Kaiser Daily Health Policy Report Rounds Up Medicare Editorials, Opinion Pieces

The Kaiser Daily Health Policy Report on Tuesday features editorials and opinion pieces that address several issues under consideration by negotiators charged with reconciling the House and Senate Medicare bills (HR 1 and S 1), such as provisions that would require beneficiaries with higher annual incomes to pay higher premiums for outpatient services under Medicare Part B than other beneficiaries (Kaiser Daily Health Policy Report, 10/7). Summaries of the editorials and opinion pieces appear below.

Editorials

• Daytona Beach News-Journal: Raising Medicare premiums for wealthier beneficiaries "seems appealing," but it represents a "retreat from the notion of Medicare as a universal program that covers all seniors equally," a News-Journal editorial states. To fund a new drug benefit, Congress should instead consider a tiered tax structure for the Medicare payroll tax that would charge higher rates on higher incomes, the editorial maintains (Daytona Beach News-Journal, 10/9).
  


• Des Moines Register: Increasing Medicare premiums for all beneficiaries would be a logical way to offset rising costs and pay for reforms lawmakers wish to enact, a Register editorial states. Although Congress is "finally acknowledging" that someone must pay for Medicare with its proposals to raise premiums for higher-income seniors, the Register notes it is "unlikely any politicians are gutsy enough to propose" that all Medicare beneficiaries -- their "most reliable voters" -- pay higher premiums. The Register concludes, "But it makes sense. Medicare has to be paid for. It stands to reason seniors pick up more of the cost of their own coverage" (Des Moines Register, 10/14).
  


• Minneapolis Star Tribune: "A good deal" of the money set aside for Medicare reform "will flow to drug manufactures and insurance companies" under two provisions being considered, one of which would ban the government from negotiating drug prices for beneficiaries, while the other would offer financial and enrollment incentives to insurers to create Medicare preferred provider organizations, a Star Tribune editorial contends. The editorial states that Medicare "has used volume discounts with doctors and hospitals very effectively to control costs, ... and there is no reason it shouldn't do the same with drug prices." In addition, the Star Tribune writes, incentives for insures could create an "uneven playing field" between national for-profit insurers and local not-for-profit insurers, as well as "balkanize" the Medicare market by pushing healthy beneficiaries into private plans while leaving poorer and sicker patients with not-for-profits or traditional Medicare (Minneapolis Star Tribune, 10/13).
  


• Providence Journal: Opponents of tying Medicare Part B premium rates to income contend that it would set a "dangerous precedent" and cause the program to be viewed as welfare; however, "Medicare is welfare," and there is "nothing inherently wrong" with charging wealthier beneficiaries more, a Journal editorial states (Providence Journal, 10/12).
  

Opinion Pieces

• John Fox, Washington Post: Although the prescription drug benefit proposals in the House and Senate Medicare bills "arise from good intentions," they contain "worrisome flaws" that would leave "millions of low- and moderate-income seniors still unable to afford most of their prescription drugs while subsidizing millions who don't need any aid," Fox, a professor at Mount Holyoke College, writes in an opinion piece. "Even more worrisome," Fox adds, "is the simple truth that, whatever program the House and Senate conferees finally vote into existence, it will be a program that America just plain can't afford." Conferees should make their first priority assuring "seniors in need that they can buy the drugs they require," Fox writes, stating that only then should negotiators consider whether the "prescription drug program should be extended to all seniors" (Fox, Washington Post, 10/12).
  


• Robert Goldberg, Washington Times: "Genuine Medicare reform" is "being poisoned to death by politicians" who want to provide "importation legislation" -- which would allow the reimportation of lower-cost U.S.-made prescription drugs from Canada and other industrialized nations -- "that reduces the prices and profits of drug and biotech firms," Goldberg, director of the Manhattan Institute's Center for Medical Progress, writes in an opinion piece. Supporters' claims that "importation will save half of what insurance companies, government and consumers spend on medicines is laughable," Goldberg writes. He adds the policy would cause problems in the United States similar to those in Europe, including limited access to medications and "significant cost[s] in patient health" (Goldberg, Washington Times, 10/9).
  


• Ramon Castellblanch, Hartford Courant: The claim that it is "fairer" to charge higher-income seniors extra for Medicare Part B is an "illusion," Castellblanch, an assistant professor of health education at San Francisco State University, writes in an opinion piece. The policy would drive out not only wealthier seniors -- who "would be able to get better deals in the private market" -- but also middle-income seniors, which would eventually result in increased costs for the government as traditional Medicare cares for the older and sicker patients left in the program, Castellblanch writes (Castellblanch, Hartford Courant, 10/10).
  

USA Today Point-Counterpoint

• USA Today: The "singular focus" on creating a prescription drug benefit under Medicare is "dangerous" because it diverts attention from the "more pressing" health issue of providing coverage to the nation's uninsured, a USA Today editorial states. Although the Census Bureau last month estimated that the number of uninsured people in American increased by two million, to 43.6 million, between 2001 and 2002, Congress is "concentrating its energies on further enhancing benefits for seniors," and lawmakers have "failed to put broader solutions on the calendar," according to USA Today. The editorial states that a "national conversation" on covering the uninsured is "long overdue," because "ignoring the problem won't make it go away." USA Today concludes, "That conversation can't be heard ... when it's drowned out by all of the noise generated by a flawed senior drug bill" (USA Today, 10/14).
  


• William Novelli, USA Today: It is the "ultimate false choice to pit one deserving cause against the other," and the country should not have to choose between providing prescription drug coverage under Medicare and finding ways to cover the nation's 43.6 million uninsured, AARP CEO Novelli writes in a counterpoint in USA Today. Novelli notes that the United States "can do more" to provide coverage for the uninsured by opening existing public health programs to more people or seeking other solutions, but a "vital first step" to improving health care in America would be to "take advantage of what may be our last opportunity for years" to add drug coverage to Medicare. Novelli concludes, "We can't turn away from the immediate opportunity and pressing need to add prescription drug coverage in Medicare" (Novelli, USA Today, 10/14).