MANAGED CARE October 2001. ©MediMedia USA
The vicious terrorist attacks on the World Trade Center and the Pentagon have, appropriately, refocused the government's attention on a coordinated response. And though President Bush has pledged to be a faithfulsteward of the country's business while directing the war against terrorism, nobody is predicting that what had been pressing health care issues before Sept. 11 will now be dispatched swiftly.
The Patients' Bill of Rights was at the top of that list. Tantalizingly close to resolution after years of PARCAs and partisan feuds, the issue quickly went into exile that terrible morning; it may not emerge for some time, despite Bush's dictum to his cabinet to keep some focus on domestic issues — including patients' rights.
If the issue does resurface this year, conferees will have a lot of differences to bridge between the House- and Senate-passed bills. It remains to be seen whether the newfound bipartisanship on Capitol Hill will extend to this and other concerns that fall short of the nation's very survival. Many observers feel that only those bills with broad backing from both parties — patients' rights not being one of them — will pass by the end of the year.
The other once-hot topic now on ice is Medicare reform. It's becoming clear that one aspect of that, a Medicare prescription drug benefit, is toast — despite its popularity with voters and with politicians who promised it to voters. Bush's proposition of a $180 billion economic-relief package in the aftermath of the terrorist attacks would consume the entire budget surplus, leaving nothing for a drug benefit.
Outside the beltway, though, the machinations of Medicare reform continue. A U.S. judge granted the National Association of Chain Drug Stores' request for a preliminary injunction, halting implementation of Bush's drug-discount card program while the merits of the NACDS/National Community Pharmacists' Association lawsuit to stop the program are heard. Thomas Scully, administrator of the Centers for Medicare and Medicaid Services (formerly HCFA), says the government will appeal the ruling, suggesting that the discount proposal may be the only action beneficiaries will see on prescription drugs for a while.