Washington In an exclusive interview, Sen. Debbie Stabenow, D-Mich., told us, "If Medicare were being written today instead of 1965, we wouldn't be having this discussion. Prescription drugs would be included."
The discussion she is referring to is whether to include a prescription drug benefit in Medicare and how it should be done. President Bush campaigned on a promise to include such a benefit, but the overwhelming majority of Republicans with his support are actually advocating drug-industry sponsored legislation that subsidizes private insurers and drug companies.
The Republican Party opposed Medicare in 1965 and is lukewarm about adding to it now. There is nothing sinister in this. It is a philosophical difference between Republicans and Democrats, whose modern roots date back to Franklin Roosevelt's New Deal social legislation, when Republicans opposed Social Security and other programs.
Today, there are Republicans who continue to believe that Medicare and Social Security involve more government meddling than is offset by public benefits. There are others, such as Sen. John McCain, R-Ariz., who, along with New England Republicans, tend to adhere to the Democrats' point of view that these are beneficial programs that should be enhanced. And then there is the largest group, those Republicans in between these two views, who look upon these and other government-sponsored social programs with skepticism.
This last group sought to privatize part of Social Security by allowing a portion of contributions to go into the stock market, though recent market declines have had a dampening effect on this idea. But this same privatizing concept is inherent in the Republican-sponsored prescription drug bills in both the House and Senate.
On the other side is the Graham-Miller bill in the Senate. Sens. Bob Graham, D-Fla., and Zell Miller, D-Ga., have offered a prescription drug plan which, according to The Hill, has "no deductible, 50/50 coinsurance up to $4,000, full government-provided coverage over $4,000, and a $25 monthly premium."
The problem is that the Democrats fail to advertise the primary aspect of the bill: The prescription-drug benefit would not be a stand-alone program, but a part of Medicare. As such, prescription drugs would be treated like any other medical procedure.
In our discussion with Sen. Stabenow, we used an example: A patient goes to a doctor who prescribes surgery to cure a particular ailment. Another doctor prescribes medication. Both methods cure the patient. Why, therefore, should medication be treated differently than surgery? The senator agreed.
And this is where the most important part of the prescription drug benefit comes in. Just as Medicare determines appropriate prices for surgery, it would determine appropriate prices for prescription drugs. As Stabenow noted, "Every other country in the world has its government negotiate bulk prices." And this is what Medicare would do.
And, just as is the case with doctors, pharmacies could choose whether to provide services and medication to Medicare patients or not.
Prediction: Stabenow said: "For the first time since Medicare was enacted, a majority of members (52) voted yes to modernize." The Democratic version or something close to it will succeed now or succeed later after the November elections.