Friday, January 20, 2006


Medicare, Then And Now

The StarTribune and Paul Krugman (via Atrios) have joined the lefty blogosphere's call for an honest probe into how the Republicans destroyed Medicare Part D just so their buddies could wring a few more bucks out of it. As the Strib says:

Leavitt's performance in implementing Part D should certainly be one focus of any hearings. Baucus and other experts warned HHS months ago that dual eligibles -- many of them confined to nursing homes, many with mental impairments -- would be highly vulnerable in the transition from Medicaid. Starting a month ago, governors began warning federal authorities that local pharmacists were reporting alarming gaps in coverage for these beneficiaries. But Leavitt shouldn't take all the heat, for the very legislation that created Medicare Part D in 2003 contained horrible strategic and design flaws. It's still worth asking why Congress insisted on turning Medicare's new drug benefit over to scores of private insurance companies, when Medicare had a documented record of lower overhead costs and higher customer satisfaction. Lawmakers should also ask why Washington will spend hundreds of millions of dollars to subsidize these private insurers, when the starting premise was that they would save the government money, and why several surveys have found that elderly patients pay more for their medications in the heavily subsidized Part D plans than they would at normal discounters such as The Republican lawmakers who created Medicare Part D insisted that it would offer the best of both worlds -- a generous government subsidy combined with private-sector efficiency. Instead, it is proving a huge drain on taxpayers and a giant headache for elderly consumers, and is giving both the public sector and the private sector a bad name.
And here's The Shrill One:
At first, federal officials were oblivious. "This is going very well," a Medicare spokesman declared a few days into the disaster. Then officials started making excuses. Some conservatives even insist that the debacle vindicates their ideology: see, government can't do anything right. But government works when it's run by people who take public policy seriously. As Jonathan Cohn points out in The New Republic, when Medicare began 40 years ago, things went remarkably smoothly from the start. But this time the people putting together a new federal program had one foot out the revolving door: this was a drug bill written by and for lobbyists.

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