WASHINGTON -- It's back.
Pharmacy retailers concerned about the impact of prescription discount cards on their profit margins should heed the words of Casey Stengel. When it comes to the Bush administration's unsuccessful attempt last fall to impose a federal discount card on the nation's pharmacies, it's deja vu all over again.
With the release of the fiscal 2003 federal budget last month, it became clear that the Medicare prescription discount card is again on the table. And with the president and other federal officials signaling their determination to implement the card plan as an election-year boost to uninsured seniors, the card may be difficult for pharmacy groups to derail.
Within the government's $489 billion spending plan for the Department of Health and Human Services is a provision for long-overdue prescription drug benefits for seniors on Medicare. But while HHS secretary Tommy Thompson called those benefits "a central part of the president's framework for strengthening Medicare," he also said one of his department's primary elements this year would be the rollout of a stopgap pharmacy discount card in lieu of long-term Medicare reform.
"As you know, last year the president proposed the creation of a new Medicare-endorsed prescription drug card program to reduce the cost of prescription drugs for seniors," Thompson said in testimony before the House Ways and Means Committee Feb. 6. "This year, HHS will continue working to implement the drug card, which will give beneficiaries immediate access to manufacturer discounts on their medicines and other valuable pharmacy services. The president is absolutely committed to providing immediate assistance to seniors who currently have to pay for prescription drugs."
The Bush discount card plan immediately touched off a firestorm of protest among the nation's chain and independent pharmacy groups. Bush presented the plan as an interim step to provide at least some prescription drug benefits to uninsured and low-income seniors while Congress wrangles with a comprehensive, long-term overhaul of Medicare and real prescription plan coverage.
Thompson called the lack of drug coverage in the current Medicare program "just one example of its outdated benefits," and he pledged to work to enact the Bush administration's plan to overhaul the program to reflect the realities of modern health care and prevention. High on that list, he said, is the need for a drug program for uninsured seniors.
Drug retailers are generally very supportive of a drug benefit, but decry the discount card plan as a political ploy that won't substantially reduce seniors' drug costs. Craig Fuller, president and chief executive officer of the National Association of Chain Drug Stores, warned NACDS members about the resurgence of the federal discount card plan at last month's Regional Chain Conference in Key Biscayne, Fla. "As soon as our guard is down, this bad idea will slip back in," he said. "We simply cannot afford for that to occur."
The card program, Fuller added, "wasn't a real pharmacy benefit for seniors--and it stuck our industry with the bill." Pharmacy leaders also object to the plan's lack of a provision for payment for any pharmacist services.
The White House spending plan allocates $190 billion over 10 years for targeted improvements and comprehensive Medicare modernization, including a subsidized prescription drug benefit, better insurance protection and better private options for all beneficiaries, Thompson said. Included in that funding are $20.7 billion over five years and $77.1 billion over 10 years for "instituting a transitional low-income drug benefit," he added.
"Right now, Medicare covers only 53 percent of the average senior's annual medical expenses, and the program's benefit package has not kept pace with advances in medication and treatment," the HHS chief said. "The bottom line is that we need to provide a prescription drug benefit [for seniors] this year."
Thompson said the drug discount card is just one of a range of proposals for overhauling Medicare that are found in the HHS budget. The administration, he said, also proposes to allow states to expand drug coverage to Medicare beneficiaries up to 100 percent of the poverty level at current Medicaid matching rates, much like existing programs that subsidize Medicare premiums and cost-sharing for low-income Medicare beneficiaries. In addition, he said, the budget would allow Medicare to pay 90 percent of the cost of expanding coverage for beneficiaries between 100 percent and 150 percent of the poverty level, with the states being responsible for the remaining 10 percent.
The HHS budget also provides for a massive increase in funding for research to combat threats of bioterrorism. The Bush plan calls for a sixfold increase in funds for the effort to nearly $1.8 billion.
U.S. health care budget for 2003
(partial list of spending requests)
Department Request for Change vs.
program total fiscal 2003 (*) FY 2002
CMS total $397,335 +$22,600
Medicare 259,989 +8,131
Medicaid 158,692 +13,941
Food and Drug Administration total 1,727 +123
Drugs total 476 +93
Office of Generic Drugs 46 +5
Prescription Drug User Fee Act 272 +103
Food 430 +9
Bioligics 217 +35
Center for Disease Control and Prevention 5,765 -1,000
National Institute of Health 27,335 +3,712
Substance Abuse and Mental Health Services 3,198 +57
HHS total budget 488,800 +29,200
Source: Department of Health and Human Services
(*)Dollar amounts in millions
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COPYRIGHT 2002 Gale Group
