- The Washington Times - Sunday, June 8, 2003

President Bush is recommending changes in Medicare that would offer incentives for some seniors to get improved prescription-drug benefits by switching to private health plans while offering some type of drug benefit for all in the system.

“Today, doctors routinely treat their patients with prescription drugs, preventive care and groundbreaking medical devices, but Medicare coverage has not kept pace with these changes,” Mr. Bush said in his weekly radio address yesterday. “Our goal is to give seniors the best, most innovative care.

“This will require a strong, up-to-date Medicare system that relies on innovation and competition, not bureaucratic rules and regulations,” he said. Mr. Bush has said he wants to sign legislation this year.

Democrats have sought to claim the issue of improving prescription-drug benefits as a central campaign theme in recent elections.

On Friday, the Bush administration praised a bipartisan plan for prescription drugs under Medicare, the federal health insurance program for the elderly.

But Thomas Scully, the administration official who oversees both Medicare and Medicaid, the program for the poor and disabled, told lawmakers that he disagrees with a feature in the plan that would offer equal benefits to all elderly regardless of how they receive health care.

Mr. Scully prefers that older people have a stronger incentive, in the form of enhanced drug coverage, to enroll in private plans.

Mr. Bush favors a plan that would offer better drug benefits to those who enroll in preferred provider organizations, or PPOs, part of an approach the administration says would modernize Medicare while strengthening its finances.

Under PPOs, beneficiaries may see any physician for their care but would pay higher costs, sometimes much higher, if the doctor were outside the insurance plan’s network.

Co-sponsors of the bipartisan measure in Congress reject that approach of offering different levels of drug benefits. Some opponents of Mr. Bush’s approach say the many different approaches could be confusing to seniors.

The president will meet Wednesday with medical professionals in Chicago and Thursday with older people in New Britain, Conn., to drum up support for his approach to Medicare.

He outlined four goals for the Medicare system:

• Allow those who like the current Medicare system to stay where they are and receive prescription-drug benefits.

• Allow those who want more coverage for preventive care and other benefits to choose from multiple health plans under a Medicare that would have an option similar to the health care coverage available to federal employees.

• Allow older people who want to use managed care plans, including prescription-drug coverage, to choose from a range of plans.

• Provide extra help for low-income seniors so they can choose among different Medicare options while retaining access to prescription-drug benefits.

Mr. Bush was at Camp David, Md., yesterday and called German Chancellor Gerhard Schroeder to relay condolences about the suicide attack in Afghanistan that killed and wounded several German peacekeepers.

As the president and lawmakers debated the best way to change Medicare late in the week, federal officials announced an expansion of benefits for those needing a medical device that helps protect against potentially fatal out-of-synch heart rhythms.

The officials want to expand Medicare coverage for patients who need implantable cardioverter defibrillators.

Makers of the defibrillators had asked Medicare to cover the devices for tens of thousands of patients who had had heart attacks but did not have the characteristic arrhythmic heartbeats. Medicare officials say they will provide coverage only to those who appear to be most likely to benefit, far fewer than the companies wanted covered.

The devices can cost $25,000 to $40,000 to buy and implant in a patient, according to some estimates.

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