Bungled Medicare Prescription Drug Benefit Creates Opening for Dems

With the Republicans' Medicare prescription benefit nearing full implementation, it is becoming increasingly clear that the Democrats have a prime opportunity to reclaim territory among older voters.

During his reelection bid in 2004, President Bush did surprisingly well among older voters, outpolling John Kerry by a 54 percent to 46 percent margin among voters over the age of 60. This mark represented a seven-point swing for Bush between 2000 and 2004, the largest such swing among any age group.

Bush's performance among older voters was no doubt affected by the high expectations for the Medicare prescription drug benefit, which was rammed through the Republican House during an unprecedented three hour vote. For the first time in nearly four decades, a President had been able to create a new entitlement program -- and a much-needed one, at that.

But the Republican prescription drug benefit has not met expectations -- not by any stretch of the imagination. Although prescient Democrats warned that the program would not achieve what it sought to, that it was merely an expensive gift to the pharmaceutical lobby, most Americans -- particularly older Americans -- seemed willing to give the President and his party the benefit of the doubt. Now, these same Americans are coming to terms with just how cumbersome this Republican program is.

In the latest poll commissioned by the Associated Press, Ipsos Public Affairs found that a majority of Americans -- and an overwhelming majority of older Americans -- find the program to be puzzling. Specifically, 52 percent of all Americans and fully two-thirds of older Americans find the program "confusing" and "tough to understand." Even before the implementation of the benefit began, Pew found less than majority support for the program, and a particularly sharp decline in approval for the program among Republicans. The headline of Janet Hook's Los Angeles Times article from Saturday perhaps sums it up the best: "Medicare Drug Program May Harm, Not Help, GOP."

So where does this leave the Democrats? There are certainly many Americans unpleased with the Republican prescription drug benefit, but their confusion will not necessarily lead them to vote Democrat in November -- or even not vote Republican.

The Democrats must come up with at least a temporary solution to the Medicare problem. It need not be a panacea for all of the issues faced by the entitlement program, but the key is keeping the plan simple and easy to understand.

If older voters face a choice between a Republican program that is difficult to understand and a Democratic plan that is significantly clearer (not to mention more effective), there is a real possibility that they will come back to the Democratic camp in November after straying in 2004. What's more, their baby boomer children, many of whom are no doubt helping their parents navigate this complicated program, might also be persuaded to shift their allegiance to the Democrats this fall (they, too, supported Bush in 2004, though by a narrower margin).

The potential benefits for the Democrats are immense, so the time is now to begin coalescing around a few ideas (and I do mean just a few) that would make the prescription drug benefit more accessible and effective and to start clearly articulating these ideas to voters around the country.

Tags: Pulse (all tags)



Single Payer
I think this is the time to push for a single payer system. Reasons?
  1. Seniors that have just experienced first-hand what competition in health care means - confusion and a loss of benefits.  On the other hand, they get to experience single-payer medicare and medicaid.
  2. 50 Million Americans without adequate healthcare - who see teh terminally poor being cared for by Medicaid while they work and their children go without.

The time is now.
by Robert P 2006-01-22 03:11PM | 0 recs
competence matters - good government matters
I don't really know much about the polling data on Bush's re-election efforts and the prescription drug benefit, but it seems to me that the broader problem we face is an ever increasing mistrust of Federal Government programs. A central tenet of the Conservative movement (not necessarily demonstrated by the 'conservatives' currently in power) is that government is not a particularly good vehicle for delivering services... Thus, a failed medicare prescription drug program merely serves as proof of their core belief. Rather than merely provide an alternative prescription drug program, we need to think of a way to ensure that the failure of THIS program is attributed to the horrible way in which it was written and then the outrageous way in which it was implemented.
by Marc Laitin 2006-01-22 05:44PM | 0 recs
Re: competence matters - good government matters
That's the whole point. This government benefit failed because it was privatized, not because it was a government benefit.
by antiHyde 2006-01-23 04:16AM | 0 recs
Swing attributed to different factor
The older age group had stronger memories of a real world war. The fake war that the oil corporations waged against Iraq for their oil fields, in which America invades an innocent country - was made to look like a real one.

Karl Rove today announced that he will continue with that strategy, so there will be yet another attempt to fool these people. Just as the medicare plan fooled them.

However, the swing vote should be looked upon not as a referendum on the fake medicare plan, but instead the fake war.

Never switch presidents during wartime. That would have worked in WW2 with a real enemy. These people all lived through that, they thought they were helping.

So they elected Osama Bin Laden's best friend..

by turnerbroadcasting 2006-01-22 08:03PM | 0 recs
with the benefit will continue to grow even after teething problems are solved, because the benefit is so niggardly.  A typical plan offers only a small discount off grossly inflated list prices, or does not cover many expensive drugs at all, providing only catastrophic drug coverage.  The government is said to put a lot of money into the program, and one wonders where it is going.
by Bob H 2006-01-23 02:48AM | 0 recs
Re: Dissatisfaction
It's going to the drug companies.
by antiHyde 2006-01-23 04:19AM | 0 recs
Opportunity Missed?
I see no sign the Democrats recognize the opportunity this poses. After all, the country has the current appalling mess of Part D because the Democrats so badly bungled the opportunity to even present a good alternative package when the Republicans proposed the current abomination.
by S1 2006-01-23 03:33AM | 0 recs
Re: Opportunity Missed?
How many of our "leaders" took drug company campaign contributions? A pretty whore is still a whore.
by antiHyde 2006-01-23 04:20AM | 0 recs
Fixing the drug benefit
The simplest thing to have done was to just add drugs (or most drugs) to the list of covered services, with a small co-pay, like really good private plans.  Then use the feds' bargaining power to reduce the cost of drugs.  The principled objection at the time was that this would be too expensive.  (The unprincipled one was that it would not give enough profit to the drug companies and make Medicare too good.) However, given the true costs of the Republican plan, with high costs and the subsidies they built in, this may end up being cheaper.  

I don't think there is any way to fix the current mess.  It has to be scrapped and done over.  It can't be until the GOP, in thrall to big Pharma, loses its majority.  That is the point that the Dems have to make.  Return us to power and we will fix it by just adding drugs to the covered benefits.

by Mimikatz 2006-01-23 11:10AM | 0 recs


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