Pharmacists insist on stopgap prescription drug aid


WASHINGTON -- Otto von Bismarck, not known as a strong champion of the democratic process, once aptly observed: "Laws are like sausages, it is better not to see them being made."

While there is little debate in Washington over whether prescription drugs should become part of the benefit package for Medicare beneficiaries, the legislative branch in Washington certainly looked a lot like a sausage factory as Congress tackled the contentious issue of finding -- or at least looking as if it was finding -- a way to provide prescription drug coverage to seniors.

The apparent division between Republican and Democratic proposals is so great that it threatens to overwhelm the policy discussion needed to accomplish comprehensive Medicare reform.

On one hand, the marketplace insurance-based approach advocated by Republicans is characterized as unworkable by the very insurance industry on which the GOP pins its hopes.

Conversely, the Democratic plan calling for a universal prescription benefit for all Medicare beneficiaries is viewed as too expensive. It is such an over-arching Medicare reform that many argue it should be part of broader debate on long-term comprehensive reform.

But there is another plan worth congressional consideration. It would give both sides a major point of accomplishment while providing real help now to needy seniors. Moreover, this "lifeline" would provide time for a more orderly approach to building a national consensus for the types of Medicare reforms that we may have to live with for many years.

As head of a national organization representing companies that operate more than 32,000 community pharmacies, I hear often from the 94,000 pharmacists who serve as front-line community health care providers about the plight of elderly patients.

They see firsthand the struggle of seniors having to choose between food and medicines because they lack prescription drug coverage for what have become increasingly complex and effective, but expensive, medications.

No American should have to make a choice between food and the lifesaving medications they need. Yes, prescription medication costs have risen in recent years with the many new drugs that have come on the market and increased utilization.

Yet, an estimated 13 million seniors have no coverage for prescription drugs. The majority of these are low-income and can't afford prescription insurance.

A coalition of groups representing community pharmacies and pharmacists, consumers and health insurance underwriters have allied behind a plan that could be implemented this year, providing crucial prescription coverage now for the most needy seniors.

Our plan, SenioRx Gold, would send federal funds to states to establish state-based and state-run drug assistance programs for low-income seniors (those in a single household with less than $16,500 annual income and $22,100 for an elderly couple).

Meeting the immediate needs of the neediest now would provide time for the next Congress -- and a new administration -- to tackle comprehensive Medicare reform, a process that if done right could take years.

Because SenioRx Gold is designed to sunset within five years, Congress would have to address comprehensive prescription coverage in overall Medicare reform. In the meantime, needy seniors would get much needed relief.

Stopgap coverage like the SenioRx Gold plan already enjoys overwhelming public support. Fifteen states now provide similar coverage to needy seniors, while 11 others have considered legislation in the past year to provide prescription drug coverage to this segment of the population. A recent study shows that 83 percent of Americans favor Congress acting now to provide states with funds to implement state-based prescription drug programs for the neediest of seniors.

President Clinton is right when he says that "no one creating the Medicare program today would think of doing so without prescription drug coverage." And House Speaker Dennis Hastert of Illinois is right when he says we need to meet the prescription drug needs of our seniors now.

The time to stop political posturing is now. As a matter of public policy, we should add prescription drug coverage for those most in need while we work to find the right way to accommodate an interim approach in comprehensive reform.

Craig L. Fuller is president and CEO of the National Association of Chain Drug Stores.

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