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Bush Vows Veto of Any Cutback in Drug Benefit
By ROBERT PEAR

Published: February 12, 2005

WASHINGTON, Feb. 11 - President Bush threatened on Friday to veto any bill that scales back Medicare's prescription drug benefit, which becomes available in January 2006 to millions of elderly and disabled people.

New estimates showing that the benefit will cost $724 billion over a decade have touched off a furor in Congress, where lawmakers originally believed that it would cost much less. Many members of Congress say they want to revisit the Medicare law this year. Conservatives seek cutbacks in benefits and cost controls. Liberals and some centrists want to require the government to negotiate prices with drug manufacturers.

But on Friday, Mr. Bush said, "I signed Medicare reform proudly, and any attempt to limit the choices of our seniors and to take away their prescription drug coverage under Medicare will meet my veto."

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I'm not very knowledgeable about how your American Medicare system works (forgive me, I have the unfortunate handicap of being Canadian.) To me, reading this, it sounds good, and I am inclined to applaud. Opinions?

[ February 12, 2005, 12:36 AM: Message edited by: digging_holes ]
 

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Posted by fugu13 (Member # 2859) on :
 
Bush got a bill passed by intentionally using fudged estimates to make it look like it cost lower. He deceived Congress, and Congress is now threatening to alter the law to reflect their intentions (provide a prescription benefit that costs a certain amount), rather than his deceptions.

This is particularly meaningful as Bush is the one talking about a restricted budget, yet he's not willing to take the burn on any of his pet programs that haven't generated results (and the prescription drug benefit bill has already been attacked as pretty much a turkey, even without the cutback).

If he does veto such a bill, I do believe that would be his first veto as President, ever. He has made a political career out of never saying no to any bill, meaning its extremely hard for anyone to pin him for opposition to anything, and no matter what's politically popular he can say "I signed a bill into law that XXXXXXX".
 

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Posted by Morbo (Member # 5309) on :
 
Yes, Russell, Bush has yet to veto anything.
So this is what Bush has been saving his veto for: to save a pet program for his drug company supporters from any revision, after monster cost overruns.

digging holes, the original cost estimates for the bill, supplied by the administration, were around $400 billion for the 1st decade, and it passed Congress under those numbers, after lengthy debate.

Two months later the real numbers (which had been supressed by the administration until after the bill passed) came out, and were about $530 bill, which caused many congressmen, including republicans, to wail and gnash their teeth.

Now, these figures come out, $724 billion, and there may be a revised bill. Hopefully.

The bill is basically a valentine to the drug companies, any way--one of it's key provisions prohibits the government from any drug price negotiations. Hardly an attempt to be cost effective.

[ February 12, 2005, 06:19 AM: Message edited by: Morbo ]
 

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Posted by digging_holes (Member # 6237) on :
 
So is it your position that it is better to cut benefits that seniors would recieve, rather than force the drug companies to lower their costs? (Because, as all of us in Canada know, you guys are getting royally screwed when it comes to drugs down there.)
 

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Posted by fugu13 (Member # 2859) on :
 
Forcing drug companies to lower their costs would cause fewer drugs to be developed, plain and simple. A lot of the reason Canada hasn't been screwed is we're supporting your price differential. The only way we could get a significant decrease in cost without a signifiant decrease in drug development would be if you were to increase your cost a good amount (not up to our level, but in the same ballpark).

I think it would be better for presidents not to intentionally mislead Congress as to costs.

Note that Bush is completely against forcing drug companies to lower prices, too; he wants to have the horse, eat it, then ride it back to town.
 

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Posted by Dagonee (Member # 5818) on :
 
I'm still trying to figure out why being a "senior" means you need help with prescriptions.

I know being a senior makes you far more likely to need regular prescriptions. But if we hold to a principle that says people who need prescriptions should get government help if they can't afford them, why does the age of the recipient matter?

The whole idea frustrates me. Age does not make someone deserving of assistance. Needing assistance makes someone deserving of assistance.

Dagonee
 

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Posted by digging_holes (Member # 6237) on :
 
I think the fact is that alot of seniors are retired with very little in the way of income. It's not that their age makes them eligible to recieve assistance, it's the other stuff that comes with being that age.
 

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Posted by Dagonee (Member # 5818) on :
 
But they could easily make the formula based on income and need, which would allow the program to help others who need it and not give benefits to people who don't need it.
 

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Posted by Morbo (Member # 5309) on :
 
It's true that many seniors have limited incomes and/or many prescriptions. It's also true that 65 and older is the wealthiest age bracket, in terms of assets.

I think if the goverment is going to start a massive entitlement program, they should be able to negotiate costs with the main suppliers, in this case the drug companies.
Corporations do it, via HMOs. Other countries and states do it. Even other parts of the federal government do it. Why should Medicare be exempt, other than to give drug companies massive windfall profits, most of which will never make it into new drug developement anyway.
 

