The Train Wreck named “The Medicare Prescription Drug Improvement and Modernization Act of 2003” has finally arrived and Republicans are screaming and fleeing the scene of the crash--their hair on fire, their clothing scorched, their skin scalded. Governor Huckabee had to declare a public health emergency in Arkansas. Governor Pawlenty had to sign an executive order overriding the program in Minnesota, ridiculing it as “awful” and “too complicated for many people to understand.” Twenty other governors had to step in and rescue the seniors Bush’s plan abandoned. Even the President had to order insurance companies to, basically, just ignore his brilliant idea and give poor folks their pills.

And these are just the “start-up problems.” Once the plan starts working as intended, the shit will really hit the fan--because as intended, Bush’s plan is stingy, irrational and cruel.

This Is Your Mom on Drugs To understand how nasty the Bush Rx plan is, let’s take your Mom through various scenarios:

The plan pays zero on Mom’s first $250 Rx drug bills—that’s the deductible. Of the next $2,000 she spends, it pays 75%. But at $2,250 it suddenly pays zero again—this is the notorious Doughnut Hole—and over the next $2,850 Mom’s paying all her bills on her lonesome. At $5,100 the plan suddenly kicks back in, paying 95% from then on out.

Oh yeah--there’s also a premium for playing. That costs Mom an average of $32.20 a month.

So. A third of all seniors spend less than $800 a year for drugs. If Mom’s one of them, this plan’s a total rip-off—it’ll cost her more than no plan at all! Another quarter of all seniors pay between $800 and $2,250 for drugs. If Mom’s one of them she’s comparatively lucky—at the high end the plan will at least pay almost half of her expenses.

But now--at $2,250—her luck runs out.

The Doughnut Hole: Hazardous to Mom’s Health Forty percent of seniors will fall into the Doughnut Hole before the year is out. And sixty-six percent of them will never escape. If Mom’s one of them she’s effectively, well, screwed--by the end of the year she may find she’s paid 73% of her Rx bills herself, while Bush’s plan has chipped in a paltry 27%.

In fact, Bush’s plan short-changes 96% of all seniors, since only the heaviest drug-using four percent will ever get back as much as half of their Rx drug costs!

Instead: A Plan That Can Be Explained in 25 Words So what should the Democrats’ answer be? Here is simple plan that will cost taxpayers no more than Bush’s vicious Doughnut, but will offer seniors benefits which are much, much richer.

And while it takes a book to explain Bush’s plan, Democrats can explain ours on the back of a wallet-sized card:

Medicare will pay:
70% of your first $1,000 Rx per year;
80% of the next $2,000;
90% above $3,000.
There is a $16-a-month premium.

Oh what a difference this plan could make! Remember the grisly details of Bush’s plan? If Mom spends $50 a month, Bush’s plan actually costs her money. But our plan saves her 38%. If she spends $100 a month, Bush saves her just 27%. Our plan saves her 56%. If she spends $300 a month, Bush saves her just 31%. Our plan saves her 74%. If she spends $800 a month, Bush saves her 60%. Our plan saves her 84%.

How Can Democrats Do So Much for the Same $? Because with our plan, Medicare won’t be just lending its good name. Medicare will be administering the plan. And Medicare is many times more efficient than any for-profit healthcare plan.

Medicare will also be negotiating Rx drug prices on behalf of 42 million seniors—something explicitly forbidden in Bush’s plan. At the very useful website at FamiliesUSA, we learn that for a wide range of heavily-prescribed drugs, the Department of Veterans Affairs pays on average roughly half of what consumers pay. Medicare may not be able to match that--distributing through tens of thousands of pharmacies may cost Medicare more than it costs VA. So for Medicare we’ve assumed not a 50% saving, but a 44% saving.

Democrats: Do It Now. As early as May or June, millions of seniors are going to start dropping through Bush’s Doughnut Hole. Once that happens they are going to be mad as hell. Will they take their anger out on Republicans, or on Medicare? Republicans desperately hope the latter: they’d love nothing more than to ruin Medicare’s good name. Democrats can’t let them get away with it. We need to put a smart alternative in play NOW.