The Bush administration, the right wing of the Republican Party, and the health insurance industry have achieved a remarkable feat – the Medicare Prescription Drug Improvement and Modernization Act of 2003 is a major threat to the Medicare program and a marvelous source of profits for the health care industry.

Medicare is a program that seniors have depended upon for health care since 1965, a program that relieved countless seniors from spending themselves into poverty just to obtain health care.

This new program promises prescription drug benefits. In truth, the benefits are limited, with major gaps in coverage. We’ve been told that the bill isn’t perfect, but at least it’s a start. So what is the problem? Why should women be particularly concerned?

First, seniors who currently have better coverage through their retirement plans or unions will likely lose this, as their benefits are downgraded to match the Medicare plan. Certainly tomorrow’s seniors won’t have comprehensive benefits.

Second, seniors are prohibited from purchasing Medigap insurance to cover the gaps in drug benefits, even if they could afford it. Never mind that seniors already spend more than 8 percent of their income on health care premiums (compared to 5 percent for younger people) and another 8 percent on out-of-pocket expenses (versus just over 3 percent for younger persons).

Third, the monthly premium of $35 is sure to increase, quite possibly before the program even goes into effect, with annual increases after that.

So, if this bill is such bad news, why on earth was it passed? The bill doesn’t allow the government to negotiate lower drug prices – quite a boon for the pharmaceuticals. They can be assured of sales at the prices they set and swollen profits. The real plum, though, is the billions of dollars in subsidies that will pour into insurance companies as a result of this “reform.”

That the bill is a guarantee of increased profits for the health care industry, as public dollars are poured into private pockets, is bad enough. But it’s also a threat to the Medicare program as a whole.

As healthier seniors, those whose care is more profitable, are drawn out of Medicare and into private insurance plans, Medicare will be left with a greater proportion of very ill seniors, those whose care is more expensive. As costs for this care go up, Medicare will become more financially fragile, until the guarantee of even basic health care for our most vulnerable seniors is threatened.

Currently, poor Medicare recipients in bad health spend about 44 percent of their incomes on health care. Elders at greater risk for unaffordable out-of-pocket expenses are more likely to put off needed care and more likely to die within five years. What will these people do in the future?

National Organization for Women President Kim Gandy announced that NOW and 200 other women’s organizations are working to oppose this legislation. The bill is dangerous for all seniors, with women being especially vulnerable. Even though women live longer than men, older women tend to be sicker than their male age peers.

Women are more likely to have chronic illnesses and multiple chronic illnesses. They have more disabilities. Almost twice as many women as men age 75 or older need help with daily tasks. Women take more prescription drugs. Older women have lower incomes than older men. While the mean income among men aged 65-plus is $30,238, for women it is only $16,311. Among low-income seniors in poor health, the median incomes for men and women are $14,494 and $10,029, respectively. How are these seniors to afford health care?

The Bush administration, the GOP, and the AARP are all happy with this new Medicare bill. Seniors, especially older women, are the ones paying for this celebration with their unmet health care needs and early deaths.

As a nation, we can do better. We must do better. First, we have to join the fight to repeal this dreadful bill. Then, we have to fight for a national health care system, and continue to fight until we win.

The author can be reached at pww@pww.org.

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