By Lisa Seachrist
WASHINGTON ¿ In the wake of the failure of the Bipartisan Committee on Medicare Reform last month, Senator Edward Kennedy (D-Mass.) and Representative Pete Stark (D-Calif.) introduced legislation to amend the health care program for the elderly to include a prescription drug benefit.
The legislation is the second sponsored by Kennedy that specifically addresses the burden buying prescription medicines places on the nation¿s elderly.
¿Medicare is a promise to senior citizens,¿ Kennedy said. ¿It says, Work hard, contribute to Medicare during your working years, and you will be guaranteed health security in your retirement years.¿ But too often that promise is broken because of Medicare¿s failure to protect the elderly against the high cost of prescription drugs.¿
As a result, Kennedy, with John Rockefeller (D-W.V.), introduced the Access to Prescription Medicare Medications Act of 1999 in the Senate. Rep. Stark co-sponsored similar legislation in the House with Rep. Henry Waxman (D-Calif.) and Rep. John Dingell (D-Mich.).
The congressmen describe their bill as a basic benefit of $1,700 that covers 80 percent of pharmaceutical costs for all seniors with more than $200 in annual drug costs. For Medicare beneficiaries who have more than $3,000 in annual out-of-pocket prescription drug costs, the bill would cover 100 percent of any additional costs.
The bill calls for all of these benefits to be provided through the private sector, with the secretary of the Department of Health and Human Services contracting with at least two providers, whether they be pharmacy benefit management organizations, insurance companies or a group of retail pharmacists. In addition, all Medicare HMOs would be required to provide the benefit directly, and those private businesses that extend a prescription drug benefit to their retirees would receive payments from the government to maintain the coverage.
¿This legislation is a lifeline for every senior citizen who needs prescription drugs to treat an illness or maintain their health,¿ Kennedy said. ¿It assures that today¿s and tomorrow¿s senior citizens will be able to share in the medical miracles that we can expect in the new century. In the next 10 years, there is going to be an explosion of solutions for a number of medical problems.¿
The bill doesn¿t specifically address how this benefit will be funded, and it hasn¿t yet established cost estimates. The congressmen list such potential revenue sources as higher tobacco taxes, recoupment of federal costs for tobacco-related diseases, an unallocated portion of the federal surplus, and savings from the reduced hospitalizations and other costs related to the inappropriate use of prescription drugs.
Despite the fact that the accounting still needs to be done, Stark noted that the Medicare drug benefit must be added to ensure the health of Americans.
¿We don¿t want to find out what will happen if we don¿t provide the miracle drugs to our seniors,¿ Stark said. ¿We hope to see this pass this year in Congress.¿
Rockefeller noted that in his work with the Bipartisan Commission, he found that a drug benefit was first and foremost among the concerns of seniors.
¿If anything causes a change it will be the gathering force of seniors who don¿t have a prescription drug benefit or have one that is taken away,¿ Rockefeller said. ¿This is the potential to move this bill.¿
Kennedy said they were expecting the support of the biotechnology and pharmaceutical industries. However, earlier this month Kennedy introduced legislation that proposed providing drugs to pharmacies at the federal schedule rate for Medicare recipients. That proposal was roundly criticized by representatives of the pharmaceutical and biotech industries. (See BioWorld Today, April 1, 1999, p. 1.)
¿It¿s a good sign that Sen. Kennedy and other Democrats seem to acknowledge that price controls aren¿t the way to provide a prescription drug benefit,¿ said Carl Feldbaum, president of the Biotechnology Industry Organization (BIO). ¿While they appear to have backed away from overt price controls, we need to make sure that there is nothing covert.¿
Feldbaum said BIO was going over the legislation with a fine-toothed comb and noted that the bill was a ¿complex piece of legislation.¿
¿One thing about this Kennedy effort is that he plainly appears to be taking biotech drugs into some consideration,¿ Feldbaum said. n