Molly Ivins Explains the Complicated Medicare Drug Bill

The head of the camel
Real prescription drug reform isn't going to happen this year -- but it might start.

The press is helpfully wringing its hands and announcing, "This is soooo complicated."

So let's try the unusual maneuver of actually looking at the merits of the thing. If you put, as Consumer Reports has helpfully done, the hybrid House Republican/Bush bill up against the Democrats' version by the respected Medicare expert John Dingell, it's no contest. The Democratic bill is better in every respect -- except, of course, it costs more. It has the additional flaw of being unlikely to pass in the Republican House.

In fact, the Republicans are not entirely sure they can get their own awful version passed. For starters, the Republican version covers, at best, 22 percent of projected prescription drug expenditures. It includes a $250 deductible, 20 percent coinsurance up to $1,000 and 50 percent coinsurance on $1,001 to $2,000, and costs an extra $35 a month. There's an even weirder hitch called "the doughnut," a hole in the middle, that leaves seniors spending between $4,500 and $5,800 uncovered.

Don't even ask how that got in there -- you don't want to know about that bit of sausage-making.

According to CR's calculations, the average Medicare beneficiary now spending $2,318 for meds would find the out-of-pocket cost under the Republican version higher in 2007, a total of $2,954 in constant dollars. Under the Senate bill, CRE estimates the same $2,318 would come to $2,524 in 2007, including premium, deductible, co-payments and the "doughnut."

Bottom line, Kennedy's right: The Senate version is incrementally better, and in politics, you should always take half a loaf, or even 22 percent of a loaf, if you can get it. But if the Senate version is even slightly weakened by the repulsive House version, fuhgeddaboutit.

The Senate bill has no chance and is of minimal benefit anyway. The majority of seniors would be better not signing up for it. Should you let GOP take credit for a drug bill because it will help some people with huge med bills? This is a Rove bill, whichever way the Democrats play it they lose.