Senate Democrats today failed to gain enough support to force a vote on legislation that would allow government price controls in the Medicare prescription drug program. Phil adamantly opposes this misguided legislation, because it’s the marketplace that has kept prices low and choices vast for our seniors. The Wall Street Journal this morning (subscription required) makes the case against this legislation.

[T]here’s no denying the program’s innovation of using private-sector competition has worked far better than critics predicted. In the first year alone, the cost of Medicare Part D came in 30% below projections. The Congressional Budget Office calculates the 10-year cost of Medicare Part D will be a whopping $265 billion below original estimates.

Seniors are also saving money under this private competition model. Premiums for the drug benefit were expected to average $37 a month. Instead, premiums this year are averaging $22 a month — a more than 40% saving. Democrats don’t like to be reminded that many of them wanted to lock in premiums at $35 a month back in 2003. No wonder recent polls find that about 80% of seniors say they’re satisfied with their new Medicare drug benefits.

Democrats who opposed all of this private competition now say that government-negotiated prices will do even better. They must have missed the new study by the Lewin Group, the health policy consulting firm, which found that federal insurance programs that impose price controls typically hold down costs by refusing to cover some of the most routinely prescribed medicines for seniors. These include treatments for high cholesterol, arthritis, heartburn and glaucoma.

…Supporters of federal price “negotiations” — really, an imposed price — also like to point to the example of the Veterans Health Administration, which negotiates prices directly with drug companies…Here’s the real kicker: Statistics released March 22 by the VHA and Department of Health and Human Services show that 1.16 million seniors who are already enrolled in the VHA drug program have nonetheless signed up for Medicare Part D. That’s about one-third of the entire VHA case load. Why? Because these seniors have figured out that Medicare Part D offers more convenience, often lower prices, and better insurance coverage for their prescription drugs. In short, seniors are voting with their feet against the very price control system that Democratic leaders Harry Reid and Nancy Pelosi want to push them into.

For the complete article, click HERE. For more on why Phil opposes this legislation, click HERE.

In today’s Roll Call Newspaper, Phil opines on the long-term care crisis facing our nation - and what Congress can do to prevent it. Phil explains:

With the baby boomer generation set to retire, the U.S. is verging on a long-term care crisis. Millions who haven’t planned for this expensive stage in life are rapidly approaching it. Since Medicare doesn’t cover most long-term care, these costs can quickly bankrupt seniors whose assets preclude them from Medicaid coverage.

This has left many Americans with two unappetizing choices: to quickly burn through their savings paying for long-term care, or to hide their assets and get the government to pay for their care through Medicaid. The first is unfair to seniors who have worked hard to save for retirement. The second is unfair to taxpayers who don’t want to see skyrocketing Medicaid spending due to abuse in the system.

Phil also cautions that Congress take the right approach to reform:

As Congress looks for solutions, we must take care not to create more problems. Entitlement spending has ballooned over the past decade, rapidly engulfing a growing portion of our federal budget. To make our long-term care system sustainable and affordable, Congress needs to pass market-based reforms and encourage individuals to take responsibility for their long-term care needs.

Click HERE to read Phil’s recomendation for fixing this problem - and assuring seniors can better afford their long-term care needs.

The Detroit Free Press reports this week:

More than 39 million elderly and disabled Americans are saving $1,200 a year, at a cost of only $22 a month, through Medicare prescription drug plans, federal officials announced Tuesday.

Not only are seniors satisfied with the program, but they’re smart shoppers, too:

[W]hile 75% of recipients reported satisfaction, one in 10 switched plans, mostly for greater coverage in the so-called doughnut hole, the phase of the program during which members must pay all or a large portion of drug costs. 

The fact that 85% of beneficiaries enrolled or switched plans shows they are “smart shoppers and informed consumers,” said Leslie Norwalk, acting director of the Centers for Medicare & Medicaid Services.  In fact, 350,000 of the 900,000 who enrolled last fall registered through the Medicare Web site, www.medicare.gov, she said. That contradicts the prevailing wisdom that many recipients found enrollment options confusing and were bewildered by sorting them out on the Web.

