The link to the Consumer's Union review of the bill & proposed problems was cut off. The link is: http://www.consumersunion.org/health/skimpy-rpt.htm
----- Original Message ----- From: <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]> Sent: Monday, November 17, 2003 2:57 PM Subject: Drug bill unveiled, gets Bush support > This story was sent to you by: Corey > > This article from the Chicago Tribune basically explains the different sections of the Republican proposed Medicare Bill which is planned to include a Prescription Drug Benefit, as well as include changes to "improve" the financial footing of the Medicare program itself. Here is also a link to the > > -------------------- > Drug bill unveiled, gets Bush support > -------------------- > > Key lawmakers upset by provisions of Medicare plan > > By Jill Zuckman > Washington Bureau > > November 17, 2003 > > WASHINGTON -- Congressional leaders on Sunday unveiled their sweeping plan to provide a Medicare prescription drug benefit to 40 million senior citizens, and President Bush vowed that he will actively push for the legislation. > > "I think there's going to be immense pressure on members of both the House and Senate to support this bill," Bush said as he returned to the White House from a weekend at Camp David. > > The deal, which was hammered out behind closed doors and largely excluded Democrats, would start by providing prescription-drug discount cards in April 2004 that could provide discounts of 15 percent or more. > > In 2006, seniors could sign up for prescription drug coverage after paying a $275 annual deductible and premiums roughly averaging $35 per month. Medicare would cover 75 percent of the cost of medicines and seniors would pay for 25 percent of the cost, up to $2,200. > > A coverage gap would begin when drug costs exceeded $2,200, but the program would step back in when a senior's out-of-pocket expenses reached $3,600. After that, 95 percent of all drug costs would be covered. > > For low-income seniors, the cost of all premiums and deductibles would be waived when earnings do not exceed $12,123 a year. Also, the coverage gap after $2,200 would be eliminated. > > "We are an eyelash away on a plan that has been discussed and debated for six years," said Senate Majority Leader Bill Frist (R-Tenn.), who helped resolve the final disputes, along with House Speaker Dennis Hastert (R-Ill.). > > But that eyelash may be the most difficult part of the journey. > > Key lawmakers in the Senate expressed their disquiet as the details came to light. > > "The last thing we want to do is relive the catastrophic health coverage debate of the 1980s, when we passed legislation with broad support from members and seniors' interest groups, and had to repeal it the next year because it lacked support among the seniors it was designed to benefit," warned Sen. Olympia Snowe (R-Maine). > > Sen. Edward Kennedy (D-Mass.) said he did not think the legislation could pass the Senate. > > "This bill is a partisan attack on Medicare, a respected program that's a lifeline for our senior citizens," Kennedy said. "It will leave millions of seniors worse off than they are today, with higher premiums and higher drug costs." > > But participants in the negotiations said this is the best chance Congress will have to provide a prescription drug benefit through Medicare. Congress budgeted $400 billion over the next 10 years to institute the program, and that money is not likely to be available again as the deficit continues to soar. > > "I understand some Democrats have reservations. Some Republicans have reservations," said Sen. Max Baucus (D-Mont.), the ranking member of the Finance Committee, which oversees Medicare. But he warned "we should not nitpick, we should not find fault, we should take it as a whole." > > Republican leaders in the House and Senate are banking that it will be too hard to vote no on a bill that ultimately provides senior citizens with some of the assistance they have been seeking for the high cost of prescription drugs. > > Private insurance plan > > Referring to the role of drugs in medical care, Frist said,"the most powerful tool that we have today has not been a part of Medicare." > > But Republicans had also sought to use the carrot of a prescription drug benefit to rein in the traditional health coverage of Medicare, which they argue is financially unsustainable. > > Under the proposal, lawmakers agreed to conduct a demonstration six-year program beginning in 2010 with private insurance plans competing with the regular fee-for-service Medicare program. The experiment would be conducted in six metropolitan areas to