Emphasizing Accountability For Seniors On Election Day

Access to health care coverage will certainly play a role in the upcoming presidential election on November 2. At the end of last year, President Bush signed the Medicare reform bill into law (see “Medicare Reform: Just More Smoke And Mirrors?,” page 14, February issue). Aside from the significantly underestimated cost of the Medicare reforms, people on Medicare are not exactly thrilled with the new law, according to a recently released survey by the non-partisan Kaiser Family Foundation. Nearly half of seniors and non-elderly people with disabilities on Medicare have an unfavorable view of the Medicare law while a quarter of respondents say they don’t know enough about it to have an opinion and a quarter of respondents view it favorably. Among those who view the Medicare reforms unfavorably, 72 percent say the changes are too complicated for people to understand and 81 percent say the new law does not provide enough relief with drug costs. Nearly half of the Medicare recipients polled say the Medicare reforms cater more to drug companies than people on Medicare. Another aspect of Bush’s Medicare legislation is the much ballyhooed prescription drug benefit plan that goes into effect in 2006. However, the early word about model formulary guidelines is not promising. Critics of the initial draft by the United States Pharmacopeia (USP) say the guidelines have too many classes of drugs (146), which hampers the negotiating position of health plans. Even the pharmaceutical companies were highly critical of the draft guidelines. According to a recent amednews.com article, Richard Smith, a senior vice president for policy, research and strategic planning at the Pharmaceutical Research and Manufacturers of America (PhRMA), noted that “a prescription drug plan’s formulary could fully comply with the USP draft model while omitting numerous types of medicines that patients need and use, and that physicians prescribe.” The USP, which has contracted with the Centers for Medicare and Medicaid Services (CMS) to develop these guidelines, emphasizes that the draft guidelines are a work in progress. Who holds sway over these, ahem, “works in progress”? Consider the drive behind the Medicare reforms. A February 2004 article on the Web site of media watchdogs Fairness And Accuracy In Reporting (FAIR) revealed the powerful influence of campaign contributions. Citing numbers from the Center for Responsive Politics, the article noted that Republicans in the House of Representatives who voted for the Medicare legislation received “three times as much” money from pharmaceutical lobbyists than Republicans who did not support the legislation. The Democrats who supported the Medicare legislation received “more than twice” the campaign contributions from the health insurance lobby than those Democrats who were against the legislation. To his credit, Democratic presidential nominee John Kerry reportedly voted against Bush’s Medicare package last year because he wanted to see more benefits for seniors, according to a Houston Chronicle article. However, a Washington Post article notes that the senator missed the vote on the final passage of the Medicare prescription drug bill. The Bush campaign has cited Kerry’s history of missing votes in the Senate and the lack of a strong rebuttal from the Kerry campaign on this issue is certainly troubling. I harbor no illusions about the possibility of genuine change within the current two-party system but it would be nice to see the candidates have more accountability to their constituents. According to the Kaiser Family Foundation survey, nearly a third of those polled say the passage of the Medicare law will have an impact on their vote. Let us hope their voices will be heard on November 2.