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Negotiating for Lower Drug Costs in Medicare Part D

USA Today has a must-read editorial supporting our position that Medicare should be allowed to negotiate with drug-makers for lower prescription drugs, just as the Veterans Affairs department currently does.

“Part D already costs about $80 billion a year and is on track to double by 2022 as benefits improve and Baby Boomers retire. For two reasons, a significant chunk of that money is wasted on overpayments to drug companies: When Part D began, millions of patients were shifted over from Medicaid, the state-federal program for low-income people that gets far lower drug prices than Medicare. Suddenly, the cost of providing drugs to the same people shot up. Congress barred Medicare from negotiating the way Medicaid and the Department of Veterans Affairs do with drug makers to get lower prices. Instead, lawmakers insisted the job be done by private insurance companies.”

The fact that Medicare is forbidden in the law that created Medicare Part D to negotiate lower prices is no accident.  The drug lobby worked hard to ensure Medicare wouldn’t be allowed to cut into the profits which would flow to big Pharma thanks to millions of new customers delivered to them by Part D.  Even some Republican House members (this was a GOP sponsored bill), including Rep. Walter Jones from North Carolina and Rep. Dan Burton from Indiana, were aghast at the whole process:

"The pharmaceutical lobbyists wrote the bill," says Jones. "The bill was over 1,000 pages. And it got to the members of the House that morning, and we voted for it at about 3 a.m. in the morning," remembers Jones.

Why did the vote finally take place at 3 a.m.?

"Well, I think a lot of the shenanigans that were going on that night, they didn't want on national television in primetime," according to Burton.

Unfortunately not much has changed since 2003.  Roll Call has this wrap-up of what drug companies spent during the last quarter alone on lobbying Congress:

Five pharmaceutical companies have reported million-dollar increases in their spending on lobbying the federal government during the first quarter of 2014. Pfizer Inc., Novartis, Johnson & Johnson Services, Bayer Corporation, and Merck & Company have each boosted their lobbying of the executive and legislative branches.

Here are the top pharmaceutical spenders in the first quarter of 2014:

Pharmaceutical Research & Manufacturers (PhRMA) $4,680,000 – up from $4,050,000 in 2013 Q4.

Pfizer Inc. $3,190,000 – up from $2,090,000.

Novartis $2,580,000 – up from $920,000.

Amgen USA Inc. $2,560,000 – up from $2,330,000.

Eli Lilly & Co. $2,086,000 – down from $2,430,000.

Johnson & Johnson Services $2,110,000 – up from $860,000.

Bayer – $2,040,000, up from $1,000,000.

Merck & Co. $2,000,000 – up from $820,000

These are the same companies which claim any attempts to rein in their overpayments in Medicare will kill their research and development of new drugs:

“The drug companies say they must impose higher prices in the U.S. to pay for research that enables them to innovate and develop new drugs that save our lives. But that’s not true. Half of the scientifically innovative drugs approved in the U.S. from 1998 to 2007 resulted from research at universities and biotech firms, not big drug companies, research shows. And despite their rhetoric, drug companies spend 19 times more on marketing than on research and development.”  Healthcare for America Now

Meanwhile, in their opposing USA Today editorial big Pharma also argues that people like Part D so it shouldn’t be changed and, by the way, prescription drugs help people stay healthy.

“Surveys show 90% or more of Part D enrollees are satisfied with their coverage and say it works well. The use of medicines under Part D also helps to reduce spending on other health care services in Medicare, a fact that was recently acknowledged by CBO.”

Of course, access to prescription drugs helps people stay healthy but what does that have to do with whether or not Medicare should be forced to overpay for those drugs? Naturally, seniors like Part D.  Why wouldn’t they when before its passage they had absolutely no drug coverage?  That doesn’t mean Americans support paying more than they, or the government, should in order to pad drug makers’ pockets.  

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Seniors and Poverty

The Kaiser Family Foundation has produced a wonderful new video, Old and Poor: America’s Forgotten.  It was debuted at this week’s Senate Special Committee on Aging hearing examining the war on poverty and seniors.  We consider this a must-watch, must-share video.