The newspaper confirms what we’ve known for some time: marketplace competition is driving down costs, and affording our seniors better choices within the Medicare program. For more on Medicare Part D, click HERE.

Breaking news from the Department of Health and Human Services:

HHS Secretary Mike Leavitt today announced that more than 1.4 million beneficiaries have enrolled in Medicare’s Part D program since June 2006, bringing the total number of people with Medicare now receiving comprehensive prescription drug coverage to more than 39 million.

For more on how Medicare prescription drug coverage is helping seniors, click HERE. If you or a senior in your life needs more information on the Medicare Part D program, click HERE.

Medicare’s Acting Administrator Leslie Norwalk today put the Democrats’ Medicare D proposal into perspective:

“It’s not negotiation — it’s interference” Norwalk said.

She went on to explain:

For the government to push for lower prices without restricting available drugs would be challenging, Norwalk said. With numerous insurers offering multiple plans, those who want a specific drug can now choose a plan offering it.

“For the government to restrict that formulary makes me nervous,” Norwalk said. “Do you really want the government in your medicine cabinet deciding which (drug) makes the most sense for you?”

Medicare officials would also be subjected to political pressure over which drugs to target during negotiations, she predicted.

Finally, she dismissed the Democrats’ proposal:

“It’s a solution in search of a problem,” she said. “We have 90 percent Medicare beneficiaries with coverage, an 80 percent satisfaction rate and it costs us 30 percent lower than originally estimated.”

See Phil’s previous post for more on the Democrats’ misguided plan.

Medicare Part D, prescription drug coverage for seniors, has been a tremendous success. Thanks to this new program, 90% of seniors now have prescription drug coverage, and seniors are saving an average of $1,200 a year on their drug costs.  

So why are Democrats intent on messing with success? And why do they want the government to control which new drugs seniors can access?

On Friday, the House will vote on H.R. 4.  This Democratic plan requires the government to set price controls on seniors’ medication.  As you might guess, its a bad idea for many reasons. First, according to the non-partisan Congressional Budget Office and Medicare’s own actuaries, the change won’t produce any substantial savings. Competition in the marketplace works, so much in fact that Medicare plan providers have delivered premiums 40 percent lower than expected.  Maybe this is why Bill Clinton’s own Medicare prescription drug plan shunned government price negotiation.

And if you hear the Democratic rhetoric saying their plan wouldn’t restrict senior access to drugs, you might want to share with them what Dr. Alan Garber, director of the Center for Health Policy at Stanford University, told the New York Times today:

Dr. Alan M. Garber, director of the Center for Health Policy at Stanford University, said he did not see how Medicare officials could obtain big discounts unless they were able to establish a restrictive formulary.

“To obtain drugs at low prices, a purchaser must be able to say no to covering a particular drug,” said Dr. Garber, who is an economist and a physician. “If you cannot walk away from a deal, there’s no way you can be sure of obtaining a low price. That’s true whether you are buying a car, a house or medications.”

Seniors like choice – and they don’t want the government picking their drugs.  When will the Democrats get the message?

I invite you to check out my December e-Newsletter by clicking HERE.  You can learn about the Iraq Study Group Report, the recently passed tax relief bill, the Unborn Child Pain Awareness Act, and my advance directive legislation the House passed this month.

Today’s Wall Street Journal has a great column on Medicare prescription drug coverage and how the program has defied the critics and helped our seniors afford their medications.  David Wessel writes:

The Medicare prescription-drug benefit… was panned by critics when it was in previews. Now, after a year’s run, the elderly audience seems to be applauding, public and private actors are clicking better in the very complex production, and costs are below initial estimates.

Seniors are “delighted” with the program:

A survey of 3,400 beneficiaries by J.D. Power & Associates found 45% “delighted” with the program, rating their Medicare drug plans 10 on a 10-point scale; another 35% rated them an 8 or 9.

