[Congressional Record Volume 146, Number 124 (Friday, October 6, 2000)]
[House]
[Pages H9454-H9455]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WHAT IS BEHIND OPPOSITION TO THE DEMOCRATS' MEDICARE PRESCRIPTION DRUG
PLAN
The SPEAKER pro tempore. Under a previous order of the House, the
gentleman from Ohio (Mr. Brown) is recognized for 5 minutes.
Mr. BROWN of Ohio. Mr. Speaker, earlier this year a confidential
document prepared for House Republicans somehow found its way into the
public realm.
It was not big news at the time, just some talking points prepared by
Republican polling firms on the Democrats' Medicare prescription drug
plan.
According to their analysis, one way to create opposition to the
Democratic plan is to call it a one-size-fits-all plan or a big
government plan.
{time} 1445
One cannot blame the public for bristling at those phrases. I do not
know
[[Page H9455]]
anyone who likes big government for big government's sake. However, one
can blame politicians for exploiting those terms instead of confronting
the fundamental differences between the Democratic and Republican
prescription drug plans. One can blame the drug companies and the
chamber of commerce for spending $40 million already and promises of
another $40 million on phony groups on television such as Citizens for
Better Medicare.
The Democrats plan would add an optional drug benefit to Medicare.
The Republican plan, the drug company plan, would bypass Medicare and
subsidize private, stand-alone insurance plans.
So is the Democrats' Medicare prescription drug coverage a one-size-
fits-all program as the Republicans and the prescription drug companies
tell us? I do not think so.
It is difficult to conceive of a program offering more choice than
Medicare. The Medicare program covers medically necessary care and
services. Beneficiaries can see the health care professional and go to
the facility of their choice.
Similarly, under the proposed drug benefit, enrollees can go to the
pharmacy of their choice. FDA-approved medications prescribed by a
physician would be covered under the Democrats' Medicare prescription
drug plan.
Given this level of flexibility, how would a legion of new private
health plans enhance the beneficiary's choice in any way that matters?
It is more likely that the Republican plan, the prescription drug
company plan, like any other managed care product, would restrict
choice and add to the insurance and drug company's bottom lines.
Medicare is a single plan that treats all beneficiaries equally,
provides maximum choice and maximum access for patients and doctors.
The Democrats' prescription drug coverage proposal embraces the same
principle. Is that a one-size-fits-all program?
Under the Republican prescription drug proposal, under the drug
companies' plan, Medicare beneficiaries would have to choose among
private stand-alone insurance company prescription drug plans. They say
that enables seniors to tailor their prescription drug coverage to
their particular needs.
None of these private plans, however, will provide more choice to the
Democrats' plan than the Medicare plan in terms of which medications
are covered since the Democrats' plan covers all Medicare doctor-
prescribed medications. None of these private plans could provide a
broader choice of pharmacy since the Democrats' plan does not restrict
access to pharmacies.
Under the Republican plan, under the prescription drug company plan,
it appears that choice is actually code for ``wealth.'' Higher-income
seniors could, in fact, afford a decent prescription drug plan, one
with the same level of coverage as would be available to all
beneficiaries under the Democrats' Medicare plan. Lower-income
enrollees, however, would be relegated to restrictive alternatives.
Some choice.
Is the Democrats' prescription drug coverage plan a big government
program as the Republicans and the prescription drug companies'
executives tell us? Hardly.
Medicare is a Federal Government program with the beneficiary
population of 39 million. It is definitely big. But Medicare is also
one of the most enduring popular public programs in the Nation's
history. Medicare far outranks both employer-sponsored and individually
purchased private insurance as a trusted source of health care
coverage.
So when opponents of the Democrats' prescription coverage plan berate
it for being one size fits all or big government, they, in fact, are
berating Medicare itself.
In fact, the Republican prescription drug proposal, the plan from the
big drug companies, which ignore Medicare to establish new private
insurance policies, is an insult to the Medicare program. Their plan
pays homage to those Members of Congress who favor privatizing
Medicare. Parenthetically, I have to say I have not yet met anyone
outside of Washington who wants to privatize Medicare.
It is no coincidence that the only way a Medicare beneficiary could
avoid carrying multiple health insurance policies under the Republican
plan, under the prescription drug company plan, is to join a private-
managed Medicare-managed care plan.
As Congress and the presidential candidates debate the merits of
competing prescription drug coverage proposals, watch for allegations
to be thrown around like one size fits all and big government program.
Because when applied to insurance coverage offering maximum choice in
matters that matter, choice of provider access to medically-necessary
care, which is what Medicare is all about, those, those threats, those
accusations of one size fits all and big government program, those
terms simply fall flat.
Bear in mind that more than the structure of prescription drug
benefit is at stake. The future of Medicare hangs in the balance.
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