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Celebrating Our Social Security & Medicare Successes

We've seen a constant threat to Social Security and Medicare benefits coming from Washington over the past many years.   While the war to preserve and strengthen these vital programs certainly isn't over (for example the President's budget, the debt ceiling fight, are still ahead in 2014), it's important to celebrate the battles we have already won. And they are many.  Thanks to our vigilant NCPSSM activists for their hard work in reminding Washington why the vast majority of Americans of all ages and political parties do not support cutting benefits. 

30 Years of Fighting and Winning to Protect Your Benefits

2013

A year of fiscal crises repeatedly threatened benefit cuts to Social Security and Medicare. The National Committee successfully prevented a Social Security Cost-of-Living Adjustment (COLA) cut and an increase in the Medicare eligibility age from being written into the fiscal cliff bill. We also defeated efforts to continue the two-year-old Social Security payroll tax holiday that was undermining the Social Security system. 

The National Committee launched a nationwide pilot to inform America’s same sex couples of their new rights to Social Security benefits after the Supreme Court’s Defense of Marriage Act decision in 2012.

Joining with other advocates, we delivered more than 2 million petitions to the White House protesting President Obama’s plan to cut Social Security benefits through the Chained CPI.

2012

NCPSSM President/CEO, Max Richtman, met with President Obama and other national leaders at the White House to talk about fiscal challenges facing the nation. He urged the President to preserve Social Security and Medicare benefits in ongoing budget debates.

We stopped a proposal to increase Medicare premiums from becoming part of legislation to extend the Social Security payroll tax holiday.   

2011

The Congressional “Super Committee” hoped to solve the federal debt crisis by cutting Social Security, Medicare and Medicaid, but thanks to our lobbying efforts, a national ad campaign and the work of our grassroots activists, the Super Committee adjourned without reaching consensus on any plan to cut benefits.                                             

The National Committee helped win the battle to save traditional Medicare from the House Budget Committee Chairman’s dangerous proposal to privatize the program.  Privatization benefits insurance companies at your expense, making it harder for seniors to choose their own doctor while cutting prescription drug, preventive care and nursing home benefits.

For the third time in over a decade, we successfully protected Social Security and Medicare funds from being cut by a Balanced Budget Constitutional Amendment. Your signed petitions and letters along with our grassroots opposition helped turn the tide against this harmful amendment. 

The National Committee to Preserve Social Security and Medicare launched the largest grassroots mobilization and media campaign in its long history of defending  programs vital to millions of Americans.  Millions of Americans engaged Congress and we successfully fought back against benefits cuts to Social Security and Medicare.

2010

NCPSSM fought to ensure Medicare was improved and strengthened as part of the Affordable Care Act by lowering beneficiaries’ out-of-pocket costs and closing the Part D prescription drug “donut hole” and making preventive services available to people with Medicare for free.

2009

Seniors received stimulus checks as part of the federal stimulus plan thanks to our successful lobbying efforts.  The initial proposal for the Recovery and Reinvestment Act targeted all workers, but excluded non-employed seniors. Seniors were included in the final bill.  This time seniors were not required to complete any IRS filings and automatically received checks.

2008

We led the battle to stop the harmful “Medicare Trigger” that would have imposed an arbitrary 45 percent cap on the government’s funding of Medicare.  And we achieved victory, although temporary, convincing Congress to postpone this harmful provision of the Medicare Modernization Act.

The National Committee helped persuade Congress to pass the Medicare Improvements for Patients and Providers Act (MIPPA), which reduced taxpayer handouts to private Medicare plans, improved benefits for mental health and averted a 10.6 percent cut in fees to physicians who treat Medicare patients, helping to preserve beneficiary access to doctors and other practitioners.

2007

NCPSSM lobbied Congress to strengthen Medicare.  The House ultimately passed legislation strengthening Medicare for future generations and correcting many of the flaws in the Medicare Modernization Act of 2003.

