Telegraph Herald - Interview

Telegraph Herald (Dubuque, IA)

HEADLINE: Grassley touts Medicare reform; Senator praises voluntary aspects of the new measure

BYLINE: MARY RAE BRAGG

DATELINE: Dubuque

BODY:
U.S. Sen. Charles Grassley's persona as a straight-talking Iowa farmer was evident Monday as the Iowa Republican talked about health care and the Medicare reform bill he crafted last year as chairman of the Senate Finance Committee.

Speaking to about 100 people gathered at the Dubuque Greyhound Park and Casino, Grassley said many Iowans told him they want their Medicare program left alone.

The plan he was instrumental in creating leaves that program intact, Grassley said, but it also provides access to options that are voluntary, universal and targeted to those with low incomes and people with catastrophic health costs.

"Voluntary, as far as I'm concerned, is the most important part of it," Grassley said. "Seniors who get nervous about what goes on in Washington can be at ease."

Medicare recipients who feel they have made a mistake in selecting coverage can, after a year, opt out and switch to another plan or return to basic Medicare, Grassley said.

With just 5 percent of Medicare recipients responsible for 50 percent of the costs, it makes sense to change Medicare toward more preventive care, cutting costs by prevention and management of chronic diseases, he said.

Preferred provider organizations replace health maintenance organizations that didn't work, Grassley said. A major stipulation is that preferred providers will not be able to serve only parts of an area, "cherry-picking" the most profitable operations while refusing others, he said.

The bill signed by President Bush does not include a provision for the government to negotiate prescription drug prices, "Because we don't want the federal government in your medicine chest," Grassley said. "You can't have the bureaucrats coming between you and your doctor."

Grassley said a major challenge remains in getting the Medicare reimbursement formula to result in a more favorable rate for Iowa, where health care quality is high while the reimbursement rate is lowest in the nation.

At the other end of the spectrum is Louisiana, which has the highest rate of reimbursement, but is ranked 50th in quality of health care, Grassley said.

Grassley said he will continue to work to insert a quality factor into the reimbursement formula to reward Iowa health care providers.

"I know you're cynical about Washington, but I believe if you're right, eventually you win out," Grassley said.

During a question-and-answer exchange, Grassley said that once the Medicare prescription drug coverage begins in 2006, drugs prescribed for mental conditions will be covered on par with other drugs. Bills providing parity for mental health typically pass in the Senate, he said.

Grassley said he is aware that raising the federal sales tax on cigarettes could help cut the number of smokers, but he does not favor increasing any taxes. Of the 30 bills the Senate voted on last week, most included some type of tax increase, he noted.

Problems with the federal budget are the result of diverting money to fight the war in Iraq and Congress' penchant to overspend, he said.

"I'm probably responsible for some of that, so I'm talking to myself, too," Grassley said.

Grassley is working with Sen. Ted Kennedy, D-Mass., on a bill that would allow importation of pharmaceutical drugs from Canada. Advisers for both presidents Clinton and Bush have opposed importation because of safety issues, but Grassley sees it as a trade issue.

"We believe in free trade," he said. "But when it comes to pharmaceutical companies, we don't."

Grassley was speaking as a guest of the Tri-State Health CARE Coalition, a committee of the Dubuque Area Labor-Management Council.