Medicare – We Need to Protect Its Promise

I was a junior in high school when Medicare was voted into law and the first beneficiaries were registered a year later in 1966. President Lyndon Johnson arranged for former President Harry Truman to receive the first Medicare card in recognition of President Truman’s advocacy for a national health insurance program back in 1945. I don’t remember anything about Medicare when I was in high school. I don’t remember my parents talking about it or hearing about it anywhere, but in my own defense, I was in high school and had much more important things to care about. But I do remember the increase in taxes in my paycheck from my summer job in 1966, and it wasn’t until later in life I understood how important those deductions were to the promise of Medicare. I do remember, prior to 1966, my parents worrying about the health of my maternal grandparents and discussing how they would take care of them as they grew old. I can only imagine that, before Medicare, everyone would worry about growing old and getting sick. Medicare is a safety net that lightens the worries of getting old.

Medicare is a promise that the money we pay into Medicare over our years of employment will give us access to good healthcare in our old age. There have been changes over the years:

·       The addition of younger disabled adults and coverage for those with kidney failure

·       Hospice coverage

·       Private-plan options (Medicare Advantage; Part C)

·       Prescription drug coverage (Part D)

·       Drug price negotiation and out‑of‑pocket caps on medicine

‍What I do know, in the almost 30 years I’ve been advocating for older Americans, is the promise has been kept. There have been bumps in the road, too many regulations, roadblocks to access, the inefficiency of fee-for-service, and fraud and abuse, but we keep working to make Medicare better. Lately, it seems that we sometimes forget how important the Medicare promise is. Take the last changes for instance. We finally put a cap on the yearly out-of-pocket costs for medicines, something that alleviated the specter of runaway drug costs and made retirement planning much easier. On the other hand, we inserted the inefficiencies of price controls on prescription drugs that have put a chill on innovation. Short-term solutions and ill-advised intrusions into a successful government program are not the changes we need.

‍Every year, Medicare Today, a project of the Healthcare Leadership Council, conducts a survey to ascertain the feelings of seniors concerning Medicare and Medicare Part D. Every year, the approval rating comes in around 90%. I don’t know of any other government program that is as popular. While I’ve said in the past, “if it ain’t broke, don’t fix it”, it might be more accurate to say, “don’t replace the engine if your car only needs an alignment”. Which brings me to the subject of our Facebook Live Event scheduled for Wednesday, May 20th at 1:00 PM ET. In this event, I’ll be discussing the Most Favored Nation option of controlling the price of medicines with RetireSafe’s Mark Gibbons. I’ve written multiple blogs on this subject, here’s a recent blog that will give you some background, but it keeps coming to the forefront of policy discussions and seems to be taking on a life of its own. I encourage you to click here to get the event details. Be sure to mark yourself as “going” on the event page if you plan to tune in. It will be a great way to find out more about this policy and how it will affect all of us.

‍The MFN approach is a way to set the price of selected medicines by comparing the price of those medicines in foreign countries to the price in the U.S. While some believe this is a way to stop other countries from free loading on our country’s investment in research and development, it is really just another way to impose government price controls on these drugs. We’ll talk more about this approach in our discussion this Wednesday, but there is one thing I’d like to talk about that maybe we haven’t focused on.

‍In the not-so-distant past, the European nations, primarily France, had a robust, and in some areas, world-leading research and development program in prescription drug discovery. They had world-renowned scientists who made important, life-changing discoveries. Then they began enacting price controls in many facets of their healthcare, including prescription drugs, and restrictive government controls, and the drug research financing began to dry up. With the United States passing the Bayh-Dole Act and the Hatch-Waxman Act, many of the top scientists and manufacturing experts left for the more fertile research environment. This helped establish the U.S. as the world center for drug innovation. I see the establishment of price fixing, restraining regulations, and constricting government oversight in our government as indicators that we might be headed down the same road that Europe did. Today, some European countries and China are becoming powerful competitors in the development of new medicines. We need to stop putting up roadblocks to the search for new cures. Using MFN as the basis for more price fixing is not the answer.

‍I encourage you to take the time this Wednesday to tune into our Facebook Live Event. Click here to get the event details. It is important to understand the impact of these policies on your healthcare and on the promise of Medicare.

‍Best, Thair ‍