Hi all,

The Antlanta paper reported today that the recently passed Medicare Bill will forbid persons receiving prescription benefits from having 'medigap' coverage and will also shift low-income elderly from Medicade to Medicare - lowering their benefits.

I have written my congressman and Senators to express my opposition.

I am wondering what prescription drug benefits are available to the elderly in the various European countries.

I don't know what prescription benefits Europeans have, but I do know their exact same meds are a LOT cheaper. I buy my prescription allergy nasal spray in France when we go. I pay 13 Euro for it there and it is $68.00 here..same drug , same manufacturer ! I also pick up my allegy tablets 8 E, there , $38.00 here. I stocj up and what I save practically pays my plane fare.

I wrote my senators and reps BEFORE the vote for all the good it did. You should read the message boards at AARP..there are a lot of MAD seniors!

Arrangements differ between countries. Over retirement age in the UK, for example, all medicine is free. European analogies are of limited value in an American context, since:

1. Almost everyone in Western Europe gets heavily subsidised medicine anyway. Retirees, typically, merely get bigger subsidies than most, and the same subsidies as a large proportion of the population (in Inner London, my pharmacist looks truly surprised when I pay for prescriptions, since 90% of his other customers get them free)
2. By the time we're 65, we have about 40 years of heavy tax paying behind us.

However, doubtless you're mostly interested in making your point. Your Social Security people compare things country-by-country at www.ssa.gov/policy/docs/progdesc/ssptw/

I think your last point is key - something that few Americans realize is that our taxes are way lower than those in Europe - both sales taxes - which are often 15% in europe - and income taxes - which in europe can be up to 90% for the wealth.

In the end you get what you pay for - you just have to decide if you want to pay through the government (taxes) or right out of your own pocket.

And while it is true the meds cost much less in Europe - that's because they're almost always bought by the government which fixes max prices. Which our government chooses not to do.

The tax comparisons can be misleading because we may be paying equivalent costs elsewhere, such as heatlh insurance. Some claim that our system is one of the most inefficient of the indutrialized nations. There are other elements to consider. In France, indigent care is also the responsibility of the adult children, whereas in the States, only the spouse can be legally impoverished before the patient receives Medicaid. As for lower prescription drug costs: I don't see the drug companies dropping out of the European market.

Thanks flanneruk,

That's a very interesting link.

<And while it is true the meds cost much less in Europe - that's because they're almost always bought by the government which fixes max prices. Which our government chooses not to do.>

And why is that? It couldn't possibly be because of excessive contributions and lobbying by pharmaceutical companies , could it? Maybe some of the drug company executives would have to give up their 20 million dollar bonuses( Glaxo). And the R and D issue is prectically irrelavant as a lot of research is being out-sourced but the advertising and promotion budgets are being expanded.

To be fair the R&D isues is not practically irrelevant becasue even though it is outsourced the pharma companies still pay for it. As far as letting the government behave the way it does about meds, shame on us for putting up with it. I know this isn't a political board - but if this is a big issue we need to elect a government that is reponsive to the needs of citizens and not just big corporations.

nytraveler puts the blame right where it belongs. One of our founding fathers said we "get the government we deserve". If we are not willing to invest the time and energy to elect representatives that will do our bidding, then we can't complain when our elected officials take care of themselves instead of us.
By the way, was AARP looking out for us or taking care of its health program?

Something to note. Healthcare in any other country could not possibly be better than in the US. The US is the richest country in the world and it spends more per capita on health care than any other country.

As a medical professional I very STRONGLY disagree with the assertion that "Healthcare in any other country could not possibly be better than in the US." In many cases it is better to include fewer infant deaths, better elderly care, lower prescription costs, a much more realistic and non-religious-oriented attitude toward lessening infectious disease spread, etc.
Throwing money at something doesn't necessarily make it better as we continue to prove over and over again in the US. If that weren't the case this thread would probably never have started.

Question for Jody:
I buy my mother's prescriptions, and it sounds like it might be worthwhile to pick up 90 days' (or more) supplies when we are in Spain and France next March. Do your US doctor's prescriptions work, or do you have to get a prescription in the country where you are filling an order?

ira, what is "medigap insurance" and why would it be banned? Is there another side to the story?

<<Message: Something to note. Healthcare in any other country could not possibly be better than in the US.>>

I also would strongly disagree with this statement. So does the World Health Organization, which for several years has done rather comprehensive rankings of healthcare around the world. France is number 1, Italy number 2 (or perhaps it was reversed last year); the USA ranks 37th. See:

http://lists.isb.sdnpk.org/pipermail...ne/000010.html

http://www.huppi.com/kangaroo/L-healthcare.htm

http://dll.umaine.edu/ble/U.S.%20HCweb.pdf

http://www.makethemaccountable.com/m...HealthCare.htm

Also, in my fairly extensive experience with the healthcare systems in both France and Italy, as a patient and more frequently the mother of a patient, the care we have received has been so far superior to that of my HMO as to make the latter seem laughable.

