Wednesday, June 2, 2004

Medicare legislation a fair compromise

Your voice: Dr. Paul J. Nugent

There have been a number of recent stories in the Enquirer concerning the new Medicare legislation and its pharmaceutical benefit, with a drug-discount card plan that kicked off Tuesday.

This legislation has been very controversial, with some Democrats saying it is too stingy and some Republicans saying it is far too generous. With that in mind, it makes me think that it might be a fair compromise.

As a physician in Cincinnati, I see a large number of Medicare patients who are rightly concerned about the cost of their prescriptions. It is important to note that when Medicare was established 40 years ago, we did not have the wonderful, life-saving medications we do today, so that is why there has been no prescription benefit.

Note that the average Medicare patient pays somewhat more than $100 a month for prescriptions. Under the current benefit plan, which goes into effect in 2006, that average patient would save $500 a year, not an insignificant amount. Those who have catastrophic disease with very high drug costs will see an even greater savings.

There has been some criticism from uninformed sources concerning the law's association with managed-care plans and privatization. Remembering that a large number of retired people are better covered by private plans, contributions had to be made to ensure continued viability of those private plans. Also, the privatization experiments do not begin until 2010 in six cities to see if there is a private alternative to hold down increasing Medicare costs.

This is, of course, not perfect legislation. I would have liked to see the federal government use its purchasing power to buy medications wholesale from drug companies, as states do under Medicaid. It would also be better if the program (especially the discount drug cards now being offered) were simplified.

But it seems to be a good start. Keep in mind that the Democrats controlled the White House and parts of Congress for eight years recently and did nothing.

Finally, I would like to encourage all patients to be proactive when it comes to their health care. Discuss with your doctor your options, and discuss with them generic and over-the-counter medications, which today are often as effective and far cheaper than expensive brand-name ones. This will help to keep down the soaring drug costs to which many seniors are subjected.


Dr. Paul J. Nugent is a family physician in Cincinnati.

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