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Dr. Sanjay Gupta: Prescription drug dilemma
(CNN) -- Health care, especially prescription drug benefits for senior citizens, is one of the top domestic issues that President Bush is expected to address in his State of the Union speech Tuesday night. CNN Medical Correspondent Dr. Sanjay Gupta spoke Tuesday with anchors Paula Zahn and Bill Hemmer about some options for prescription drug benefits. GUPTA: It may not be as big as the war or economy, but certainly health care will be a big topic for the State of the Union. What we expect are really three hot-button issues that the president has talked about in the past. Prescription drug benefits for seniors tops the list. [Then there's] modernizing Medicare and access to health care. Prescription drug benefits are something we have talked about a lot. When Medicare was actually started back in the '60s, prescription drugs were not a huge part of overall health care costs, but now they are a huge part. So Medicare, back when it was founded, only covered in-hospital medications. But now the United States is actually one of the most expensive countries in the world when you look at average drug costs. Also, if you look at some of the most common drugs and compare them, you'll see in the United States that these drugs are more expensive here than anywhere else. We're expecting that the president is going to actually talk about options for seniors and prescription drugs. There are really three options that sort of spring to mind: • The existing fee-for-service plan, which is Medicare really the way [it] exists now; • HMOs with prescription benefits; • private plans with prescription benefits. What we're talking about is getting seniors to join private plans -- taking them out of Medicare, putting them in private plans with prescription drug benefits. Those are the big three that are probably going to be the options. Not everyone agrees with this. Barbara Kennelly, who is president of the National Committee to Preserve Social Security and Medicine, says, "Prescription drug benefits for current beneficiaries should not be held hostage by the requirement to enroll in a private plan" and that probably is one of the biggest issues Bush has been talking about. Can we get these seniors who are involved in Medicare, which is going to cost $400 billion over 10 years, to actually join private plans by giving them prescription drug benefits? ZAHN: What do you think? HEMMER: Well, I think that that's an option really. Prescription drug benefits has become a much bigger stumbling block than it has been in the past. So anything you can do to make sure these seniors aren't forced to choose between buying drugs or paying rent is possibly a good option. Here's the problem though, and the problem that Bush has already seen in part -- the HMOs actually have to bid on these seniors. They actually have to be able to provide the health care at the same quality and same quantity as Medicare. The HMOs haven't been doing the bidding. They haven't been trying to recruit these seniors into their programs. And if they don't do that, the plan sort of falls apart. And you have to make it worth their while to do this. ZAHN: And structurally are they capable of handling it? GUPTA: That's right. This is a huge infrastructure. There's 42 million people that are uninsured right now in this country. ... If you throw all these new people at the private sector and the private HMOs, are they going to be able to handle this sudden influx?
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