The Bush Drug Lottery Flops

The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.

Sir William Osler, Science and Immortality

The good news is if the compassionate George W. Bush is elected in November he won’t be taking over the health care system. Mr. Bush has announced that in order, one assumes, to reassure the uninsured and the elderly. It’s not clear that’s the kind of reassurance they needed from a compassionate conservative.

At last count there were more than 43 million Americans without health insurance, including 8.5 million children. A recent study conducted by the Institute of Medicine of the National Academies of Health found that about 18,000 unnecessary deaths occur each year because of individuals’ lack of health insurance. According to the Institute the cost to the United States because of poor health and early deaths of uninsured adults is the equivalent of $65 billion to $130 billion annually.

On the positive side, people without insurance do not have to worry about the government meddling in their lives and that independence gives them something to feel good about-until they get sick and can’t get medical treatment. If Mr. Bush is reelected those 43 million people can count on Mr. Bush not interfering in their lives. If Mr. Kerry is elected, Mr. Bush said in mid-September in Michigan, we can expect a “government takeover of health care with an enormous price tag.” That’s probably true. It would be very expensive to provide medical care for 43 million people. Better they stay uninsured than that we impose an additional burden on the good people who pay taxes and make this great country what it is.

It’s not only the uninsured who won’t have to worry about the government involving itself in the minutiae of medical care. The elderlys’ needs have been addressed by both candidates. Unlike the 43 million, the elderly do have insurance. It’s called medicare. The elderly have just learned that next year medicare premiums will increase by 17.4 percent and they will have to pay $78.20 a month for their coverage. The presidential candidates are understandably very concerned about this since each of them caresnot only about the elderly but about how the elderly will vote. Each of them has addressed this huge increase in premiums in his own way. Mr. Bush’s response to the announcement was to tell supporters at rallies that Mr. Kerry voted for the legislation that brought about the increase. Mr. Kerry said that if elected he will rescind the increase.

On the same day the increase in medicare premiums was announced it was disclosed that another effort on the Bush health care front was a disappointment if not an outright failure. The disappointment was the government-sponsored drug lottery.

Earlier this year the Bush administration set up a drug lottery system for those afflicted with cancer and certain other serious illnesses whose victims require expensive drugs for treatment. Of the 500,000 persons afflicted with serious illnesses who were eligible to participate, 50,000 were to be selected by lottery. The lucky 50,000 would have an opportunity to obtain drugs for treatment that they could not have otherwise afforded. The remaining 450,000 would have to wait until 2006 to receive those drugs, assuming they survived until then. As exciting and compassionate as a program designed to give one-eighth of the people in need affordable medicine appeared to be, the program has been a flop. That’s because of the 500,000 people eligible to participate, only 7,000 have applied and fewer than 4,000 are enrolled. That is hard to understand. In addition to the fun of participating in a lottery and eagerly awaiting the results, the effects of winning can be terribly important to the participants since the winners can then afford to buy the drugs they need to stay alive.

One medicare official suggested that it had been a mistake to describe the process as a lottery. He said that many of the elderly didn’t like to participate in gambling activities. When the program was announced, Tommy G. Thompson, secretary of health and human services said the program was a boon to the elderly. It was obviously not perceived as such by the elderly sick since they’ve not tried to enter the lottery.

There is one bit of good news from a public relations point of view, however. If fewer than 50,000 people enroll then everyone who does will be a winner. No one who applied will be denied admission and forced to wait for their required drugs until 2006. George Bush will like that. It makes for a great sound bite on the campaign trail and that, as far as this administration is concerned, is what health care is all about.

Christopher Brauchli is a Boulder, Colorado lawyer. His column appears weekly in the Daily Camera. He can be reached at: brauchli.56@post.harvard.edu

 

 

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