Bush renews call for Medicare prescription drug card

Medication costs must be covered, pharmacy group says

The Bush administration may have failed in two attempts to offer a prescription drug discount plan, but that won’t stop it from trying again.

In an address on March 4 to an American Medical Association conference, President Bush outlined his budgetary plan for Medicare reform. Included in his plan is the administration’s newest proposal for Medicare prescription drug coverage.

Bush says his framework for Medicare reform gives seniors three choices:

  • Stay with the current Medicare system and receive help for prescription drugs. Bush proposes that the government issue a discount card that would reduce the cost of prescription drugs for every senior by 10-25%. Medicare also would provide an annual $600 subsidy to low-income seniors to pay for prescription drugs, plus it would set annual limits on the amount seniors would have to spend out of pocket on drugs at no additional premium.
  • Choose an enhanced form of Medicare. This option would include full coverage for preventive care, a comprehensive prescription drug benefit, protection against high out-of-pocket costs, and extra help for low-income seniors. Seniors would be able to choose their specialists, hospitals, and primary doctors. The fee-for-service arrangement would offer seniors choices similar to those now enjoyed by members of Congress, who are given a broad choice among competing health care plans, Bush says.
  • Choose benefits available in managed care plans, including prescription drug coverage. This option would place seniors in a network of doctors and would provide drug coverage.

As the program is being implemented, Bush suggests that all American seniors should receive a prescription drug discount card to use right away. In addition, low-income seniors would be eligible immediately for the annual $600 Medicare prescription benefit. Bush has included $400 billion over 10 years in his budget to fund the proposal.

Pharmacists respond

One pharmacy advocacy group found it encouraging that the president seems committed to adding prescription drug coverage to Medicare. The American Pharmacists Association (APhA) in Washington, DC, however, is more cautious about the discount card portion of the proposal. "APhA opposes poorly designed discount card programs that fail to provide a true benefit for seniors," the association says.

A rational approach is to provide Americans access to the medications they need as well as pharmacy services to help them make the best use of their medications, says John A. Gans, PharmD, APhA executive vice president. "Something is wrong when we pay to diagnose a senior’s condition, but then we don’t cover the treatment he or she needs."

APhA has developed four principles for a high-quality Medicare pharmacy benefit:

  • coverage of prescription medication costs — not just discounts;
  • patient access to pharmacist-provided medication therapy management services;
  • patient choice of providers;
  • administrative efficiencies to ease patients’ and providers’ paperwork burden.

APhA, along with other pharmacy groups, plans to continue to work with the administration and Congress on a possible Medicare prescription drug benefit.