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In its new spirit of cooperation, Congress could fix health care

With members of the new Congress falling over themselves to exhibit a spirit of cooperation and bipartisanship (at least for the TV cameras — and it would doubtless be churlish to ponder why it took an election upset to bring it about), one of the areas to which they could well apply some mutual effort is health care.

There is no reason, in the 21st century, with all the expertise, technology, and resources available, that this country can't do a better job of insuring that all its citizens have access to decent health care at a cost that doesn't bankrupt the treasury.

It is unconscionable that, for many Americans, basic health care is (1) unattainable at any cost because of uninsurable health conditions, or (2) unavailable because an employer can't afford a health plan, or (3) unaffordable for those not in a group plan and wanting personal or family coverage (many of America's family farmers fall in that category).

For an administration and a party whose principles supposedly center on the economies and efficiencies that derive from a free enterprise, competitive, market-based system, one need only to look at the Medicare drug program that began in 2006 for a glaring example of those principles gone astray.

In a deal critics have labeled “welfare for drug companies,” the program was written to prevent Medicare from directly negotiating price discounts with drug manufacturers.

Thus, already expensive drugs cost far more under Medicare than they would under a negotiated pricing structure. The Veterans Administration, for example, has a negotiated pricing arrangement that allows it to purchase the same drugs at significantly lower prices than the new Medicare program.

The 20 top drugs used by seniors, according to the Congressional Budget Office, will generate excess profits to manufacturers of $7.6 billion per year under Medicare, compared to what the VA pays for the same drugs.

To add insult to injury, the Medicare program has a gap in coverage — the “doughnut hole” — that kicks in when a person's drug expenditures fall between $2,250 and $5,100 per year. Any drugs needed during that gap must be purchased by the individual, at the inflated prices, plus the monthly Medicare drug program premiums. Is that a deal, or what?

The further irony is that the CBO says the $7 billion in excess profit that's going into drug company coffers would more than pay the cost of eliminating the “doughnut hole” in the Medicare program.

Much ado has been made by this administration over the need to reform Social Security and to move toward some degree of privatization. Yet, Social Security's unfunded liability, at about $4 trillion, pales beside a potential $30 trillion for Medicare.

And costs throughout the medical system keep escalating. General Motors says it spends more per car on employee health care than it does for the steel that goes into a car. And individuals outside a company health plan often pay more for insurance than for their mortgage.

Something's wrong. This Congress could start doing something about it by eliminating the excess profits to the drug companies.

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