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Who'll Pay for the Rx Drug Benefit?

I spent much of the afternoon on August 15, 1971 in a GTO, moving slowly in a massive traffic jam on Route 1 while heading to the first game at Schaeffer (beer) Stadium, the new home of the New England Patriots. My date and I didn't make it to the stadium until the end of the third quarter, after abandoning my car on the side of the road and walking the last mile and a half. The traffic didn't flow, but the beer did. Unfortunately the plumbing didn't, the restrooms stopped working, and Destiny ordained the odor that encompassed the team for many years.

Historians may recall something else about that day. While sitting in the car we heard President Nixon give his famous speech establishing wage and price controls. He decreed that you couldn't change prices, and you couldn't change wages. The economy was ordered to remain stable for the immediate future.

Say what? Why on earth would freezing wages and prices in the United States in any way affect our position within the world's economy? Certainly oil prices, tariffs, currency exchange, international banking and trade would exert influences making these local freezes silly. It had to be too simplistic an answer for a very complicated problem.

Knowing that the Nixon program failed has not prevented our government from imposing a malicious form of wage and price controls on us. The prices and wages we pay go up annually, while the fees paid to us are frozen and regularly reduced. Now I read about the proposed Medicare drug benefit and I am quite sure, despite all reassurances, that the only politically feasible way to pay for it is by using funds presently budgeted for professional services. We could soon be tapped to pay for the medications we prescribe.

Smell That? A Shifting of Funds is in the Air

We often read of the elderly not buying medicines they can't afford. That's partly because stores don't provide product for free. Could those same elderly patients see the doctor without money or coverage? Of course -- it is our social contract to see them! So, might we have a shift of government funds from those willing to provide for free to those who are unwilling?

We could be facing a fight that encompasses all physicians in all specialties. Now may be the time to stop fighting about how to split the pie, and work instead to be sure more than crumbs remain. I haven't belonged to the AMA for many years, but I may sign up again.