And more seniors than ever have access to prescription drug coverage:

Critics said a lot of seniors simply wouldn’t sign up, a vexing problem for any voluntary insurance program. Back in 2002, 45% of Medicare beneficiaries lacked prescription-drug coverage for all (18%) or some (27%) of the year. Now, more than 90% of Medicare beneficiaries have drug coverage. In all, 22.5 million people are enrolled in what is known as Medicare Part D…

As a physician, Phil has been a long-time supporter of Medicare Part D, and he has made a personal commitment to educate seniors in the 11th District about the program.  To learn more, click HERE.  To read the complete Wall Street Journal article, click HERE (subscription required).

The Associated Press this week reports that the Medicare prescription drug program, called Medicare Part D, is costing less as it delivers affordable medication to our seniors:

The Medicare drug benefit has cost nearly $13 billion less than expected this year, a rare federal program coming in under budget. President Bush credits competition among the dozens of private insurance companies administering the program for the cost coming in at $30 billion in 2006, about 30 percent below the projected $43 billion.

The articles goes on to note:

The savings being achieved by the program could make it harder for Democrats to make changes, particularly with surveys showing high satisfaction rates among seniors and the disabled. So Democratic lawmakers may focus on where the savings are coming from.

Medicare Part D continues to prove the naysayers wrong. It is improving the quality of life for our seniors, and costing far less than originally projected, thanks to competition built in to the program.  Part D saved seniors an average of $1,100 this year, and helped low-income seniors access the medicines they needed for only a few dollars a prescription.  Nearly 90 percent of Medicare recipients are now saving money and improving their health with affordable prescription drug coverage, and recent surveys show the vast majority of seniors are enthusiastic about their Part D coverage.

For more information on Medicare Part D, click HERE.

The Wall Street Journal today reports:

Medicare beneficiaries poring over their drug-benefit options for next year will generally see more plans with low premiums and also a greater number of more-expensive plans with coverage of the gap known as the “doughnut hole.”

Click HERE for the rest of the article (subscription required).

If you or a senior in your life is thinking about enrolling in a new Medicare Part D prescription drug plan this year, I encourage you to check out the new features available at www.Medicare.gov.  Click HERE to compare plans by cost, medications covered and benefits.  You can also see what your monthly costs would be under a specific plan.  Click HERE to learn more about the Medicare Part D plans available in Georgia.

Medicare Part D is helping seniors save money (an average of $1,100 a year) and live healthier lives. If you have any questions about this benefit, please contact my office. My staff is trained to assist you.

A word of warning to our seniors. According to the Federal Trade Commission:

Scam artists also follow the headlines, and they are reportedly contacting seniors claiming to represent a Medicare Part D provider, when all they really want is personal information, like Social Security numbers or checking or credit card account numbers. They can use this information to commit financial fraud.

To protect yourself from Medicare scams, the FTC offers the following advice:

–  Keep all personal information safe. Don’t give it out until you are sure that a company is working with Medicare and their product is approved by Medicare.
– Resist talking to anyone who comes to your door peddling “offers” of drug coverage. The law says prescription drug benefit companies cannot visit your home unless you’ve given them permission to do so.
– Resist signing up for a plan on the telephone unless YOU make the call.
– Take a friend or family member with you if you decide to attend a sales pitch.

– Also, remember that  Medicare Part D plan providers may ask you how you want to pay your premiums, but they may not ask you for payment over the phone or through the Internet. They must mail you a bill for the premiums. Be aware that there is no fee to enroll in a plan.

If you think you have fallen victim to a Medicare scam, please contact the U.S. Department of Health and Human Services Fraud Hotline at 1-800-447-8477.

Phil wants to remind seniors that this year’s open-enrollment for Medicare prescription drug coverage begins November 15, 2006 – that’s this upcoming Wed.

To learn more about Medicare Part D, click HERE or visit www.Medicare.gov.

I want to share some great news for our seniors.  Medicare has launched a new tool on it’s website that will help seniors save more money by finding the prescription drug plan that’s right for them. As the Miami Herald reports:

Medicare unveiled on Friday its enhanced website where people interested in switching plans can winnow the scores of options available next year.

