Whenever the issue of prescription drugs comes up, I find myself thinking about Kay Schulz.  Kay and her husband Ron live in Hot Springs, South Dakota.  Ron owns a little cafe in town.  Kay is a nurse, but she doesn't work anymore.  She can't.  She has cystic fibrosis (CF).  She's 52 years old.

If you know anything about CF, you know it's a miracle that Kay's still alive. But that miracle doesn't come cheaply.  Kay takes 35 different medications each day.  One of those medications, which she takes to thin the secretions in her lungs so she can breathe, costs more than $52,000 per year.  Together, Kay's medications cost $70,814 per year.

Medicaid used to pay for them.  But Kay lost her Medicaid coverage on New Year's Day because Ron made too much money last year.  He made $26,000.  Last year, after Kay and Ron paid all their other bills, they had $6,568 left.  How do you pay for almost $71,000 worth of prescriptions when all you have is $6,568?  Because she is disabled, Kay is also eligible for Medicare.  But like most other Medicare beneficiaries, Kay has no prescription drug benefit.

When Medicare was created, its benefits were modeled after private sector health plans, which rarely included coverage for prescription drugs.  Today, while nearly all private plans include some type of drug coverage, Medicare does not.

As a result, three out of five Medicare beneficiaries lack decent, dependable coverage for their drug costs, and more than one-third have no coverage at all. Seniors often pay twice as much as Health Maintenance Organizations (HMOs) and big insurance companies for the exact same medications.
 
Pharmacies, unable to keep up with the increasing cost of providing medicine, are forced to close shop.  Many rural Americans are left without convenient access to prescription drugs and are forced to drive great distances, sometimes over one hundred miles, to get their prescriptions filled.  This simply shouldn't be.  In January of 2001, I introduced a bill that provides Medicare beneficiaries with comprehensive prescription drug coverage that is universal, voluntary, and affordable.

The Medicare Prescription Drug Coverage Act of 2001 ensures that every Medicare beneficiary has the option of prescription drug coverage.  Medicare would contract with private companies to offer the prescription benefit.  The coverage is not mandatory.  No beneficiary would have to give up existing coverage.  If you are already enrolled in a prescription coverage plan you like, you may keep it.  The choice is yours.

This prescription coverage plan would be affordable because beneficiaries with lower incomes would pay less, based on a sliding scale.  For example, couples earning about $20,000 per year would have up to 55 percent of their premium costs paid by Medicare.  Couples earning $15,000 or less would pay nothing.

In my Medicare prescription drug proposal, as the beneficiary's out-of-pocket spending increases, so does Medicare's contribution.  Once the annual $250 deductible is met, the beneficiary has to pay a co-payment, but there are no limits, caps, or gaps in coverage.  The most any beneficiary would pay out-of-pocket is $4,000, and after that Medicare would foot the bill.

This legislation also recognizes that any prescription coverage plan must include protections for the pharmacists serving Medicare's elderly and disabled beneficiaries.  Beneficiaries should not be forced to travel long distances or use mail order to get the drugs they need.  Private entities administering the benefit would be required to ensure convenient access to pharmacies.  If needed, pharmacies in rural communities and hard-to-serve areas would receive bonus payments to ensure rapid delivery of prescription drugs.

The Medicare Prescription Drug Coverage Act will provide real and meaningful benefits to millions of Americans.  Please join me in supporting legislation that provides voluntary, universal, and affordable prescription drug benefit to America's Medicare beneficiaries. 

If you would like to sign our online "Petition to Congress for Voluntary Medicare Prescription Drug Coverage" click here:  http://action.tscl.org/VolMedicarePresDrugCoverage.asp

To read more about this subject click here to review "Congress Puts Off Action on Prescription Drug Benefit" http://www.tscl.org/newcontent/101247.asp 

January 2002