Carpetbagger has an excellent reminder that a bill conceived in the most underhanded possible manner probably won’t result in good legislation:
The program was passed in 2003 under unusual circumstances that included bribes on the House floor. Before lawmakers agreed to the plan, the administration went to great lengths to deceive Congress about the cost estimates for the plan. Once it became law, and seniors started to learn about the new program, everyone was completely confused and couldn’t figure out what to do.
Steve (aka Carpetbagger) neglects to mention that the bill only passed after House Republicans flouted standing rules and kept voting open through the night. Recall how Republicans reacted when House speaker Jim Wright held voting open for all of 15 extra minutes in 1987:
Republicans denounced this as an outrageous departure from regular order. Then-Rep. Trent Lott (R-Miss.) railed against “Jim Wright and his goons.” And a Republican congressman named Dick Cheney denounced the move as “the most arrogant, heavy-handed abuse of power I’ve ever seen in the 10 years that I’ve been here.”
Ye gods, how today’s Congress must wound his conscience. Cut to Dick Cheney, today, standing on a windswept field observing Tom DeLay’s congress and, silently, shedding a single tear.
Anybody who could read predicted that the implementation would be a disaster. The White House said that they’re on it, which obviously turned out to be complete bullshit:
It’s a Government Accounting Office report, issued in December, warning that the Bush administration hadn’t done enough to make sure the most medically and financially vulnerable Medicare beneficiaries could actually get their drugs.
If you do get around to reading it, make sure to check out the part where Mark McClellan, director of the Center for Medicare and Medicaid Services, says the GAO has it all wrong — the part where he insists that “CMS has established effective contingency plans to ensure that dual-eligible beneficiaries will be able to obtain comprehensive coverage and obtain necessary drugs beginning January 1, 2006.”
Carpetbagger (same post) and practically everybody else have first-draft surveys of the ongoing train wreck. Take the time to read Hilzoy’s post at Obsidian Wings:
So: what would Medicare Part D mean for me? For starters, this business about not being able to get medication for days would be, for me, a very serious problem. As I said, it seems to take four days after I stop taking medication for me to have a seizure. Predictable as clockwork. If I couldn’t get medication, I would probably have one. That being the case, if I had the money to buy some, I would, even if it meant not eating for a while. And if I didn’t, I’d probably have my first seizure in 21 years.
Let’s assume I had this seizure in optimal circumstances: while lying in bed, for instance. It would still be a very big deal for me. You see, the only reason I am allowed to drive is because I haven’t had a seizure for so long. If I had one, I’d lose my license, and for good reason. As it happens, I live outside Baltimore, and without my car I would, essentially, be marooned. That would be a serious problem, to put it mildly. I would absolutely have to move. No question about it. And I’d be thanking the Republicans in Congress who designed this program all the way.
Let’s suppose, though, that I was lucky enough not to have any problems with enrollment. Would I be OK? No. It turns out that the medication I take — Mysoline/primidone — is not covered by almost any plan. (And for some unfathomable reason, prescription drug programs are barred by law from covering barbiturates, which are also used to treat epilepsy.)
Worth reading in full. This bill simply can’t be explained away as something that government just does. Every clause of the bill was written for somebody’s sake.
If not for the patients, then for whom? No point in being coy. We all know for whom. Banning certain generics and banning the government from negotiating lower prices spells it out pretty clearly. I guess the theory is that some of that Pharma/insurance company wealth will trickle down to the medicare recipients after they’re dead.