Bush Gets Prized Medicare Deal, but Pressure for Cheap Drugs Still There WASHINGTON (CP) - The U.S. Congress passed President George W. Bush's prized Medicare overhaul Tuesday with a new prescription drug benefit for seniors and a large future role for private insurers.  But analysts predicted there will still be pressure for price controls and cheaper drugs from Canada as Americans search for further relief from the highest medication prices in the industrialized world.  While Bush and other legislators called the $400-billion US bill a historic revision to the 38-year-old Medicare plan, critics argued that it serves the interests of insurers and drug companies and will actually amount to little savings for some 40 million seniors and disabled people.  Canadian provincial plans have covered some medications for years. Starting in 2006, Americans will be able to buy drug coverage for about $35 US a month, with a $250 deductible.  The plan covers 75 per cent of costs until they hit $2,250 a year. It kicks in again at total costs of $5,100 and covers 95 per cent, with no coverage in between - considered a major problem by critics of the legislation.  And the bill creates direct competition between Medicare and private plans beginning in 2010, touching off arguments like those heard for years in Canada about privatization and a better system for those who can afford to pay.  Some groups, like the Seniors Coalition, argued that while the plan isn't perfect, it's a basis to build on. And they noted that low-income seniors will save up to 25 per cent with a drug discount card until the new drug benefit begins.  Others were outraged.  "Shame on the House and Senate for not taking the time to do the work to give seniors a comprehensive drug benefit," said the Alliance for Retired Americans. "Shame on Congress for opening the door to privatized medicare."  In this legislation, the big pharmaceutical companies have ducked their two biggest fears - price controls and legalizing cheaper drugs from Canada.  But they shouldn't breathe too easy, said Joe Antos, a health policy analyst at the American Enterprise Institute, who predicts the monumental coverage will cost more than anyone anticipated.  "Now that the federal government is involved with drugs for 40 million people," said Antos, "it's a no-brainer that we're going to be looking at some aggressive form of price control within a couple years of this kicking in.  "You could see some weird things, like expansion of the drug benefit and then Medicare-wide reductions in payments to hospitals and doctors."  And, said Antos, the lure of Canadian drugs at up to 80 per cent less will always be there.  "It wouldn't take much, under extreme cost pressure, for a government to look at the importation issue again."  The new Medicare bill does nothing to encourage importing drugs from Canada, despite tremendous political pressure and surveys suggesting that most Americans approve of it.  Drugs are cheaper in Canada because provinces buying in bulk negotiate deals and pharmaceutical companies get longer patent protections in exchange for lower profits.  The new bill does say the U.S. Department of Health and Human Services is supposed to study the issue to find out if there's a way to ensure the safety of imports.  "It doesn't change a thing for us," said David MacKay, executive director of the Manitoba-based Canadian International Pharmacy Association.  "Canadian mail-order pharmacies are open for business. We're not breaking any Canadian laws."  The U.S. Food and Drug Administration typically looked the other way when Americans crossed the border to fill prescriptions or ordered online.  But the agency is now cracking down on U.S. companies that help Americans buy drugs in Canada and is warning cash-strapped states and cities to stop thinking about buying in bulk north of the border.  MacKay, who has talked to a lot of U.S. jurisdictions, predicted that some may simply have their workers and retirees buy individually and submit receipts.  "For now, their best bet is to become an educational resource, unless they want to become a target for the FDA."  Some Canadian pharmacists' organizations have warned about higher prices and drug shortages at home as a result of trying to supply more of the vast U.S. market.  This story originally came CBC... Return to the Media Section

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