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Posted by digging_holes (Member # 6237) on :
 
I think you need universal healthcare. Although given the way our health system is going, I can understand why you might be reluctant.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
It would help if y'all stopped undercutting the financial support for it, d_h. *wry grin

fugu, much much more of the pharmacaeutical budget is spent on advertising than R&D -- something like 2-3X more. IIRC, the 9 public US drug companies spent $45 billion on marketing and advertising and less than $20 billion on research and development (in 2001).

[ February 12, 2005, 03:07 PM: Message edited by: ClaudiaTherese ]
 

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Posted by fugu13 (Member # 2859) on :
 
Yes, but forcefully lowering the costs isn't going to decrease the proportion of their budget going towards advertising.
 

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Posted by digging_holes (Member # 6237) on :
 
CT - Canada is undercutting the financial support for your health system?
 

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Posted by ClaudiaTherese (Member # 923) on :
 
fugu13: Nope. But drugs aren't marketed to this extent in Canada, so I suspect that it is more that Canadian revenues are supporting the US advertising moreso than the US supporting Canada's price differential.

[Edit: I believe the increase in US drug prices has been outpacing inflation for some time, and a good chunk of that has been tied to upsurges in advertising. Not just direct-to-consumer, either -- that's actually a relatively small portion of the total advertising budget, or so I've heard. Still a significant amount, though.]

[ February 12, 2005, 03:18 PM: Message edited by: ClaudiaTherese ]
 

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Posted by ClaudiaTherese (Member # 923) on :
 
d_h: Nah, you seem (from this Yank's perspective) to be doing well enough of that for your system as it is.

Hasn't the budget for Canuck healthcare been getting cut on a regular basis these last few years? I remember watching the percentages drop since 1998 or so.
 

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Posted by digging_holes (Member # 6237) on :
 
That depends on who you ask. If you ask the federal government, they'll tell you that they spend most of their money on healthcare. If you ask the provinces, they'll tell you that the percentage of health care costs shouldered by the federal government has decreased from 50% to 16% in the last decade and a half.

In any case, I am certainly not going to start praising our ailing health-care system. It's a good idea, but has suffered for years at the hands of corrupt and incompetent governments.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
You all still have better morbidity and mortality outcomes than in the US.

(*off to go work )
 

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Posted by Kayla (Member # 2403) on :
 

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I'm still trying to figure out why being a "senior" means you need help with prescriptions.

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Dag, what kind of insurance do you have? Are prescriptions covered? All of the health insurance plans I've had before had co-pays for prescriptions.

Currently, my husband and son pay $15 for generic prescriptions, $30 for formulatory and $45 for non-formulatory. So, for a prescription of my son's ADD medication, we pay $30 a month, rather than the $180 that it would cost us if we didn't have that insurance.

With Medicare, though, you pay the entire $180 for the prescription. If I were on my husband's medical plan, I'd pay $20 a month for prescriptions. But, as it is, I pay $60. And that is only because there are medications that have been discussed but not prescribed because of the cost. Again, if I were on my husband's plan, there are several drugs combinations my docs would like me to try. Each part of the combo would cost $30, but without insurance, each would cost over $200 a month.

And the older people get, the more prescriptions they usually have. For example, my mother-in-law spends over $700 a month for prescriptions. That's a lot of money. Could you pay $700 a month for prescriptions? I mean, it's dandy that you pay into Social Security and Medicare all your life, but if, when you retire, you get a monthly check for $1,200 and have $700 in prescriptions, what kind of retirement do you really have? A homeless one?

But, I suppose that is the point. The sooner you die, the less Social Security you use, leaving more for everyone else. The government needs people to die young. That's why they like smokers. Enough smokers die, they won't have a problem with insolvency. See, that's the problem with the whole "tobacco kills" scandal. Now they need to come up with something new to kill off taxpayer before they retire. Oh, wait, they did. Corn syrup that they add to everything which makes you fat which causes heart attacks.
 

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Posted by Kayla (Member # 2403) on :
 
Though, I would like to say for the record that I'm against this particular benefit. I don't like how it is structured at all, and I think that drug manufacturers are the ones that are being given free money. There were so many other ways to do something for seniors that would have been much less expensive. Ruling out using Medicare as a bargaining tool was just stupid. Oh, no, we don't want to work out a deal with manufacturers, like the insurance industry does.
 

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Posted by Dagonee (Member # 5818) on :
 
The average senior has annual prescription out of pocket costs of between $2,000 and $3,000 a year. The average senior is better off than the average non-senior.

What you've described is a situation where someone might need assistance. All I'm asking for is a plan that looks to the actual variables involved (income, assets, and prescription costs), rather than age, which is a surrogate for measuring the true need.

Dagonee
 

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Posted by Dagonee (Member # 5818) on :
 
OK, let me look. I'm running from memory here, but I think Samuelson in the post has put them out there before.
 

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Posted by Dagonee (Member # 5818) on :
 
Average cost per senior:

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Americans, especially the elderly, are taking more drugs and paying more for them than ever before. Annual prescription drug spending per elderly person has grown from $559 in 1992 to a projected $1,205 for this year [2000], according to a report by the PRIME Institute at the University of Minnesota College of Pharmacy.

