Fresh from his populist rebirth at the Democrats convention, Vice President Al Gore is traveling from town to town railing against the "big drug companies" and arguing that "no senior should have to choose between food and prescription drugs."
To prevent seniors from having to make this decision, Gore is pledging to add a prescription drug benefit onto Medicare. While his plan, if ever enacted, would arguably be bad news for seniors and for Medicare itself, Gore has been marginally successful in portraying himself as fighting for seniors. And his rise in the polls proves one of the most essential rules in all of politics: you can't beat a plan, no matter how bad it is, with no plan.
Sensing this, Republican candidate George W. Bush recently spelled out an innovative new approach that would give seniors a choice under Medicare among several competing plans and would ensure that all seniors have access to valuable prescription drugs.
As he had done with Social Security before, Bush has outlined an approach to Medicare that is significantly different from the thinking that usually permeates throughout Washington. First it recognizes that Medicare is going broke, fast. Any drug benefit therefore, that is not apart of a comprehensive reform of Medicare itself, like Gore's proposal, will only add to Medicare's problems and speed up its day of reckoning – already set at 2025.
The centerpiece of Bush's Medicare reform proposal is choice. Bush would begin by guaranteeing that every senior is entitled to the current set of Medicare benefits. But unlike Gore, who would only give seniors the option of taking the government's drug benefit or not, Bush would give all seniors a number of options, so that they can choose a plan that most appropriately fulfills their needs.
Some plans may be traditional fee-for-service plans, others may be networks run by doctors, but whatever the makeup of the individual plans, each must offer a minimum Medicare benefit and can add additional benefits and services to compete for customers. Most importantly, every health plan that participates in Medicare must offer coverage for prescription drugs.
In addition to ensuring that seniors can choose among competing health plans and that prescription drug coverage is included in all of the options, Bush would make sure that every senior will get assistance to make the coverage affordable. For example, seniors with incomes less than $11,300 ($15,200 for couples) won't have to pay a premium under Bush's plan and will get prescription drug coverage at no additional cost. Those just above that level will get a substantial subsidy to help them afford prescription coverage, and all seniors, at every income level, will get help with at least 25 percent of their premiums for drugs.
Under Bush's proposal, the government would establish a set of guidelines that health plans must meet to ensure that the proper benefits are offered, and to provide seniors with clear information to compare the plans.
Bush also understands that this idea is a major undertaking, and as such, it may take awhile to be enacted and fully implemented. Gore's one-size-fits-all government-run plan would also take awhile to enact and fully implement – in fact if all goes according to Gore's plan, the benefit starts partially in 2002 and slowly phases in through 2008. But unlike Gore, Bush realizes many low-income seniors cannot afford to wait for the political and bureaucratic machines in Washington. They need help now.
That's why in addition to Bush's comprehensive Medicare reform proposal he is proposing "Immediate Helping Hand." The idea is to start helping those senior in most need get their medications beginning next year. To do this, Bush would spend $12 billion a year in direct aid to low-income seniors in all 50 states. This would be an expansion of the drug assistance programs already established in 23 states.
Every senior with an income less than $11,300 — $15,200 for a couple – will have the entire cost of their prescriptions covered. For seniors with incomes less than $14,600 — $19,700 for couples – there will be a partial subsidy. With these large buying pools, Bush envisions that states will be able to negotiate for significant discounts on the drugs. In addition, Bush would make sure that no senior would pay more than $6,000 a year out of their own pocket for drugs.
With this proposal, Bush has once again proved that he can develop a common-sensed solution that empowers seniors, instead of making them wards of the state.
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