareToday.org, an organization created by the Healthcare Leadership Council, a coalition of chief executives within the health care system. A total of 10 elected officials, of both parties, were similarly congratulated across the country.
Roberts, who faces August Republican primary opposition, joined a bipartisan group opposing proposed changes in the benefit that gives seniors affordable access to prescriptions. What he and Congress haven’t done is figure out a way to lower tremendous unfunded costs, the burr in all expanded benefits.
Protectors, particularly private insurance companies, extoll the lower-than-projected costs. Thank goodness. But that’s not enough. The program costs $62 billion a year now and is expected to grow as more baby boomers retire and benefits improve. Experts say the credit for less-than-expected costs shouldn’t go to private market competition but reflects lower-than-anticipated participation, fewer expensive blockbuster drugs and growing use of generics.
And who pays? Most of the benefit comes from the federal government’s general revenue, far outstripping individual premiums and payroll taxes.
The biggest error early on was barring Medicare from the ability to push for drug discounts, as Medicaid and the VA system can. The discounts could save billions. The fiscally responsible move would be to enforce discounts.
But drugmakers continue to have their way with Congress, and their way doesn’t include dramatically discounted drugs.