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To the chagrin of Republicans who helped pass it, Bush's drug plan has turned out to be one of the biggest new entitlement programs of the past 40 years. (It only won enough Republican support to pass Congress because the Bush administration lowballed the actual price.)
To call this an "entitlement program" is really to misuse the term and debase language. The whole damned law was actually deliberately set up as a mammoth combo poison pill - to eviscerate Medicare, while offering a gigantic corporate welfare bonus to Pharma. One Goldman Sachs estimate ca. 2003 put the corporate welfare tally at near $14 billion over ten years, from the time the Part D was implemented in 2006.
This detestable pile of offal also:
a) prevented the government from bargaining for the lowest drug costs as per the VA
b) disallowed the importation of all lower-priced Canadian drugs
c) Proffered "Medicare Advantage" plans as a private (and "superior")alternative to standard Medicare. More than 40% are now on these "Advantage" plans which have but one purpose - to bleed Medicare into insolvency. (Taken as the point when Medicare's liabilities exceed 50% of its assets).
Last year alone, according to a GAO report, the MA plans cost nearly $12 billion more than standard Medicare, and this for a smaller served population.
At this rate, the GAO estimated that unless the MA plans are forced to pay higher premiums, they will power Medicare into insolvency before 2012.
Meanwhile, seniors can't catch a break and have to parse some 1,230 plans each year to try to snag the most eocnomic deals. Each year also the plans change benefits, costs etc. and what may have been a bargain in year one, will force a senior into the "doughnut hole" by year three. Thus, to get this so-called benefit seniors much jump through endless hoops.
In Barbados, meanwhile, a senior already on the National Insurance system (99% of all Bajans) simply signs up on the National Formulary and received all needed drugs for one low copay of $5. Of course, much higher taxes are paid, but the rank and file of Bajans consider it as worth it. They believe - and I agree having lived there - tis better to pay the higher taxes upfront than to try to surmount and keep up with all the medical costs later.
Dr. Nancy Sniderman yesterda a.m. on 'Morning Joe' referred to the "cheapness of Americans" and reluctance to pay higher taxes to support a decent medical care-delivery system for all. She also referred to HMOs as "raping the health delivery system".
That 2003 Medicare bill "rapes" most seniors who sign onto it despite all efforts to avoid it.
It is one of the things Mr. Obama needs to change soonest, if he is serious about controlling "entitlement" spending.