We fought against harmful budget cuts at the Social Security Administration (SSA) and ultimately convinced Congress to increase funding levels and thereby prevent massive furloughs at the SSA.  Those increased funds averted office closures all over the nation in 2007.  After continued intense lobbying, Congress approved funding for Fiscal Year 2008 at $451 million over the previous year’s level, helping speed up disability reviews.

2005 & 2006

The National Committee successfully mobilized to stop the most serious attempt ever to partially privatize Social Security, flooding Capitol Hill with petitions and letters to Congress and the White House reaffirming seniors’ rejection of private Social Security accounts.  Town hall meetings, Capitol Hill briefings, television appearances and our member-supported media campaign also helped erode and reverse lawmakers’ support for privatization legislation.  (Today, we continue to hold the line on privatization for the 23rd consecutive year!)

2005

NCPSSM launched an aggressive campaign to protect Social Security Cost-of-Living Adjustments (COLAs) from soaring Medicare out-of-pocket costs.  Under the Medicare Modernization Act of 2003, annual increases in Medicare deductibles have joined premiums in being indexed to rising health care inflation, and out-of-pocket costs will eventually consume nearly half of the average Social Security benefit check.  Our campaign was successful in bringing Congress’ attention to this critical and growing issue, but we need to fight even harder to push Congress to take corrective action.

2004

Overwhelming grassroots support from National Committee activists helped save Social Security funds from being cut under a Balanced Budget Constitutional Amendment.  With appeals from 1.4 million National Committee members and supporters, the Constitutional Amendment was pulled from consideration before a scheduled vote in the House Judiciary Committee!

2003

Millions of NCPSSM volunteers fought to prevent the full privatization of Medicare by helping defeat a dangerous House bill creating a Medicare voucher system. The misguided Medicare Modernization Act of 2003 was passed in its place and we continue the fight to fix that flawed legislation.  To date, millions of our members have signed letters and petitions to Congress urging immediate, “corrective” Medicare bills to make prescription drugs affordable and available to all seniors. 

2000

For seniors who have reached ‘normal retirement age,’ the National Committee was instrumental in earning the unlimited right to work without losing some of their Social Security benefits.  In large part because of our efforts, the Senior Citizens’ Freedom to Work Act was passed and signed into law on April 7, 2000.

NCPSSM proudly coordinated a coalition of senior organizations’ efforts to reauthorize the Older Americans Act (OAA), ensuring continued funding for a variety of state and local programs, including meals programs, in-home support services, pension counseling programs and jobs programs for seniors.  We were successful in getting this program reauthorized again in 2006.


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America's Jump From Economic Crisis to Retirement Crisis

Max Richtman recently wrote an article on Huffington Post:

Over and over again, America's seniors are being told they must foot the bill for fiscal failures which have already left them facing a weakened and tenuous retirement. In Detroit, a bankruptcy judge has ruled the city can cut pension payments to thousands of retirees, despite a state law stating otherwise. In Washington, the latest Congressional budget deal targets retirees with $12 billion in pension changes, including cutting pensions for military personnel who retire in 2015 and requiring new federal workers to contribute more to their retirement. All of this couldn't come at a worse time. Three decades of stagnant middle-class incomes, disappearing pensions, limited ability to start and maintain personal savings, and the failure of the 401K experiment lay the foundation for a retirement crisis that could further threaten millions of older Americans and their families.

According to the New School for Social Research, 75 percent of Americans nearing retirement have less than $30,000 in their retirement accounts. Almost half of middle-class workers will be poor or near poor in retirement and living on a $5-per-day food budget. The National Institute for Retirement Security reports four out of five working families have retirement savings less than one times their annual income and 45 percent do not have any retirement assets at all.

While Washington has been obsessed with the federal budget deficit, there's been virtually no Congressional conversation about the $6.8 trillion retirement savings deficit. What will happen to the millions of American families who are ill-prepared for retirement? There's almost no conversation about how to prevent this retirement crisis from impoverishing our families or about how younger generations will handle parents and grandparents who cannot support themselves. In spite of this current and growing retirement crisis, Social Security and Medicare, programs vital to a basic secure retirement, continue to be the favored targets for some in Congress who are determined to use benefit cuts to reduce the federal deficit.

