Case Study: Medicare Part D

Distortion of reality often occurs in ‘debates’ about various issues. Medicare Part D is one of those issues. The NYT recently used it to support the idea that the quadrupling of the federal deficit this year. This Medicare prescription drug law has been attacked from all sides and seems to be a favorite whipping boy. The reality is discussed by Mort Kondracke who thinks the Medicare Drug Plan Ought to Be Model for Health Reform.

Passed amid rancor and predictions of catastrophe, the law has proved to be an enormous success – much cheaper than expected and overwhelmingly popular with seniors.

The problem for liberal Democrats is ideology. The Medicare Part D program is based on competition among private insurance plans, whereas they are determined to model health reform on government-run, price-controlled Medicare Parts A and B or on Massachusetts’ individual-mandate plan.

Medicare Part D costs far less than was expected

When the prescription drug benefit was enacted, opponents predicted that few insurance plans would emerge to offer coverage. Instead, dozens did, causing critics to say seniors were confused by the choices.

premiums are lower than expected

This was one law attempting to address the health care costs problem that actually made it through the process and shows some success. It provides lessons both for how difficult it is to address health care issues in legislation as well as in the concepts that can be employed to improve the odds of success.

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