Pricey Prescription

WASHINGTON TIMES
11/28/2003

Pricey prescription


By Debra J. Saunders



    There are reasons to support the Medicare bill, passed by the
House and the Senate. Poor seniors should get relief they desperately
need. Congress should reverse a pending 1.5 percent reduction in
payments to physicians who care for elderly patients.
    Still, Tom Coburn would have voted against it. 
    Dr. Coburn is an Oklahoma physician who was elected to the House
in 1994. He continued to practice family medicine and obstetrics while
he served as a Republican congressman, until 2000 when he chose not to
run for re-election, in keeping with his campaign pledge to serve only
three terms.
    Taking a break from his patients — and from promoting his new
book, "Breach of Trust, How Washington Turns Outsiders Into Insiders"
— Dr. Coburn got on the telephone to give his take on the bill. As he
sees it, the Medicare bill is another big-spending bill from a
big-spending Republican-led Congress and a big-spending Republican
president.
    "It's pretty sad, isn't it? There's not a choice any more about
controlling the size of the federal government. It's not Democrat vs.
Republican," said Dr. Coburn. It's careerist vs. non-careerist, and
the careerists carry the day.
    "I deal with seniors every day who have to make a choice between
supper and their medicine," Dr. Coburn added. He wants the government
to do something, but he believes regulators should reduce what drug
companies charge American consumers. I doubt his prescription would
work — but at least Dr. Coburn's plan would not inflate the national
debt.
    The bill's $400 billion price tag isn't credible. For one thing,
Washington inevitably will expand benefits — that's why the AARP
supports the bill. It's the camel's nose in the tent.
    As the bill stands, seniors who earn less than $12,123 annually
would not have to pay premiums or deductibles. That's good. But other
seniors who enroll in the program would pay a $35 monthly premium, a
$250 deductible and a co-payment of 25 percent for the first $2,250 in
drugs each year. Seniors would then pay all of the next $2,850 in drug
costs — this gap is called the "doughnut hole," because there are no
benefits in the middle — until they pay $3,600, when Medicare would
pick up 95 percent of remaining drug costs.
    As the fiscal-watchdog Concord Coalition argues, there's no policy
reason for the doughnut hole. It exists solely to keep the tab under a
$400 billion limit. Which means, Dr. Coburn and the Concord Coalition
warned, it's inevitable that Congress will boost benefits and fill the
hole.
    Then, some day, Congress will have to increase the payroll taxes
of 25-year-olds to bankroll the drug bill for seniors who think that
only other people should have to pay for their medicine.
    President Bush was right to ask Congress to authorize $87 billion
in spending to fund military operations in Iraq and Afghanistan. But
the move seems to have made him feel a need to boost domestic
spending. He's so anxious to get the credit of giving other people's
money to seniors during the 2004 campaign that he has forgotten about
the future beyond the campaign. House Republicans were so eager to
pass the bill before the election heats up that they gave billions to
private employers and care providers. Anything for a win.
    As Stephen Moore of the tightwad-right Club for Growth noted,
"Republicans have lost their fiscal conscience. It's not true that we
have an anti-big government party. We have two big-government parties,
and they're in a contest to see who can outspend the other. This is
putting us on the path to national bankruptcy."
    Congress should have passed a bill to provide prescription drug
coverage for poor seniors. Instead, it was goodies for all. No senior
voter left behind.
     
    Debra J. Saunders is a nationally syndicated columnist.