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.
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