{"id":3897,"date":"2020-07-01T17:57:02","date_gmt":"2020-07-01T17:57:02","guid":{"rendered":"https:\/\/sandbox2.foxtrotdev.com\/?p=3897"},"modified":"2020-07-04T02:40:15","modified_gmt":"2020-07-04T02:40:15","slug":"ph-medicare-prescription","status":"publish","type":"post","link":"https:\/\/sandbox2.foxtrotdev.com\/?p=3897","title":{"rendered":"Cycles and \u201cGo-Rounds\u201d: A Brief History of Medicare Prescription Drug Coverage"},"content":{"rendered":"\n
\"President
President Obama signs the Patient Protection and Affordable Care Act at the White House on March 23, 2010.<\/figcaption><\/figure><\/div>\n\n\n\n

From the Collections<\/strong> is a recurring feature at aihp.org that highlights articles, artifacts, images, and other items of interest from AIHP publications and collections<\/em><\/p>\n\n\n\n

In 2020, Americans are heading to the polls. Just as Covid-19, the economy, and systemic racism will feature as significant issues, healthcare and, more specifically, Medicare outpatient prescription drug coverage will also no doubt continue to be of interest to voters. <\/p>\n\n\n\n

This is not a new issue. Thirty years ago, John Coster wrote about this topic in Pharmacy in History<\/em>, and his article, \u201cPolitics, Congress, and Outpatient Prescription Drug Coverage under Medicare: A Historical Review, 1965-1989\u201d<\/a><\/strong> documented the, then, unsuccessful twenty-five year effort to add more robust prescription drug coverage to Medicare. AIHP is pleased to make this article available via open-access until the end of 2020.<\/p>\n\n\n\n

Coster concluded that, \u201cgiven the sudden changeability of the political winds,\u201d the pharmacy profession should be prepared \u201cfor the possibility of another potential go-round\u201d on the subject (p. 126). His analysis continued only through the end of the Reagan administration. But Medicare prescription drug coverage has remained a hot topic ever since, and this post will bring Coster\u2019s historical analysis to the present. <\/p>\n\n\n\n

President Donald Trump recently released his 2020 proposed plans<\/a><\/strong> for Medicare Part D changes, which include reimbursing out-pocket drug costs at the time prescriptions are written (rather than when they are filled), prohibiting \u201cgag clauses,\u201d providing better explanation of benefits, offering beneficiaries more drug coverage plan options, allowing generic drug substitutions, and lowering cost sharing. Presumptive Democratic nominee Joe Biden has also shared his healthcare plan<\/a><\/strong>, which aims to control high prescription drug prices via cost-control and consumer inflation caps and by enabling the federal government to engage in direct<\/em> drug price negotiation. <\/p>\n\n\n\n

In short, the future of outpatient prescription drug coverage under Medicare lies in the hands of voters\u2014and the fate of health care reform depends on who they put in the Oval Office in November 2020.<\/p>\n\n\n\n

\u201cStrong Government Bureaucracy\u201d<\/strong><\/p>\n\n\n\n

Since the publication of Coster\u2019s article in 1990, Medicare\u2019s prescription drug coverage has continued to be a subject of debate in Washington. Although the biggest changes did not occur until President George W. Bush signed the Prescription Drug Improvement and Modernization Act of 2003<\/a><\/strong>, President Bill Clinton had fully intended to bring about changes to Medicare Part D. <\/p>\n\n\n\n

In a 1993 report describing the proposed Health Security Ac<\/a><\/strong>t<\/a>, Clinton stated: <\/p>\n\n\n\n

Under reform, with the addition of prescription drug coverage, Medicare will become the world’s largest purchaser of drugs. And, the Medicare program will use its negotiating power to get discounts from the pharmaceutical companies. In addition, with competing health plans trying to become more efficient, more and more buyers will use the same successful negotiating techniques.<\/em><\/p><\/blockquote>\n\n\n\n

Clinton\u2019s legislation was ultimately rejected. Opponents in Congress critiqued its \u201cstrong government bureaucracy,\u201d and Big Pharma opposed the reforms due to concerns about price control and regulation. <\/p>\n\n\n\n

The\nPrescription Drug Improvement and Modernization Act of 2003, passed with\nsupport from the Bush administration, went into effect in 2006. This remarkable\nchange in Medicare provided outpatient prescription drug programs access to\nmore drug coverage options with prescription drug discounts. <\/p>\n\n\n\n

Tweaks to Medicare Part D did not stop there; President Barack Obama followed with the Patient Protection and Affordable Care Act of 2010<\/a><\/strong> (ACA). Obama\u2019s healthcare reform was massive in all areas of Medicare, but his Part D revisions mandated that prescription drugs be covered as an essential health benefit.  <\/p>\n\n\n\n

While we await the results of the 2020 presidential election, Coster\u2019s analysis still rings true that Medicare prescription drug coverage is strongly rooted in politics and that the left and right have differing projections when it comes to the future of Medicare Part D (and to healthcare reform in general). In the thirty years since his article\u2019s publication, Coster\u2019s prediction that the future held many more \u201cgo-rounds\u201d with outpatient prescription drug benefits has proven correct.<\/p>\n\n\n\n

Contributed by Maeleigh Tidd, Doctoral Candidate, University of Wisconsin\u2013Madison School of Pharmacy, Social and Administrative Sciences Division<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

From the Collections is a recurring feature at aihp.org that highlights articles, artifacts, images, and other items of interest from AIHP publications and collections In 2020, Americans are heading to the polls. Just as Covid-19, the economy, and systemic racism will feature as significant issues, healthcare and, more specifically, Medicare outpatient prescription drug coverage will also […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-3897","post","type-post","status-publish","format-standard","hentry","category-from-the-collections"],"yoast_head":"\nCycles and \u201cGo-Rounds\u201d: A Brief History of Medicare Prescription Drug Coverage - American Institute of the History of Pharmacy<\/title>\n<meta name=\"description\" content=\"From the Collections is a recurring feature at aihp.org that highlights articles, artifacts, images, and other items of interest from AIHP publications and collections\ufeff\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sandbox2.foxtrotdev.com\/?p=3897\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cycles and \u201cGo-Rounds\u201d: A Brief History of Medicare Prescription Drug Coverage - 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