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Make drug coverage part of Medicare

ASK ANY RETIREE his or her top concern and chances are the answer will be the high cost of prescription drugs.

All too often, seniors of modest means cut back or even stop taking drugs because they can't afford to pay for them. Others see their disposable income evaporate when they reorder high-cost pills every month.

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Both Republicans and Democrats are pushing election-year plans to address this growing problem. But the GOP version appears unrealistic both politically and practically.

Republicans insist that private health insurers, not the government, should offer subsidized prescription-drug programs to seniors. That's fine in theory. That's the way the free-market, competitive system should work.

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But some congressional Republicans concede that it's an unworkable approach. Not everyone will sign up. Even health-insurance companies oppose this plan: They know there's little or no profit in it for them, but plenty of administrative headaches.

The best way to handle a prescription-drug program is through the existing Medicare system. This could be done simply. It would be easy for seniors to use and understand. And it would give the Health Care Financing Administration in Woodlawn the financial muscle to negotiate lower prescription-drug prices.

That's why drug companies support the Republican approach so vigorously. They know that a privatized prescription-drug program for seniors won't affect their operating margins, but that an HCFA-run program could lead to lower drug prices - and less profit for the manufacturers.

The Republican plan should be rejected when the House votes on this issue in the coming days. A more sensible approach, championed by Democrats, would be tying prescription-drug subsidies to the existing Medicare program. Then the GOP could negotiate other details - such as monthly premiums, co-pay, deductibles, maximum out-of-pocket expenses - with the White House.

President Clinton signaled Monday he is willing to make a deal with Republicans. If the GOP truly wants to solve this problem, now is the time to seek common ground with Democrats. Otherwise, they run the risk of angering seniors - who will have a clear response in November.


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