Picture this movie: It's 2003 in the wealthiest nation in the world and millions of Americans are suffering needlessly and dying prematurely because they cannot afford medicine.
Employers have hiked up the cost of their retiree drug coverage and pharmaceutical companies have continued to drive up the prices of life-saving prescription drugs.
Congress and the president know they must act or risk being run out of office. There is near-universal support to add prescription drug coverage to the nation's treasured Medicare program.
So, two of the nation's most powerful economic interests, the drug and insurance industries, are invited up to Capitol Hill to collude with leaders of Congress to develop a prescription drug benefit - one that serves their interests.
Taxpayers, senior citizens, people with disabilities: be damned. We have friends to pay back.
Working with $700 billion in taxpayer funds, the congressional leadership - all Republicans except then-Louisiana Sen. John Breaux (now a covert, but highly-paid lawyer for the drug lobby) and Montana Sen. Max Baucus - hides behind closed doors and gets to work.
With no public oversight and with the press milling outside locked doors, the congressional junta drafts legislation locked arm in arm with the puppeteers that control the federal government.
In a back room, they design a drug "benefit" that allows the pharmaceutical companies to further inflate the price of medications and reap billions of dollars in windfall profits. They promise tens of billions more in profits to health insurers to deliver this coverage.
But there is a human cost - this $700 billion package is leaving millions of older and disabled Americans worse off and millions more of them still without drug coverage.
The administration spin machine is hard at work to pretend that this tawdry story is not the reality facing the American people today.
Health and Human Services Secretary Michael Leavitt, with all the credibility of President Bush's now 3-year-old "Mission Accomplished" speech on the deck of the USS Abraham Lincoln, is going around the country zanily proclaiming what a marvel this drug program is. This week Leavitt unleashed a new, glossy "Progress Report " on the drug benefit. Page one proclaims, falsely, that "[m]ore than 27 million beneficiaries now enjoy Medicare Rx drug coverage."
Here's the reality: 16 million Americans with Medicare-men and women age 65 and older and people with severe, long-term disabilities-still have no drug coverage. Just 7 million Americans who were uninsured before the drug program was launched are newly insured. Six million of the poorest and frailest Americans who lost Medicaid coverage on January 1 now have inferior, less-reliable drug coverage. And the anger and dissatisfaction of people who are enrolled in drug plans increases each day as they discover how inadequate and unreliable the benefit is.
Coverage gaps, excessive out-of-pocket costs and routine denials of coverage for needed drugs are commonplace. Even enrollment in a private drug plan frequently leaves older Americans going without the medicines they need.
In this springtime of national discontent, the nation's prescription drug program resembles the rebuilding of New Orleans and the war in Iraq. They each serve as a human tragedy, an administrative fiasco and a predictable consequence of politicians willing to squander the national treasury so long as it goes into the pockets of their mercenary supporters.
For the past 40 years Medicare has been a national treasure. It has done what it promised when signed into law by President Lyndon B. Johnson in the summer of 1965. Medicare, a humane, reliable and efficient (yes, a government-run single payer) health care system, allows Americans to live longer, more productive and better lives.
Had the drug benefit been administered directly by Medicare, doctors, rather than profiteering insurers, would decide what drugs are needed, and Medicare would use its substantial purchasing power to bring U.S. drug prices in line with the rest of the world. (Americans, on average, pay double the price of other developed countries for the same medicine.)
Instead, where are we left? With a drug program that is enriching insurance and drug companies, helping far too few Americans in need, and an administration in a full-court propaganda campaign to convince the electorate that all will work out in the end.
So Secretary Leavitt, on behalf of his president, continues his whistle-stop tours. But he does it in the face of his own parents, enrolled with Mr. Leavitt's help in the drug program, having to rush to drop their plan because it imperiled their retiree medical coverage. Yes, Dad, perhaps we could have done better.
Did you know that Secretary Leavitt's father, now 76, made his fortune in the insurance business?
This could only happen in a movie.
Robert M. Hayes, an attorney, is president of the Medicare Rights Center, the nation's largest independent source of information and assistance on health care rights and benefits for older and disabled men and women. He led the national and New York Coalitions for the Homeless from 1979 to 1989, and has practiced law with firms in New York and Maine.
Harold German Bustamante
RBI- Rainbow Bureau of
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