Medicare Reform and Prescription Drugs: Ten Principles
Introduction
Unlike most of the nonelderly with private health insurance, senior citizens on Medicare do not have coverage for most prescription drugs unless the drugs are administered in a hospital. This is unfortunate. Drugs have already made a major impact on the health and well-being of the elderly:
- Between 1985 and 1999, residence rates in nursing homes declined by 14 percent among persons age 65 to 74, 25 percent among those 75 to 84, and 17 percent among those 85 and older.1
- A principal reason for the declines in nursing home admissions was the introduction of new drugs for stroke and depression.
- Also, in part because of access to new drug therapies, the proportion of Americans age 65 or older with a chronic disability declined from 26 percent in 1982 to 20 percent in 1999.2
"There are 10 principles to consider in solving the problem of seniors' access to prescription drugs."
For the future, spending on medicines as a percent of total health care spending is expected to grow. This should be good news, not bad news for seniors. More than 800 new treatments are coming online for such debilitating diseases as Alzheimer's, arthritis, osteoporosis and Parkinson's, and so are new medicines for heart disease, cancer and stroke - the three leading killers of Americans.3 Yet seniors will not be able to take full advantage of these opportunities if they cannot afford them.
What can be done about this problem? Almost everyone agrees that Medicare needs to be changed. But how it is changed makes a big difference. What follows are 10 principles to guide the reformers in their deliberations.