Leader Blues

Saturday, November 25, 2006

EDITORIALS>>Big chance for Berry

His party will run both houses of Congress in January and Rep. Marion Berry’s big issue — prescription drugs — also is at the top of the Democratic agenda. Berry aroused great expectations in the election because he has often been the party’s point man on health issues. We will see his mettle now.

Berry was a vociferous critic of Medicare Part D, the prescription-drug program passed by the Republican Congress and signed by President Bush. It was a badly flawed program, enacted by a Congress and a president who really did not believe in it. Part D’s purpose was to remove a Democratic issue that Americans overwhelmingly embraced. The first step, one that Berry has hammered for four years, is to change the law to permit the federal government to negotiate prices of widely used drugs. Though they sang hymns to competition, the Republicans cavil when it really means something. The pharmaceutical companies did not want to bid on drug sales to Medicare beneficiaries.

Berry lost that fight when the pharmaceutical and insurance companies sat down with the majority to write the Part D law and regulations. Now he has the advantage and that reform should clear the House of Representatives handily. The test will be in the Senate, where Democrats have the slimmest majority, and with a presidential veto.

But that is not the only or even the principal flaw with the drug program. Inserting a little price competition in the prescription market will reduce the government’s layout on the program and help the aging beneficiaries marginally. For many it would postpone the day when they reach the infamous “doughnut hole,” when they must pick up the full cost of drugs.

It may be that with shaky margin in the Senate and a hostile president only tiny incremental changes can be made. But Americans by a wide margin expect more. Arkansas, particularly Berry’s district, relies more heavily on Medicare for lifesaving medicine than almost any other place in the United States and nothing the Congress is apt to take up will mean more.

The fundamental flaw was to create a program for insurance companies rather than for beneficiaries. To create space for insurance company profits in the government outlay, Congress cut off benefits after each recipient reaches a certain threshold and resumed them when the drug costs reach a catastrophic level. The huge gap in coverage made no medical or rational sense.

The whole program was designed to be so bewildering that the elderly either would not participate or could not make economical choices about the kind of plan that would suit them best. They are at the mercy of the insurers’ clever marketing. Sweeping away the Rube Goldberg eccentricities of the program would help a lot.

Sen. Blanche Lincoln, one of the few Democratic senators who voted for the crazyquilt plan, was among 16 senators last week who complained to the Medicare administration about some of the misleading marketing. They can do something about that when they rewrite the law. We hope a broad revision is what Berry and his party have in mind. “Whatever we do, we do want to make it better and not worse,” Berry said this week. “In the end, our goal is that anybody that’s got a Medicare card would be able to go to any pharmacy in the United States and get their prescription at the same price.” We would like to see him amend that ambition to “get all their prescriptions at the same low price.” Then he will meet his constitiuents’ high expectations.