Start of a drug plan

Even if the Senate were to pass the skimpy prescription-drug bill similar to the one the House narrowly approved last week, there is little chance it will find enough support to overcome the promised veto by President Clinton. But the fact that Republican House leadership knew it had to present something to voters on this issue suggests an opening for proponents of a serious drug plan under Medicare.

As important, Friday’s announcement that Medicare Choice HMO plans will drop 711,000 elderly and disabled Americans, including 1,705 in Maine, at the end of this year suggests that even more seniors are soon to need a way to afford medication.

Whatever exact shape that plan finally takes, it will have to contain at least two elements — sufficient need-based coverage, so that even seniors of modest means can purchase medicine, and lowered drug pricing, to allow the program to reach as many people as possible. Maine Sen. Olympia Snowe and Rep. Tom Allen have been working at either end of these requirements; the Clinton administration has made a sound attempt with an $80 billion program, as the president has shown a willingness to trade elimination of the marriage tax for support of this plan. But, with the exception of Rep. Allen’s proposal, continued reverence for the pharmaceutical industry has prevented anyone from wondering whether the industry’s record profits at a time when Americans are dying for lack of affordable medication should be examined.

Members of Congress understand this contradiction, and the recent movement to provide a drug benefit under Medicare after so many failed attempts to do so is significant. Even so, last week’s effort by House leadership had several flaws, ably pointed out by Rep. Greg Ganske, a Republican from Iowa and a surgeon. “If you let plans design all sorts of benefit packages, as does the GOP plan,” he said recently, “it becomes very difficult for seniors to be able to compare … equivalency of plans in terms of value. I also think that plans can tailor benefits to cherry-pick healthier, less expensive seniors and game the system.”

Currently, the prescription-drug system games Americans this way: People without health insurance pay 20 percent to 40 percent more for drugs than health maintenance organizations, more than federal agencies such as the Veterans Administration and Medicaid and more than people in Canada, Mexico and Europe. Without adding administrative costs to government, without a massive addition of tax dollars, federal negotiation on senior drug costs to eliminate the current disparity makes sense. As Congress hurries toward adjournment, Maine’s delegation would do well to demand that drug prices come down as coverage increases.