HD Blog

For the next two years seniors get a 15% discount on their prescriptions with the poorest getting subsidies. In 2006 seniors can join a plan that will greatly reduce their costs. Comment: Senior's will come out way ahead on this, especially those on limited incomes.

A limited six-market, six-year demonstration to see if private competition can help keep Medicare costs down. This won't start for a few years. Comment: This doesn't start for several years and limited scope of this test may end up limiting the chance to show any cost savings. Those who claim this will cause the downfall of Medicare should adjust their medication. If it does work, it could end up saving billions of dollars.

Hospitals that serve a large number Medicaid patients will get higher payments. Comment: They threw a bone to Medicaid. Low payments to hospitals has limited access for Medicaid patients.

A cost-containment clause that forces Congress to address the problem if premiums cover less than 55% of the costs. Comment: Some are arguing that this will cause severe cuts in benefits or increased costs down the road. Based on forecasts, someday the government probably will have to make adjustments to keep the system solvent as costs escalate. This will happen with or without this clause, but it will give the politicians some political cover. This is 10-30 years away, but expect first cuts to be (appropriately) to the wealthy.

Wealthy seniors (over $80,000 in income) will have to pay more of the cost of premiums. Comment: This is better than the original plan to give ALL seniors the same benefits but it makes no sense to subsidize any senior who can easily pay for their medications. This leaves less money for those who need it most. But then this was about votes, not needs.

Allows all American's to setup tax-sheltered health savings accounts. Comment: There will be some who claim this will benefit the rich but the big benefit will be to the working poor who have few opportunities to shelter their income. Early evidence on these health savings accounts is that they are very-cost effective (from the government's point of view), they give individuals more flexibility in their health care, and they can help keep premiums down.

Payments to doctors (already too low) will not be cut 4.5% next year as originally planned. They'll get a 1.5% boost. Comment: This is a good thing. Doctor's payments have gotten so low that many offices are limiting or refusing to serve Medicare patients. This has lowered the standard of care.

Rural hospitals get additional financial help. Comment: This is a little bit of bribery to rural politicians such as Max Baucus (who was on the conference committee) but it should improve the quality of care in those communities.

Drug reimportation will, in effect, still be illegal. Comment: The alternative would have, in effect, reduced the amount of money spent on research. Since the Huntington's Disease community has no effective treatment options, we need as much research dollars as possible in order to save lives.

Pharmaceutical companies will no longer be able to issue claims to get sequential 30-month extensions on their patents. Now they only get one extension Comment: This is very good and long overdue. The pharmaceutical companies, by the time their patents expire, almost always have already recovered all their development costs and earned a good profit. This fixes an area that was being abused.

Not a perfect bill, but better than expected. The full conference committee will have to approve it and then it has to be approved in an up-or-down vote by the House and Senate. If it makes it to the President's desk, it will be signed. This isn't a sure thing, but it's looking good.