Sunday, May 19, 2002

Seniors await relief on prescriptions


Bush, Congress working on plans to ease burden

By Derrick DePledge
The Cincinnati Enquirer

        WASHINGTON — Even after the multiple heart bypass surgeries, the emergency appendectomy and the devastating medical bills, Amy Conner still feels pretty fortunate. She has Social Security and a small pension, health care through her former employer, and two sons who cover for her when her insurance does not. Still, last month, Mrs. Conner's prescription drug bill was $400.

        The 82-year-old Milford retiree said she has no idea how seniors without private insurance or outside help can survive, since Medicare, the federal safety net for the elderly and disabled, does not cover outpatient prescription drugs.

        “I was wiped out by these illnesses. It isn't really fair that we have to spend everything we have on medicine,” she said. “My sons help me out. Otherwise I couldn't make it.”

        Solving the prescription drug dilemma, particularly for low-income seniors, has been one of the main political themes of the past few election seasons, yet progress remains elusive. During his campaign, President Bush promised a solution, as did lawmakers in Congress. But much of the movement has come from the states and drug companies that have voluntarily offered some dis counts in anticipation of government mandates.

        The president has called for a federal drug discount card for low-income seniors.

        House Republicans have proposed a $350 billion Medicare reform bill that likely would offer prescription drug coverage to seniors for about a $35 monthly premium and a $250 annual deductible with the government picking up a greater share of drug costs as expenses increase. Low-income seniors likely would pay reduced or no cost for the drug benefit.

        Several competing prescription drug bills are pending in the Senate. With mid-term elections in November and slim majorities in both chambers, lawmakers are under pressure to solve the issue but cautious of missteps that could hurt them with voters.

        Rep. Rob Portman, R-Ohio, appointed to a House task force on prescription drugs, said the House may consider its version after Memorial Day.

        “We've been talking about this for years. Now it's time to act,” he said. “This will provide immediate help to seniors.”

        According to the Henry J. Kaiser Family Foundation, a Menlo Park, Calif., health research group, spending on prescription drugs was about $116 billion in 2000, nearly double the amount spent in 1995. Most workers in company sponsored health insurance plans have prescription drug coverage, and many seniors and retirees have coverage through Medicare-approved health-maintenance organizations or private insurance plans.

        But an estimated 27 percent of elderly and disabled Medicare recipients did not have prescription drug coverage in 1998, according to the foundation.

        In focus groups last year with health care workers and surveys of the elderly, the Council on Aging of Southwestern Ohio found that prescription drug costs were the top concern. In years past, the No. 1 worry was transportation or long-term care.

        Seniors who receive home-care services through the council spent an average of $732 in 2000 on out-of-pocket prescription drug costs, the council found.

        “They're making decisions between prescription drugs and food, heat, utilities and rent,” said Bob Logan, the council's chief executive officer. “After that, there's not a lot of money left.”

        In the past decade, insurance companies have paid a greater share of prescription drug costs while the amount consumers paid has declined, according to the Kaiser Family Foundation.

        Meanwhile, hospital and nursing home associations are fighting a provision in the House bill that would shave some money from Medicare reimbursement to pay for prescription drug coverage and other reforms. Reimbursement rates — the amount the government pays health-care providers to serve Medicare recipients — have been such a source of controversy that many providers have stopped serving Medicare patients.

        Federal lawmakers may settle for minor remedies this year and then attempt structural reforms to Medicare after the election.

        Seniors continue to marvel at prescription drug sticker shock. According to the Kaiser Family Foundation, the average retail prescription price more than doubled in the 1990s. Drug companies spent $15 billion on promotion in 2000.

        Mrs. Conner said she depends on heart, diabetes, high blood pressure and stomach medicines.

        “My drug bill is astronomical,” she said. She also remembers the election-year rhetoric about a prescription drug benefit and expects to see some results.

        “This is something they promised us,” she said. “And I've been waiting for it.”

       



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