Bush Plan Rx Discounts for Seniors. Part 1

President George W. Bush Thursday fired the opening salvo in the latest round of debate over a proposed Medicare prescription drug benefit by announcing a new plan that will allow seniors to sign up with private companies to get discounted medications.

Administration officials said that by November seniors could start using the plan to save 15% to 25% on their prescriptions after paying up to $25 to join. The president described the program as an initial step in improving the elderly’s access to medicines, saying that Congress still must enact a permanent Medicare cheap prescription drug benefit.

“It is a first step, and it is not a substitute for a drug benefit,” Bush said at a White House ceremony Thursday.

Millions of American seniors already have access to drug discount cards through retail pharmacies or through membership organizations like the AARP. About 14 million elderly or disabled Medicare beneficiaries currently lack prescription drug coverage.

The plan drew immediate fire from Democrats, who accused the president of making superficial gestures while Congress is busy trying to negotiate an agreement on permanent drug coverage for Medicare’s 39 million beneficiaries.

“I think it’s a redundant benefit that may offer the seniors the false hope that they are going to get some real relief” without a new Medicare benefit, Senate Majority Leader Thomas A. Daschle (D-ND) said in an interview.

“It really gives people nothing more than is already available to them,” said Sen. John D. Rockefeller, a leading Democrat on the Senate Finance Committee.

The discount program will not be offered through Medicare. Instead, private corporations called pharmacy benefit managers (PBMs) will be allowed to sell seniors discount cards bearing the Medicare logo. Seniors could use the cards at participating pharmacies or with mail-order drug retailers to get discounts.

Private insurers across the country already use pharmacy PBMs to administer their prescription drug benefits. PBMs offer discounted drugs by buying them from manufacturers in bulk or by agreeing to promote certain companies’ drugs while restricting access to similar drugs manufactured by competing firms.

PBMs also try to hold down costs by monitoring physicians’ prescribing patterns and disapproving what they deem to be excessive prescriptions.

“I would not expect to treat the Medicare population any differently than we treat the commercial population,” said Mac Crawford, the CEO of Caremark, one of five PBMs that have agreed to run the program under government supervision.

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