The changes to Medicare where deemed necessary due to the rising costs of medications and the debilitating burden that soaring costs put on the beneficiaries of Medicare. In 2002, the United States spent $162.4 billion on prescriptiondrugs with only about 22% of this paid for by the Government and 44% by personal healthcare prescriptions (Frank, 2002). The root of the problem lies in the inability of elderly and disabled Americans to be able to cover the rising price of prescription care. Each year the costs of prescription care are on the move up and out of the reach of most people on Medicare. This growing problem has forced many elderly and disabled people to choose between good health and paying one’s bills.

Beginning in 2006, the main provisions of the new legislation would allow seniors to purchase coverage for their prescription drugs as well as require higher-income seniors to pay more for Medicare Part B coverage (CBS News, 2003).  Estimates under this new program would have drug insurance premiums of about $35 a month and a deductible of $250 (CBS News, 2003). Seventy-five percent of costs would be covered until the recipient’s drug costs reach $2,250, after which there would be no drug coverage until drug costs reach $3,600, or approximately $5,100 in overall expenses (CBS News, 2003). After $5,100 in expenses, the plan would cover about 95% of prescription costs (CBS News, 2003). Even with political and special interest influences directing the policy, the Medicare reform goal was reached.   

Congressman Charles Grassley, R-Iowa, an architect of the bill, and many insurance and pharmaceutical companies were involved in setting the agenda for this policy reform to Medicare (CBS News, 2003). Together, with the support of the President, these parties and many special interest groups worked to set the formulation of change. Grassley stated that, “now was the time to act for it may be years before another opportunity comes along (CBS News, 2003).” The role of interest groups such as the nation’s various elderly and disabled groups served to display the needs and values hoped for in future reforms. Governmental leaders in both the Senate and the current administration worked to provide a service to beneficiaries that fell within current and future budgets. At times, the lofty $395 billion legislation was ignored and caused a great deal of political and public unrest.

This legislation was very controversial and in many cases proved to be more of a detriment than an improvement to Medicare.   Senate Democratic Leader Tom Daschle called the bill a "bailout for the HMOs and insurance companies (CBS News, 2003).” The administration stated that the change to modernize Medicare would have savings of between 15 percent and 25 percent off retail prices. The caused the many out-spoken critics to argue that White House estimates were inflated (CBS News, 2003). Many critics even stated that the pharmaceutical companies were the winners of this bill at the expense of low income Americans.

The stated goal of the administration was that it was time to modernize Medicare.  One factor that contributed to reaching this goal was the addition of electronic medical informatics. This electronically stored data is invaluable to evaluating both the financial viability and the practicality of medical procedures. The ability to evaluate patient data with respect to cost analysis was a crucial factor leading up to reform (Longest, 2002).   

In conclusion, the need to reform Medicare was clear and certain. The leadership at the time took decisive advantage of timing and resources in order to advance their goals and ideals. Moreover, the parties of interest and influence worked to motivate and render change. Even with all the political balancing acts, President Bush signed the bill, and it will take effect in 2006.  And while the initial goals were not entirely reached, the concept and practical value of the change can, in the future, prove to be of great value. The question to ask is whether people will appreciate it or cause it to become even more of a burden on society and political power tool.

References

CBS News. (2003). Medicare drug bill nears passage. Retrieved July 1, 2005

from http://www.cbsnews.com/stories /2003/11/25/politics/main585478.shtml

Frank, R. (2002). Prescription-drug prices. New England Journal of

Medicine. Retrieved July 1, 2005 from http://content.nejm.org/cgi/content/full/351/14/1375

Longest, B. B. (2002). Health policymaking in the United States, 3rd ed. Chicago:

Health Administration Press.