Medicare said its Plan Finder, available on www.medicare.gov, features a new monthly cost estimator. The tool generates a monthly spending chart for each plan and could help seniors determine when they will enter the coverage gap — the point where they must pay full cost for their medications until meeting an out-of-pocket threshold.

The plan finder can help people sort through plans based on what’s important to them, be it low monthly premiums, pharmacy location, coverage through the gap or the list of medications provided. Some may see changes such as a bump in the cost of monthly premiums or different kinds of drugs covered.

To view the new plan finder, click HERE.  To learn more about Medicare Part D, click HERE.

As the next open enrollment period for Medicare Part D begins November 15th, now is the time for seniors to start thinking about their options. I invite any senior who needs assistance enrolling to contact my office (click HERE).  My staff is trained to help you though the process.  Seniors who are satisfied with their current plans do not need to reenroll – your plan provider will mail you a notice if any changes are made to your plan.

Medicare Part D is saving seniors an average of $1,100 a year – and more than $2,500 for low-income seniors.  As a physician, I know that when seniors can afford their medicine, they can live healthier lives.

The Wall Street Journal’s lead editorial today praises the Republican-passed Medicare prescription drug program, noting that market-based competition works:

The Medicare prescription drug benefit is so far costing less than anticipated, while seniors are getting more insurance options at lower prices. Lesson: Maybe private competition works.

The Journal editorial board continues:

The early returns are encouraging, on both price and choice. Over the weekend insurers began marketing their 2007 Medicare drug plans, and all states except Hawaii and Alaska have more than 50 private options available — up from an average of about 40 in 2006. Seventeen insurers are selling nationwide plans, up from nine this year. That compares with the one or two that critics of including private plans predicted would be available in many markets.

The average monthly premium that seniors pay is again $24, far lower than the $37 originally estimated by government actuaries. And while Democrats have hammered away at the idea that having seniors choose among competing drug plans is too “confusing,” recent polls show satisfaction with the benefit in the 80% range.

Further, it refutes the Democratic ideas of government-controlled and dictated healthcare:

All of this would also seem to rebut the current Democratic campaign theme that having drug prices “negotiated” — i.e., dictated — by government is an urgent priority. Democrats point to the drug coverage provided by the Veteran’s Administration as a model. But the VA usually keeps costs down by refusing to pay for newer, more effective medicines. The VA drug formulary includes only 19% of the medicines approved by the FDA since 2000.

To read the complete editorial, click HERE (Wall Street Journal subscription required).

Phil has been one of the leading avocates for Medicare Part D. To learn more about this benefit for our seniors, click HERE.

There’s some great news for seniors enrolled in Medicare’s prescription drug coverage. Competition is working, and seniors are poised to reap the benefits.  USA Today reports: 

Average monthly premiums will hold steady next year under Medicare’s prescription-drug program as competing insurers offer a range of new coverage options. The average premium will be less than $24. Prices for the least expensive plans — as cheap as $1.87 in some parts of the country — will rise for the program’s second year.

And for seniors who are worried about a gap in coverage (or “donut hole”) under their current plan, there’s more good news:

More plans will have no coverage gap — a period during which beneficiaries must pay full price for drugs. Other plans will offer partial coverage in the gap for generic or certain brand-name drugs.

This year’s open enrollment period begins November 15th.  If seniors in the 11th District need help changing plans or signing up for the first time, I encourage them to contact my office. Seniors can also visit www.medicare.gov.  For more resources on Medicare Part D, please click HERE.

As a physician, I firmly believe that prescription drug coverage will help our seniors live healthier lives. We have finally delivered on a long-overdue promise to our seniors, and I am greatly encouraged that seniors will again this year have a choice of affordable coverage options.

Former Senator and Presidential candidate Bob Dole has launched a new website (www.bobdoleonmedicare.com) to educate seniors about Medicare Part D, the new prescription drug program.  Tech-savvy seniors (and seniors with tech-savvy children and grandchildren) can download pod-casts onto their i-Pods and listen to Dole discuss program basics and success stories from across America.  

Phil loves his i-Pod, and we bet a lot of you do, too. This is a great opportunity to use this new technology to educate a senior in your life about the Medicare prescription drug benefit.

