Medicare Part D Delenda Est!

During the time of the ancient Roman Republic, the Roman senator Cato the Elder worked a slogan into virtually every speech or conversation -- Carthago delenda est! -- Carthage must be destroyed! The city-state of Carthage was a economic competitor to Rome and was considered to be a constant threat (though the reality of how much a threat has always been debatable). Ultimately, the ire of Rome was raised, and Carthage was defeated, its citizenry enslaved, and the city razed to the ground. (Alas, the story that the ground there was sown with salt to prevent anything even growing there again was just a legend.) The medical world faces a similar threat today, one which I feel is non-debatable. Its name is Medicare Part D, and, paraphrasing Cato, I now say, "Medicare Part D delenda est! -- Medicare Part D must be destroyed!

Do not think me deluded or misguided. For years we in this country have been spoonfed a continuing mistruth about the "need" for a prescription drug plan under Medicare. The rationale for this has been described variously, but it usually boils down to some variation of "our senior citizens should not have to choose between buying their medicines and buying food" and other similar malarkey. However, the real reason a "Medicare Part D" was "needed" has nothing to do with altruism. It has to do with power. Political power.

For years (a couple of decades actually) the Democratic Party lorded it over the Republicans with their support of a Medicare drug plan (as opposed to the Republicans' supposed opposition to such a plan) as part of the Democratic strategy of fear-mongering to gain the votes of the AARP and other senior citizen groups. But despite being in absolute control of the House and the Senate from 1965 (when Medicare was first passed) until 1994, when the Republicans gained control of the Senate, they made virtually no effort to actually implement such a plan. When the Republicans finally gained control of both houses of government, they passed a program (the current Part D) mainly to take away the sledgehammer the Democrats had been beating them over the head with for over 30 years. It had little to do with "helping" our senior citizens, and more to do with helping the Republican party. Only they really just shot themselves in the foot (actually in a somewhat higher place of their anatomy), but they haven't fully realized it yet.

No one, not even the news media, seems to remember this, but believe it or not, the current Medicare Part D is not the first prescription drug plan passed for Medicare recipients. Back in 1988, Congress passed a bill called Medicare Catastrophic Health Insurance, designed to make sure that Medicare would never run out for extremely sick elderly persons (something which was then and is now theoretically possible). I remember this because one of this bill's main sponsors was then Texas Senator and ultimately failed Democratic Vice-Presidential candidate Lloyd Bentsen. This bill also contained a prescription drug coverage program for senior citizens, at the relatively modest cost for the entire program of an increase in the Medicare premium (deducted from Social Security checks) of $3/month. This raised the ire of the communists at AARP, who wanted the coverage but at no additional cost to their members. The political opposition was severe, and the entire bill was rescinded about three months after it was passed, and before it could actually go into operation. The AARP seems to have learned their lesson; they do not like the current Part D and want it changed into a government-controlled entitlement, but they realize now that it is much easier to get a program changed than it is to get one passed (since it took almost twenty years to get the second plan passed after they had assassinated the first one).

The problem I have with Medicare Part D (and I mean any kind of Part D, not just the one we have threatening us now) is that it is the wrong solution to the wrong problem, and it comes at a tremendous price. There has been no real public discussion on the costs of Part D, but recent estimates (in the medical press) of the costs of the second ten years of the program are around two trillion dollars. The Democrats' version would cost even more. And government cost estimates are always woefully too low. Additionally, any kind of a Part D (as I will discuss in more detail in subsequent postings) shifts at least part of the costs onto the backs of other segments of our population, which is inherently unfair.

The sad truth within the mistruth is that there are elderly people in this country who do have to make the choice, with their limited incomes, between food and medicine. But the problem is not, as we are constantly being told, that our senior citizens cannot afford their prescription drugs (which is what Medicare Part D is the solution for). The problem is that the drugs cost too much, and Medicare Part D is not the solution for this; it will in short order actually make this problem worse, at least for some Americans (the ones least able to afford it).

The real reasons that drugs cost too much in this country are not what you think or what you are being told. But they can be easily uncovered. A Congressional investigation could get to the bottom of it in a couple of years. Time, Newsweek, or U.S. News and World Report could do an investigation and have a cover story in about six weeks. But all it really takes is to open one's eyes and look at the obvious truths in plain sight. Which unfortunately, no one at any point along the political spectrum, from the farthest left to the farthest right, seems willing to do. But I will, and my observations will be forthcoming in my next several posts.

Until then:
Medicare Part D delenda est!
Medicare Part D delenda est!
Medicare Part D delenda est!