GOVERNMENTGOP may tap private sector for Medicare drug benefitsLawmakers believe competition among drug plans to sign up beneficiaries would keep costs down.By Markian Hawryluk, amednews staff. May 6, 2002. Washington -- With prescription drug prices on the rise, House Republicans and the Bush administration are turning to private-sector approaches in an effort to make a Medicare prescription drug benefit affordable. At an April hearing, Ways and Means Committee Chair Bill Thomas (R, Calif.) spelled out his principles to establish prescription drug coverage for Medicare beneficiaries. "We really should rely on the private-sector innovation in delivering the drug benefit," Thomas said. "The Congressional Budget Office has certified that the private-sector approach on controlling drug prices really delivers the most savings per prescription." Thomas said he planned to rely on private-market competition under which competing drug plans would be required to provide actuarially equivalent coverage. The benefit would presumably include significant cost sharing for most beneficiaries but is expected to provide some sort of stop-loss coverage. Beneficiaries would be able to choose whether they wanted to enroll in the plan. Additionally, there seems to be a consensus among lawmakers that low-income beneficiaries should be provided additional assistance to ensure that the drug benefit is affordable. But while the government has allowed states to provide drug benefits to low-income seniors through Medicaid waivers and other programs in the past, Thomas said the new drug benefit should be national in scope and not rely on states' willingness to cover low-income seniors. Thomas is also interested in placing limits on direct-to-consumer drug advertising, which he believes is fueling the rise in spending on prescription drugs. One proposal circulated on Capitol Hill would provide higher reimbursements for those drugs that were not marketed to consumers.
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Copyright 2002 American Medical Association. All rights reserved.
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