Studies Back Targeting of Drug Benefits
As the White House and Congress debate who should be eligible for a new Medicare prescription drug benefit, researchers are bolstering the Republican argument that aid should go to the neediest senior citizens.
“There is a core group of elderly--those who are poor and those who have chronic illness--who have the greatest need for a drug benefit,” said John K. Inglehart, founding editor of the policy journal Health Affairs, which published three new studies of retirees’ prescription costs and usage in an issue released today.
The findings come as Congress and the Clinton administration wrestle over how best to help elderly and disabled Americans, who get health insurance under Medicare, pay for drugs. Medicare provides no reimbursement for most prescriptions.
President Clinton has proposed offering an optional, limited drug benefit to all 39 million Medicare beneficiaries. Republican congressional leaders say it should be targeted more narrowly.
One study confirmed past estimates that at least two-thirds of Medicare beneficiaries already have some type of drug coverage--generally from private sources such as corporate retirement benefits, HMOs and Medigap insurance, or from state health programs for the poor.
Researchers John A. Poisal and George S. Chulis, who work at the federal agency that runs Medicare, based their findings on a 1996 government survey of beneficiaries.
The percentage of Medicare recipients who said they were in fair or poor health was roughly the same--about a quarter--regardless of their drug coverage, suggesting similar medical needs.
But the 11.6 million recipients without drug coverage used five fewer prescriptions on average in 1996 and still spent 83% more of their own money on drugs--an average $463 compared with $253 for those insured, the researchers found.
A second study suggested that senior citizens with chronic illnesses would continue to face high out-of-pocket costs under a widely available but limited Medicare benefit like the one President Clinton has proposed.
The study, financed by the Henry J. Kaiser Family Foundation and conducted by private researchers, looked at 1998 claims by 375,000 Americans age 65 and older who have drug coverage as part of a corporate retirement plan.
It found that 18% purchased no drugs at all in 1998. But among those who bought drugs used to treat chronic diseases--including diabetes, high blood pressure, depression and osteoporosis--more than one in four spent at least $2,500, with the top 1% spending as much as $10,000.
The third study found that elderly patients with high blood pressure are less likely to buy medication for the condition if they lack insurance coverage. Those who did buy it paid 36 cents more per pill and purchased an average of 37 fewer tablets a year than their insured counterparts.