Washington's almost single-minded focus on the budget deficit has allowed the retirement deficit to grow with each passing year. Rather than cutting vital programs like Social Security and Medicare to pay down a deficit these programs did not create, Washington should be looking for ways to address the retirement deficit head-on. Part of the solution includes raising Social Security benefits.

Thankfully, not everyone in Washington is blind to what's coming. Sen. Tom Harkin (D-IA) and Rep. Linda Sanchez (D-CA) have sponsored legislation that would address Social Security's long-term solvency, eliminate the payroll tax cap over time while boosting benefits for all beneficiaries by approximately $70 per month, and switch the cost of living formula to the more accurate consumer price index for the elderly (CPI-E). Legislation proposed by Rep. Gwen Moore (D-WI) increases the minimum benefit to workers in low-wage jobs, provides a five percent benefit increase for the very old, and eliminates the payroll tax cap. Contrary to the popular rhetoric that we can't afford Social Security, both of these legislative proposals extend the solvency of Social Security while also increasing the program's already modest average monthly benefit of just $1,269.

America has the largest economy in the world, yet our seniors get lower retirement benefits than most other retirees throughout the world. Only three advanced nations provide less retirement security for their citizens which makes the argument that America can't afford to support our retirement safety net laughable. The truth is that we can't afford to ignore the retirement crisis and it certainly shouldn't be hastened by those in Washington driven by a political agenda to cut benefits -- no matter its consequences -- to millions of American families.

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Social Security, Medicare and Budget Conferees

Tomorrow, the newly appointed budget conferees meet for the first time to hammer out a budget deal conservatives hope will include benefit cuts to Social Security and Medicare.  In spite of the fact that budget cuts have already paid for nearly 75% of deficit reduction, with only 25% coming from revenue increases, even that’s not enough as some in Congress continue their attack on America’s safety net programs.

The National Committee urges Congress to reject plans to cut Social Security benefits through adoption of a new COLA formula called the Chained CPI.  We explain why in a letter sent to all 28 Budget Resolution Conferees today:

The chained CPI would reduce Social Security benefits for the oldest and most vulnerable Americans who would be least able to afford it.  Three years after enactment, the chained CPI would cut the Social Security benefits of a typical 65 year-old by about $130.  By age 95, the same senior would face a reduction of almost $1,400 per year.  Moreover, the chained CPI would have a harmful economic impact on every state and congressional district in the country.  In a National Committee report released earlier this month, we found that the COLA cut could result in a $31 billion loss in economic output and the loss of more than 200,000 jobs nationwide in 2023.  For an estimate of how your state’s economy would be affected by the chained CPI, please see our Foundation Report.

Social Security does not face an immediate crisis and is not driving either the short-term deficit or long-term debt. Rather than cutting the already meager benefits, Social Security should be strengthened for the long-term by increasing the current payroll tax cap on earnings.

We’ve also urged the conferees to reject proposals to cut Medicare:

Regarding Medicare, beneficiaries already have high out-of-pocket costs, and because over half of beneficiaries are living on incomes of $22,500 or less, they cannot afford to pay more.  However, if the budget resolution includes Medicare cost shifting proposals, seniors and people with disabilities could be required to pay a $25 increase in their Part B deductible, a $100 copayment per home health episode, and higher Part B premiums for purchasing comprehensive Medigap plans.  And, further means-testing of Medicare would mean middle class seniors would pay higher Part B and D premiums.  These proposals would shift costs to beneficiaries without solving the underlying problem of overall health care inflation, and would make Medicare more complicated and difficult to administer.

Conservatives have said they hope to use these benefit cutting proposals, also included in the President’s budget, as bargaining chips in the budget conference which begins tomorrow.  The National Committee will continue our efforts to stop these harmful cuts including a demonstration next month at the White House reminding the President and Congress that the American people, of all ages and political parties, do not support cutting benefits to balance the budget.

 

 

 

 

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