If an ounce of hypocrisy is worth a pound of ambition then Ron
Pollack, the head of Families USA, the liberal health care interest
group, is the most ambitious health policy wonk in Washington.
Pollack has been working overtime as a fierce critic of what’s
wrong with the new Medicare drug plan. On the surface it would seem
his attack stems from his belief that the program is too little and
too late. Indeed, he recently said, “When the Administration touts
that 25.4 million seniors now have drug coverage, it masks the fact
that the overwhelming majority of them — all but approximately 4.9
million — had drug coverage that was at least as good before the
program even began.”
But in 2000 Pollack thought coverage was so lousy he was moved
to say that “each year, it becomes increasingly difficult for
millions of senior citizens to pay for the drugs they need. Their
incomes remain fixed as they watch drug prices soar out of sight,
taking the promise of effective treatment with them.” Pollack
thought it such a big problem that he got President Clinton to
release a Families USA assault on drug prices at the White House as
part of the push for Clinton’s own Medicare drug benefit plan.
The coverage problem didn’t get any better in the intervening
years. In a 2003 national survey of Medicare beneficiaries age 65
and older, more than one-quarter reported no prescription coverage,
and nearly half of low-income seniors in some states lacked
coverage. Meanwhile, the proportion of Medicare beneficiaries ages
65-69 with employer coverage declined from 46 percent in 1996 to 39
percent in 2000. The proportion with drug coverage from an employer
declined from 40 percent in 1996 to 35 percent in 2000.
Paradoxically, despite thinking the coverage seniors now have in
the private sector is just fine, Pollack also believes that current
the Medicare program falls short of helping seniors. In a USA
Today editorial entitled (incredibly) “Benefit Will Harm
Seniors,” he objected to the fact that the new law prohibits
Medicare from bargaining on behalf of 42 million seniors — as the
Department of Veterans Affairs successfully does for veterans — to
get lower prices. And he believes that Medicare instead relies on
many private plans, none with the bargaining clout to secure
significant price concessions.
He blames the design on the pharmaceutical lobby’s desire to
protect profits. But he should blame Bill Clinton and the Democrats
instead, who in 2000 put forth a Medicare drug benefit that, as
Clinton noted as that time, “competitively selects private benefit
manager to deliver benefit to enrollees in traditional program,”
and instead of “government negotiating directly for prices (price
controls) the new benefit has privately-negotiated discounts,
gained by pooling beneficiaries’ purchasing power, for all drug
expenses.”
Pollack supported the private sector approach when Clinton was
pushing it but trashes it now. (He also had nothing to say when
Clinton proposed $59 billion in Medicaid cuts.) In fact, the Bush
plan is better. First, the Clinton prescription plan was scheduled
to kick in four years after it was to pass in 1999, not in two as
the Bush plan anticipates. Second, it covered a lot fewer people.
And third, the Clinton plan didn’t cover catastrophic drug
spending; it capped government spending at about $2,500 per senior
with some adjustment for inflation. The Bush plan covers all drug
costs over $3,600 a year.
But why let facts get in the way of distortion? Pollack claims
that “most tragically, only a tiny fraction of the low-income
seniors who could most benefit from the new program are now
receiving drug coverage.” Pollack said that in January when the
program was less a week old. Three months in, nearly 8 million
seniors, nearly half of them the 5 million low income seniors
previously with no drug coverage, have signed up for the Medicare
prescription drug benefit. On average, these individuals are saving
about $2,000 a year in drug costs. How tragic indeed.
Finally the private sector plans Pollack now hates are
protecting people against the cost of drugs. Eighty percent of all
seniors have chosen a plan with no deductible. Twenty percent of
seniors have chosen a plan covers all drug costs. In nine states
the average premium is $5 a month. In seven states, its less than
two bucks. The poorest seniors, the Medicaid seniors can switch
plans once a month to make sure they get the drugs they need at the
lowest price possible. And they can join managed care plans that
cover all their drugs for one flat fee.
For every dollar seniors use in new drugs they save Medicare and
themselves about 8 dollars in other health care spending. Best of
all, the more new drugs they use, the longer they live. Yet Pollack
supports a national drug formulary system like the one used by the
Veterans Health Administration that is associated with a decline in
life expectancy among seniors. Ron Pollack, advocate for the
elderly? That’s the biggest hypocrisy of all.