be named. > > Long considered the most controversial aspect of the legislation, the competition proposal was scaled back considerably from Bush's first draft. Originally, the administration had proposed giving the prescription drug benefits only to seniors who agreed to leave Medicare for the private insurance programs. At the time, Hastert said he warned Bush that it could not be done humanely, politically or practically. > > The legislation includes far-reaching provisions to rectify longstanding inequities in rural health care, such as unequal reimbursement rates to doctors and hospitals in rural areas, compared with urban centers. Those provisions are expected to cost at least $25 billion over the next decade. > > "Iowans and taxpayers in 30 other states pay the same payroll tax to help run Medicare as the rest of the country, but have been penalized for providing cost-effective medicine," said Sen. Charles Grassley (R-Iowa), chairman of the Finance Committee. "This will make a big difference in recruiting physicians and maintaining the strong health care delivery system we have in rural America." > > In addition, the agreement includes a "Welcome to Medicare" program that would provide new Medicare recipients with a physical, as well as screening for diabetes and cardiovascular disease. > > To control the cost of drugs, Americans would be allowed to buy their prescription drugs from Canada as long as the secretary of Health and Human Services certifies that it is safe. > > For the first time, high-income Medicare recipients would be charged higher premiums and co-payments under the plan. Seniors with incomes exceeding $80,000 would pay more, under a sliding scale. > > The legislation still faces a difficult and acrimonious road. First, the Congressional Budget Office must decide that the cost is within the $400 billion ceiling. Then it must pass the House and the Senate. > > Bush set the tone for the week as he began to pressure lawmakers to support the deal. > > "I urge the members of the House and the Senate to take a look at it, vote it and get it to my desk as soon as possible," Bush said. > > "We're changing a Medicare system that has been stuck in the past for a long period of time," he said. "I know I will be actively pushing the bill." > > AARP, the premier seniors organization, is expected to endorse the legislation, though on Sunday officials would say only that they were "hopeful" and "encouraged" but still examining the legislative language. > > The American Medical Association, the leading advocacy group for doctors, offered its support. The bill would stop planned cuts in payments to physicians in 2004 and 2005, and replace them with increases of 1.5 percent. > > Democratic critics > > Both Democratic leaders in the House and Senate made clear Sunday that they do not view the legislation as a boon to senior citizens. > > "It keeps drug prices high, causes two to three million retirees to lose drug coverage, and coerces seniors in HMOs," said Senate Democratic Leader Tom Daschle of South Dakota. "It is hard to imagine a plan less faithful to what seniors have been promised." > > House Democratic Leader Nancy Pelosi (D-Calif.) called the deal "fig-leaf bipartisanship." Sens. Baucus and John Breaux (D-La.) worked on the deal with Republicans. > > "Republican leaders are leaving seniors at the mercy of HMOs, increasing the costs for seniors, including the costs for doctors' visits, and dismantling Medicare," Pelosi said. "In the backrooms of backrooms, Republican leaders had a one-sided debate about dismantling the Medicare program that seniors have known and trusted for nearly four decades." > > - - - > > New Medicare drug plan for 2006 > > Highlights of the new prescription drug plan unveiled Sunday by Republican congressional leaders: > > PREMIUM* > > $35 per month on average > > DEDUCTIBLE* > > Individual must spend $275 before benefits begin > > INITIAL COVERAGE > > Insurance pays 75 percent of drug costs from $276 to $2,200 > > COVERAGE GAP* > > No coverage when drug costs exceed $2,200 and before out-of-pocket costs reach $3,600 > > When out-of-pocket spending reaches $3,600, 95 percent of costs are covered > > CATASTROPHIC COVERAGE > > *Waived for low-income seniors > > Source: Associated Press Chicago Tribune > > > Copyright (c) 2003, Chicago Tribune > > -------------------- > Improved archives! > > Searching Chicagotribune.com archives back to 1985 is cheaper and easier than ever. New prices for multiple articles can bring your cost down to as low as 30 cents an article: http://www.chicagotribune.com/archives /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
