James Sensenbrenner, July 3, 2003

Every time I hold Town Hall Meetings, or schedule Office Hours in my district, the conversation invariably turns to the issue of health care, and oftentimes, the role of a prescription drug benefit for folks on Medicare. Well, Congress has long considered adding a prescription drug benefit to Medicare. In fact in 1988, Congress passed the Medicare Catastrophic Coverage Act, which provided a prescription drug benefit, but required beneficiaries to foot the bill. I realized that this bill was indeed "catastrophic" and voted against it because the complicated benefit was difficult to explain and was doomed to have low participation rates. To its credit, Congress recognized its error and repealed the legislation a year later.

Congress once again revisited this issue in the early hours of June 27 by passing HR 1, the Medicare Prescription Drug and Modernization Act of 2003. This bill, which passed by a one vote margin, provides a voluntary prescription drug benefit to all eligible Medicare beneficiaries. Nevertheless, I voted against this bill, because it is fraught with problems.

According to the New York Times, HR 1 represents "the biggest expansion of Medicare since its creation nearly four decades ago." The Medicare program is already overtaxed fiscally, and while proponents of the bill maintain that the drug benefit will cost $400 billion over 10 years, this figure is merely an estimate. I believe the $400 billion will be a floor, rather than a ceiling, and HR 1 will plant the seeds of destruction for the Medicare program, which is an important social safety net for America’s senior citizens.

As Americans learn more about the details of the bill, they will see that for the most part, private prescription drug plans will be better for Medicare beneficiaries than the option provided under HR 1. But private companies will not be able to compete with the government, and as businesses and employers start dropping them in favor of the less expensive government plan, the beneficiaries will suffer through reduced or insufficient services.

Another concern I have with HR 1 is that it does not allow Americans to purchase prescription drugs from Canada, where they are generally cheaper than in the US. If this provision had been included, it would have helped to drive drug prices down, without cost to the federal government, or the taxpayer. Certainly, there are legitimate safety concerns that must be met to allow this practice, but I support allowing American seniors and others to determine if this option is right for them.

Congress would be well served by taking a look at Wisconsin’s SeniorCare Prescription Drug program, where the lowest and middle income people without a health plan get more help than those seniors who are financially well off. Under the current bill, I have grave concerns about whether the Medicare program will stay afloat once the Baby Boom generation is eligible for Medicare and Social Security. Adding a drug benefit that does not place constraints on future spending would result in massive tax burdens for our children. Now that the House and Senate have each passed a Medicare Reform bill, I hope that the conference committee, comprised of Members of both legislative bodies, will do all it can to reform Medicare’s bureaucratic structure, rather than throw money at the problem.

James Sensenbrenner, Jr., is a Republican Member of Congress representing the Fifth Congressional District of Wisconsin. He chairs the House Judiciary Committee.