Medicare Debacle

Over at Talking Points Memo, they've started a new special-purpose blog to cover the Medicare Part D debacle, called, conveniently enough, the Drug Bill Debacle Blog.

The first post, by Kate Steadman, does an excellent job of explaining the history and details behind Part D: The A, B, D's of Medicare.

But no clause in A or B covered prescriptions. The pharmaceutical industry as we know it today was non-existent in 1965 -- few effective pharmaceuticals had been developed and the majority of health care costs came from hospitalization and surgery. A drug benefit wasn't necessary and would have only compounded the political hurdles getting government-sponsored health care passed in the first place.

And the second post, by Ezra Klein, "expand[s] on the genesis and corporate rot of the Medicare Drug Benefit," in Corruption Matters.

A normal drug benefit would, as Kate said, simply tack on prescription coverage to Medicare Part B, paying a portion of pharmaceutical costs as part of the outpatient benefits. Medicare could then use its massive size and market share to bargain down drug prices, ensuring affordability and long-term savings over the fractured, smaller private system. But the two losers in that equation -- private insurers and pharmaceutical companies -- were the two with access to Congress, and so the bill takes precisely the opposite approach, choosing to involve and enrich the affected industries rather than achieve savings, comprehensive coverage, or simplicity.

Together these two stories provide a perfect case study of what we get under Republican "leadership", even in the life-and-death area of medical care for seniors: cronyism, corruption and incompetence. As Klein notes,

The Medicare Modernization Act was the K Street Project in action... The bill is a mess of bad policy and industry giveaways, and even once the initial administrative hitches calm, the prices will remain exorbitant, the benefit will remain labyrinthine, and the stories of seniors falling ill only to find their plan lacks coverage for their treatment will remain common.