Opinion: Confronting costly drugs

Democrats support a plan to combat the rising cost of prescriptions drugs for the elderly, but Republicans don't like it and could derail it with their own, more risky plan.

Congress has spent hundreds of billions of dollars taking care of farmers, corporations and wealthy taxpayers. Now it is time to take care of elderly Americans who are suffering under the rising cost of prescription drugs. They are at least as worthy a group.

Sen. Bob Graham has proposed a prescription-drug benefit that would address the needs of all retirees. It would allow those on Medicare to buy medicine for a reasonable copayment, with poor recipients getting coverage at no additional cost. All older Americans who chose to participate would be spared catastrophic drug costs, with out-of-pocket expenses capped at $4,000 a year.

Graham has the backing of powerful Democrats in the Senate, including Majority Leader Tom Daschle, and they promise to pass a bill by the end of August. The chance of that bill becoming law, however, is another matter.

House Republicans are hostile toward the Graham plan and have come up with their own proposal. It is a confusing mishmash of coverages and based on a concept of drug-only insurance that doesn't exist in the real world. It could turn out to be more a political hoax than a workable program. It is unfortunate that Rep. Michael Bilirakis, R-Tarpon Springs, has co-sponsored the bill.

The Republican plan would carry a higher monthly premium ($35), require a $250 deductible and offer no reimbursement for drug costs between $2,000 and $3,800 a year. The Democratic plan has a $25 monthly premium, no deductible and no gaps in coverage.

What particularly disqualifies the Republican plan is the requirement that benefits be provided through private insurers. There is no indication that any company is willing to take on such financial risk. "We are not enthusiastic about that approach," Thomas Boudreau, an executive with Express Scripts, one of the major administrators of prescription drug programs, told the New York Times.

In fact, no one currently offers that kind of insurance. So the Republican plan would be a risky experiment, at best. Such a program could end up stranding retirees, said AARP policy director John Rother, "repeating the HMO experience."

Not surprisingly, the Democratic plan would cost more: $500-billion over 10 years, compared with $350-billion for the Republican proposal. Neither party has been clear about where they would get the money, but that hasn't stopped them in the past.

Congress passed a $190-billion farm bill that encourages agribusiness to overproduce without suffering the financial consequences. President Bush and Congress concocted a $1.35-trillion tax cut, with most going to the wealthiest Americans. In neither case did they worry about the financial consequences. If Republicans say we can't afford the Democratic prescription plan, then we can't afford the tax cut either, and it should be repealed.

The stakes are great in the prescription-drug debate, involving human suffering. Nearly a third of Medicare recipients have no drug benefit, so they either go without medicine they need or they neglect other necessities. Imagine having to choose between purchasing life-giving medication and living in poverty. Even those who have limited drug coverage through a pension plan or Medigap policy face daunting costs.

Sen. Zell Miller, D-Ga., who supports the Graham plan, put the issue in perspective. "We want to tell America's seniors who have been waiting in line for a long time that finally -- finally -- they have reached the front of the line," he said.

But will their patience be rewarded?

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