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Rep. Ron Paul, M.D., a lifetime member of AAPS (Association
of American Physicians and Surgeons), issued the following statement
regarding passage of H.R. 1, the Medicare Reform bill, including
prescription drug coverage:
In a late-night vote last week, the Republican congress managed
to do what Hillary Clinton and Ted Kennedy tried to do 10
years ago: take the next big step toward socialized medicine
in America. More specifically, Congress voted for a huge expansion
of Medicare that enriches pharmaceutical companies, fleeces
taxpayers with billions in new spending, and forces millions
of seniors to accept inferior drug coverage. Conservatives
might ask themselves whether this is what they had in mind
when the party of "limited government" gained control
of the House, Senate, and White House.
Seniors have been terribly misled about this new Medicare
scheme. The essence of the new plan is government control.
Government will play an even greater role in deciding what
drugs seniors get, how doctors and pharmacies are paid, how
private medical information is distributed, and what drug
companies benefit most. The plan moves America disastrously
toward a complete government takeover of medicine.
In order to participate, seniors must choose between staying
in traditional Medicare and joining an HMO/PPO organization.
This means either a federal bureaucrat or a nominally private-sector
bureaucrat will decide what drugs will be available. Both
Medicare and HMO bureaucrats inevitably will be forced to
control costs, because the demand for subsidized drugs will
be unlimited. They will do so by rationing drugs, especially
expensive drugs. Bureaucrats may even go so far as to forbid
seniors from using their own money to buy Medicare-covered
drugs, just as Medicare rules now prohibit use of private
funds to buy unapproved health-care services.
Medicare bureaucrats also will seek to pay pharmacies as
little as possible for drugs, just as they now pay doctors
as little as possible for services. Many doctors refuse to
take Medicare patients, and now many pharmacies might follow
suit. So in addition to the inevitable drug rationing, seniors
will have fewer doctors and pharmacies to choose from.
The majority of seniors who like the private drug coverage
they already have are the biggest losers in the new scheme.
It provides a perverse incentive for private plans to dump
seniors into the government plan, and some companies with
large numbers of retirees have already announced their intention
to do so. The Joint Economic Committee estimates that nearly
40 percent of private plans will stop providing prescription
drug coverage because of the new Medicare plan. This number
is sure to skyrocket as the cost of providing health care
rises, and companies look to pass off the high costs of health
care for their retired employees.
Pharmaceutical companies are the biggest winners under the
new plan. Demand for drugs will rise, as our already overmedicated
seniors will be happy to pass the cost off onto younger taxpayers.
Large drug makers will become virtual partners with government,
lobbying to make sure their drugs are part of the new system.
Those drugs will continue to cost much more in the U.S. than
foreign countries, despite efforts in the new bill to change
federal rules prohibiting reimportation of drugs.
The Department of Health and Human Services secretary already
stated that he will never approve reimportation. Combine this
lack of price competition with lengthy patents and protectionist
FDA rules, and you have a perfect prescription for record
pharmaceutical profits. The pharmaceutical industry reportedly
spent $135 million in recent months lobbying for the new Medicare
bill. This speaks volumes about how seriously they viewed
the stakes involved.
Taxpayers certainly can't afford an expansion of Medicare.
Economists estimate the new program will cost between $3 trillion
and $4 trillion over time, all financed by payroll taxes.
Even as the added drug coverage makes Medicare more expensive,
more seniors than ever will be herded into the program. This
new strain on taxpayers will be especially acute when the
large Baby Boomer generation retires and younger workers are
expected to pay the bills.
A better approach would utilize Medicare Medical Savings
Accounts (MSAs) to provide flexibility and choice. Medicare
monies could be placed in tax-free savings accounts and used
by individual seniors as they see fit to buy prescription
drugs, visit the doctor, or buy special services like mammograms.
MSAs allow consumers to make their own choices by eliminating
the federal middleman. But even this compromise approach means
giving individuals control over tax dollars, which bureaucrats
hate to do.
Drug rationing, fewer choices, bureaucracy, subsidies, and
a declining quality of health care--these are the hallmarks
of government medicine.
More from Rep. Paul at: www.house.gov/paul/tst/tst2003/tst063003.htm
Association
of American Physicians and Surgeons July 1, 2003
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