Drug Benefits That Work

Like an effective tonic misplaced at the back of the medicine chest, the idea of adding a prescription drug benefit to Medicare has been gathering dust since both parties shelved it after the 2000 election. In his State of the Union speech Tuesday, President Bush called for more affordable prescription drugs. He had already told legislators he wanted to set aside $77 billion over 10 years to help states provide prescription drug coverage to people in families with incomes of up to about $20,000 a year. The president has also asked Congress to shell out an additional $113 billion over 10 years for a still murky “comprehensive Medicare reform” plan that would give a prescription drug benefit to all seniors in Medicare.

Now legislators should press Bush to improve his plans before he finalizes the 2003 budget proposal he will submit to Congress next Monday. Leaders of both parties have already promised to set aside at least $100 billion more than the president has proposed. The challenge will be to do more than fling money at a problem that voters are eager to see remedied. At a minimum, congressional members must ensure that the plan meets these two basic goals:

* Washington must cover all drugs that doctors deem medically essential. The current Bush plan would let states decide which drugs should be covered. This could encourage state legislators to spend erratically, funding drugs for a favorite disease of the month at the expense of other treatments--paying for Viagra, for instance, but not for infertility treatments, as California’s managed care agency once recommended.

* Give the neediest middle-class Americans relief from soaring drug costs now. Under the Bush plan, states could use some of the $77 billion to help low-income Americans as early as this fall, but they wouldn’t receive a penny of the $113 billion until fiscal year 2006. That’s scant comfort to the thousands of working-class families that every year teeter on the edge of bankruptcy to pay for the medicines their loved ones need to stay alive. What’s needed is a new “catastrophic drug benefit” to help the sickest Americans, not just those in families making less than $20,000 a year.

These families’ hardships are likely to grow with the recession and the increasing cost of drugs. When 77 million baby boomers start retiring in 2010, things will only get worse. That’s why Congress and Bush must stop playing at reform and commit serious time and money to the problem now, even if it is more fun to bask in foreign policy triumphs and patriotic fervor.