Of course, I understand where the differences in approaches to healthcare lie among different nations; still the statement above is simply not true.

Here in the UK I recently had to have a course of antibiotics. I got out my purse to pay for them and the pharmacist said that I had obviously enjoyed good health for the past four years because they are free for the over 60s.
I get free eye examinations but have to pay for my glasses. My husband is diabetic and gets all his prescriptions free.
The NHS is certainly not perfect but I and my family have always had excellent service from it.

Studies that rank the US health care system relatively low among developed nations almost always penalize countries that don't have a socialist-based system. Rich or poor, anyone that would prefer to be treated for cancer within the context of a socialist healthcare system, as opposed to the US model, is dangerously misinformed. Any healthcare system in which the waiting time for someone on an "urgent list" for an MRI or colonoscopy is typically more than six months, is seriously flawed.

The most important fact about the European system is that it will not be sustainable (demographically or politically) for another generation. Consider the unrest that retirement/health issues have caused in France within the past year. Even the moderate left in both France and Germany concede that something has to give.

The reason that the US refuses to adopt a European-style healthcare system is not because of a conspiracy between the pharmaceutical industry and the Congress, it is simply because more than a critical mass of Americans are satisfied with the current situation. Despite many of the theories proposed in this forum to account for all kinds of US-Europe differences, the reasons for these differences are simple - the majority of Americans prefer things the way they are. Healthcare is no exception.

Healthcare reform in America will have to occur in a different form, such as means testing. Hugh Hefner can afford to buy his own Viagra.

Hi Degas,

Everyone over 65 in the US has to enroll in Medicare.

Medigap insurance is any private insurance plan that covers the difference between what Medicare pays and what you would normally get if you had that private plan.

The new Medicare legislation provides for limited prescription payments. It forbids the sale of new medigap prescription plans after Jan 1, 2006.

From what I read in the newspaper, this is a cost-containment measure, because people who have prescription plans supposedly have higher prescription costs.

As written, the prescription plan requires $3500/year out-of-pocket payments for all but those at the poverty level.

I'm laughing at that statement about the US having the best health system because we spend the most on it. Two words come to mind -- educational system.

I do consulting in the health insurance area and have been doing some work related to the new bill for some clients and have it in front of me. What newspaper is this, out of curiosity, Ira? I read something in the Atlanta-Journal Constitution or something but it didn't look like a good newspaper from what I read, so I thought maybe that wasn't the main paper in town. I didn't see anything about Medigap in that article.

I don't work on Medigap issues that much, but that isn't really true, so either they wrote it wrong or you misunderstood. Some Medigap policies will not exist any more because they are not applicable with the new benefit. There are 10 std. Medigap policies that Medicare defines and only 3 of them have basic drug benefits so I think Medicare may eliminate those three and people cannot buy drug coverage through Medigap policies anymore. Very bad incentives and risk pools would exist if certain benes opt out and buy private drug coverage for better rates, and those companies get the healthiest beneficiaries that way and leave the higher cost pool to the others. Many of the Medigap policies don't have anything to do with drugs and they will still exist and people can still have Medigap policies for other things.

I thought that was a joke when someone wrote that the US must have the best health care because we spend the most per capita. US health care is good for those who can afford it and have insurance but even then it is not necessarily superior. I don't agree with several things written above regarding how great the US system is and how other countries' systems are not sustainable. I also don't agree that other countries' taxes are so much higher than ours on average. I think US citizen's pay very high taxes for what we get and it is shameful that we don't have a better govt health care insurance system. I think we are now the only industrialized country in the world with such a fragmented and poor and privatized health insurance system that leaves so many citizens without health insurance. As I recall, we used to be in a club with only a couple countries -- South Africa and South Korea, but now we are the only one without some form of govt. universal health coverage.

As for the shifting from Medicaid to Medicare, I believe that is true as Medicare is primary carrier for those with dual coverage, although a state's Medicaid program may pay the premiums for someone to be in Medicare. I don't know how it will work if someone had better coverage under Medicaid for drugs, though--possibly it could pick up the difference (that's not really my area).

For ira and Degas...I too read (NYTimes) about this prohibition on any supplemental insurance in this new law.

The rationale, as I recall, is that they want to curtail 'abuse', wherein the beneficiary must pay something out-of-pocket to 'appreciate' the value being received.