With all the attention that’s been paid this year to Bush’s stalled Big Plan in domestic policy–Social Security privatization–there’s been little talk in political circles about the fate of his last Big Plan–the Medicare prescription drug benefit enacted in 2003 after an enormous amount of GOP arm-twisting.Opponents of the plan–which included the DLC–pointed to a wide variety of problems, ranging from its exceptional and much-disguised cost, to its relatively meager benefits, to its incredibly complex structure, to the windfalls it might provide to drug companies, especially given the bill’s failure to authorize government negotiations over prices.But now, two years later, the big problem is simply that seniors, and more specifically a broad cross-section of seniors, might not sign up.That’s the news from Robert Pear of The New York Times, who wrote up the first stop–in Maine–of an administration road show aimed at promoting the benefit.Pear succinctly describes the major fear gripping administration officials:
The economics of the new program depend on the assumption that large numbers of relatively healthy people will enroll and pay premiums, to help defray the costs of those with high drug expenses. Insurers say the new program cannot survive if the only people who sign up are heavy users of prescription drugs.
Ah, but there’s the rub. The better-off and healthier seniors are among those who look at the benefit and its costs in premiums and aren’t exactly excited about it:
People who said they were healthy said they saw no immediate need to buy the Medicare drug coverage. People who said they were ill said the benefit seemed meager. And local insurance counselors said they shuddered at the complexity of the program.
The road show, which will soon be supplemented by a publicity blitz by a wide array of senior and health care organizations, may get seniors who will clearly benefit from the Rx coverage to sign up. But the underlying problems with the whole plan are not going to go away, and could make its costs go even higher than previously assumed. If so, Republicans will be left holding the bag for a genuinely unique accompishment: a new and very expensive government entitlement that its intended beneficiaries don’t like.