6/27/00 4:15 p.m.
Drug Wars Take Center Stage
A prescription for politics.

By Grace-Marie Arnett, president of the Galen Institute

he 21st-century drug wars are escalating, with both parties in a bidding war to spend taxpayer dollars to win voter approval for their Medicare prescription-drug benefit plans.

President Clinton has just thrown in another $58 billion of the projected budget surplus to create a whopping $253 billion drug-benefit program over ten years. And Republicans in the House of Representatives have been working around the clock to prepare their $155 billion plan for a floor vote this week.

Both Republicans and Democrats rely on budget surpluses to finance their expensive new entitlements, which will remain even if surpluses vanish.

But Washington appears determined to move forward, making it all the more important for seniors to examine the fine print of the deals they are being offered. The first question should be, "Who controls the choices? Me and my doctor, or Washington bureaucrats?"

Mr. Clinton and top Democrats in Congress would graft yet another entitlement onto the already-antiquated, financially-doomed Medicare program. They would assign all seniors living in a "geographic service area" to one plan run by government agents. Republicans, on the other hand, want to rely on individuals to make their own choices from at least two private, competitive plans.

The government-run benefit being advocated by the Democrats appears to offer more help with routine bills to the majority of seniors. But that's only at the outset. Those who think this approach is preferable should take note of the experience of British citizens.

In the U.K., government decides what drugs citizens will or will not get under their system of socialized medicine. Take breast cancer, for example. Two drugs — Taxol and Taxotere — have been licensed in Britain for several years and are widely used around the world when women do not respond to standard chemotherapy.

But in Britain, according to Reuters, 30,000 women are diagnosed with the disease every year and 14,000 die. Yet an estimated 4,000 women did not have access to the drugs because some cash-strapped regional health authorities rejected them as too expensive.

Today's and tomorrow's seniors will demand more choice and control over their medical decisions, and centrally-controlled, government-run systems simply can't offer that. Tacking another entitlement onto Medicare, as the Democrats would do, is not the answer.

The Republican drug-benefit approach builds a foundation for a New Medicare that will give seniors more benefit options. By moving toward reform, they could prevent dramatic cuts in Medicare benefits or dramatic increases in Medicare taxes that would absorb larger and larger chunks of the paychecks of their children and grandchildren.

Yes, the Republicans create a new universal entitlement. But it entitles seniors not to all the drugs they can consume at taxpayer expense, but to participation in a private, voluntary program. That's a step away from the entitlement programs of the past.

Insurance companies have criticized the GOP approach, with many saying that the plan won't work because routine drug expenses are simply not insurable events. They argue, as do most people who have studied the teetering Medicare program, that drug coverage must be incorporated into overall reform.

Most private health-insurance plans already have prescription-drug coverage as an integral part of their benefit packages. Seniors deserve no less. Republicans and Democrats on the Bipartisan Medicare Commission agreed that this is the right approach. House Republicans offer a first step.

Whoever wins control of the Congress and the White House this fall will be able to write the drug-benefit law passed next year — and it would take the shape of the approach they are advocating during the debate this year. If those who push for government control win, it will inevitably lead to price controls. This, in turn, will mean the research base for pharmaceutical advances will begin to wither, just as it has in every country with socialized systems. This would deny patients the newest drugs by cutting off the flow of research and development funds to create tomorrow 's miracle treatments.

The new drug benefit plans are big money, but what's really at stake is the future of medical research. Seniors should examine the details of the policies these politicians-turned-insurance-salesmen are offering, to see what they would mean for their own options in the future.

While politicians think that the drug-benefit issue is a matter of political life or death for them, the direction they choose truly could be a matter of life and death for those who need tomorrow's research advances.