The White House has posted the video and text of President Bush’s remarks before signing an executive order on healthcare reform (see story below). Click HERE to read more.

President Bush today signed an executive order to promote cost transparency and health information technology. The Washington Post reports:

The executive order requires four federal agencies that oversee large health-care programs to gather information about the quality and price of care, and to share that information with one another and with program beneficiaries.

The initiative underscores Bush’s belief that the nation’s health-care system would be more efficient if consumers could shop for the best care at the best price, administration officials say. “The fact is, if you have excellent information about quality, about service and about price, people make good decisions,” Bush said during a roundtable here to discuss the initiative.

With the federal government paying for about 40 percent of the nation’s spiraling health-care bill, administration officials said the order requiring federal agencies to develop and share information about the quality and price of care should help bring greater transparency to the business of medicine.

Under the order, the four agencies must establish programs to measure quality of care, a complicated and controversial task that officials said could take years. Beneficiaries must also be able to see the prices that the agencies pay for common medical procedures, to develop and identify practices that foster high-quality care, and, whenever possible, to use compatible computer systems and electronic health records to help track a recipient’s medical care and condition. The changes must be underway by Jan. 1.

“If you have an ATM or a credit card, you can use it anywhere in the world and it works, because it’s interoperable. Everybody competes but uses the same system, basically, to transact their affairs,” Health and Human Services Secretary Mike Leavitt told reporters aboard Air Force One. “Health care isn’t like that. Roughly 85 percent of all health-care records are still paper. So a part of what we’ll be talking about today is the interoperability of systems that manage health records.”

Secretary Leavitt hit the nail on the head – healthcare technology and interoperability are crucial to healthcare reform. Phil has introduced legislation to help our medical community adopt the computer systems and electronic health records mentioned above. Click HERE to read Phil’s testimony before the Small Business Committee on this legislation.

As a physician, I’m a strong advocate for Medicare prescription drug coverage. I believe that if seniors can afford the medicines they need to prevent and manage illness, they’ll be able to live healthier lives – that’s the power of preventative care.

Today’s New York Times reports some great news for our seniors – the cost of Medicare Part D premiums will not rise in 2007. As the article notes, competition is working, and our seniors can better afford their medication.  While Congress and Medicare are constantly working to improve the Part D program, we have delivered a historic benefit that is helping our seniors every time they visit the pharmacy. I am very proud of the work this Republican Congress and the President have done for our seniors.

For the complete article, click HERE (requires free New York Times on-line registration).  Below, I’ve included some details on this exciting news:

Federal officials announced Tuesday that the average premium for Medicare prescription drug coverage next year would be about $24 a month, which is the same as this year and 40 percent less than first estimated for 2007.

Beneficiaries showed a strong preference for low-cost plans this year. In many regions, Humana offered the lowest premium — as little as $1.87 a month in seven states including Iowa, Minnesota and North Dakota. Many plans charged less than $20 a month, though at least one charged more than $100 a month.

The drug benefit is delivered by private insurance companies under contract to Medicare. Insurers compete with one another by offering lower premiums and more extensive benefits. The competition and the choices made by beneficiaries evidently drove down the average premiums for this year and next.

“Competition and choice in health care are working,” said Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services.

Premiums for a particular plan may rise next year. But, Dr. McClellan said, “the vast majority of beneficiaries will have access to Medicare drug plans that cost them the same as or less than their coverage in 2006.”

In March 2005, the government predicted that the average drug premium would be $37 a month in 2006, rising to $41 in 2007. In August 2005, federal officials lowered the estimate for this year to $32, based on the proposals submitted by drug plan sponsors. In June, after seeing which plans were chosen by beneficiaries, the administration said the average premium turned out to be about $24.

Dr. McClellan said the average premium would remain around $24 if beneficiaries stayed in the same drug plans in 2007 and could decline if they again chose less costly plans.

Lower premiums save money for beneficiaries and the government. Medicare pays insurers a subsidy, which is about three times as much as the beneficiary’s premiums.

Click HERE for more information on the Medicare Part D benefit.