House Democrats said that nearly 7 million Medicare beneficiaries were at risk of falling into the drug benefit coverage gap, while administration and health insurance industry official officials said the number was closer to 3 million. Within the coverage gap, known as the "doughnut hole," Medicare drug plan enrollees are required to pay a greater share of their drug costs until the program's catastrophic drug coverage begins.
GOP pollster Bill McInturff said that he doesn't know whether Democrats will regain control of the House or Senate in the November midterm elections but expressed doubt that the Medicare drug benefit would determine any of the races involved. The big issue in the election is Iraq, he said, and Republicans may be in trouble because voters are seeking accountability for the war.
The bipartisan leadership of the Senate Finance Committee has introduced legislation that would give researchers greater access to data on Medicare beneficiaries' use of hospital, physician, and prescription drug services. Medicare processes 500 million benefit claims a year, and allowing federal, university, and other researchers to analyze that data could help determine the safety and effectiveness of various medical treatments, according to a statement issued Monday by panel chairman Charles E. Grassley (R-Iowa).
A coalition of more than 80 health care and consumer groups have asked members of Congress to take "immediate action" to help states avert projected federal funding shortfalls in fiscal 2007 for the State Children's Health Insurance Program (SCHIP). At that same hearing, Centers for Medicare and Medicaid Services Administrator Mark B. McClellan said there is no need to worry about funding shortfalls in any state because there are enough surplus funds to distribute to states that need more SCHIP money.
A "pay-for-performance" system in Medicare would do more than the current fee-for-service payment system to improve the quality of health care provided to the program's approximately 43 million beneficiaries, according to a recent Institute of Medicine (IOM) report. Health care providers and insurers praised the IOM findings, saying they would lead to improvements in the Medicare program.
A "scorecard" of the nation's health care system released last week gave the United States an average of 66 out of a possible 100 on a series of health quality measures, with those shortcomings costing as many as 150,000 lives and $100 billion annually. The report, compiled by the nonpartisan Commonwealth Fund Commission on a High Performance Health System, found that the United States was not the top scorer in any of the 11 international indicators of health outcomes, quality, access, equity, and efficiency, despite the fact that Americans spend more on their medical care than citizens in Germany, Canada, France, Australia, or the United Kingdom.