The institute studies economic and policy issues related to pharmaceuticals. By 2010, seniors will spend an average $2,810 a year on prescription drugs, the report predicts.

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code:

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 AGE OF HOUSEHOLDER      Net worth (median value)

Less than 35 years      5,896
35 to 44 years          33,950
45 to 54 years          68,198
55 to 64 years          100,750
65 years and over       107,000
65 to 69 years          107,150
70 to 74 years          118,950
75 and over             100,000 

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What I'm asking is, if a largewr portion of thier limited income is going towards drug costs, then they aren't better off than non seniors because they are having less income for other life needs.

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But many seniors own their own homes with no mortgage, or at least have large amounts of equity and a small mortgage. They have also been buying stuff their whole lives (nothing wrong with that) and have less need for major purchases than the average non-senior.
So income is smaller, but budget needs are different, and assets levels are higher (on average, plenty of broke senior citizens.)
 

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Posted by Morbo (Member # 5309) on :
 
Bookwyrm, that's a lot of expensive medicine. Have they tried getting on any reduced cost medicine programs sponsered by the drug companies? I'm about to try that, I hope I qualify. There's an 800 number I see TV ads for all the time, but I always forget to write it down. Nor do I have a link.

Do your parents own their home, free and clear? Do they get a senior citizen exemption from property tax? (Don't answer if that's too personal, I hate to pry.) Many counties in Georgia give that exemption, which makes sense as most property tax goes to schools here.
 

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Posted by Dagonee (Member # 5818) on :
 
Thanks for finding that, Morbo.
 

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Posted by twinky (Member # 693) on :
 
Regarding the tangent about the Canadian system:

It was Paul Martin, our current Prime Minister, who made some of the deepest cuts to the health care system during his tenure as Finance Minister in the 90s. I would not, however, say that our health care system is ailing. Rather, I think the media and opposition parties love to use it as a focus for fearmongering. Yes, the system needs an infusion of cash, but it is still one of the best in the world, and Canadians need to remember that.

Over the last three weeks I have been continually astonished by the quality of care my father has received, and I'm one of the people who already thought our system was good. When you need acute care in this country, you get it.
 

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Posted by Morbo (Member # 5309) on :
 
That's too bad about the car.
 

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Posted by Kayla (Member # 2403) on :
 
Yeah, but Dag, how much do you pay for prescriptions?
 

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Posted by Chris Bridges (Member # 1138) on :
 
I would just like to point out (without jinxing it, I hope) that a thread started on the topic of Bush vowing not to veto a controversial bill has quickly turned into discussions on the validity of the bill and alternate methods, as opposed to Bush-bashing and Bush-praising.

Thank you.
 

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Posted by Dagonee (Member # 5818) on :
 

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Yeah, but Dag, how much do you pay for prescriptions?

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I'm still trying to figure out why being a "senior" means you need help with prescriptions.

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Yeah, but Dag, how much do you pay for prescriptions?

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Why is that relevant?

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It was Paul Martin, our current Prime Minister, who made some of the deepest cuts to the health care system during his tenure as Finance Minister in the 90s. I would not, however, say that our health care system is ailing. Rather, I think the media and opposition parties love to use it as a focus for fearmongering.

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The Canadian Health Services Research Foundation promotes and funds management and policy research in health services and nursing to increase the quality, relevance and usefulness of this research for health-system policy makers and managers. In addition, the foundation works with these health-system decision makers to support and enhance their use of research evidence when addressing health management and policy challenges. Any foundation project, process or activity always involves both researchers, and managers, policy makers from academia and Canada's health system.

The foundation is an independent, not-for-profit corporation, established with endowed funds from the federal government and its agencies.

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Canada is charmingly committed to an evidence-based approach, even in critiquing its own system.

Here at the Mythbusters site can be found the best evidence regarding cross-border transfers of physicians (the brain drain is reversing) and other fascinating systemic topics.
 

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Posted by Kayla (Member # 2403) on :
 
Do you consider the insurance federal employees have to be government aid? Is your insurance government aid? I don't understand why you think that after paying into Medicare for an entire lifetime, and paying premiums on top of that, it would be "government aid." That makes no sense to me.
 

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Posted by Dagonee (Member # 5818) on :
 
The premiums they paid was for coverage that didn't include prescription coverage, so that argument doesn't fly. The program isn't covered by medicare payments. It can't be supported by medicare payments.

The government is giving money in order to make prescriptions more affordable for people. The justification is that people need the help. However, the criteria is not based on whether someone needs help. They are based on criteria that are at best loosely correlated with whether someone needs help.

This program subsidizes prescriptions for the wealthy. It also subsidizes prescriptions for people who actually need the subsidy. AND it doesn't give the subsidy to some people who need it.

I propose an alternative that matches the supposed aims of the program more closely with the means.

Dagonee
 

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Posted by Dagonee (Member # 5818) on :
 
Yeah, my first post was confusing.
 

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Posted by twinky (Member # 693) on :
 

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I would still never trade our health care for the American one. But it's still not doing particularly well right now.

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