A Prescription For November

Al Gore looked every bit the good son as he accompanied Shirley Kindle to fill her prescriptions last week at an East Hartford, Conn., pharmacy. The 65-year-old retired clerical worker, who has no insurance coverage for drugs, rang up $506.34 for a month's supply of medicines to treat diabetes and other ailments; the total devouring her monthly Social Security check of $496. Gore isn't the only 2000 candidate taking trips to the drugstore with seniors. Rep. Debbie Stabenow, a Michigan Democrat running for the Senate, and Brian Schweitzer, a Montana farmer challenging Republican Sen. Conrad Burns, have both taken groups north of the border for low-cost Canadian medicines and valuable press coverage.

Drug prices may be this election year's hottest issue. Polls routinely show that voters regard escalating drug costs as the most serious problem facing the health-care system, and candidates are responding in kind. Gore and President Clinton are pitching new drug benefits for Medicare recipients. Congressional Republicans--worried about being portrayed by well-organized seniors this fall as heartless conservatives--have also developed plans to ease drug costs. "Their view is that they cannot afford to be against a prescription drug benefit," said Harvard health-policy analyst Robert Blendon. "It's a real vote mover."

Gore's plan is the most sweeping--and costly. Medicare would pay half of a senior's prescription expenses, up to $5,000. Once a recipient's out-of-pocket costs reached $4,000, the government would pay the whole tab. Seniors making under $11,000 a year would have no premiums or copayments. Gore advisers regard the plan, projected to cost a staggering $200 billion over 10 years, as a political winner in pivotal states like Florida, home to 2.4 million people over 65. During a February rally at a retirement community near Boca Raton, Democratic Rep. Bob Wexler drew cheers when he predicted that history would remember Gore as "the prescription-drug president"--perhaps not the legacy he envisions, but an indication of the issue's power.

George W. Bush has no proposal of his own yet. But he supports a plan by Senate Republicans to help low-income seniors buy prescription coverage on the private market. It would pay full premiums for a person making less than $11,273 a year or a couple earning $15,188. But critics say the plan ignores more than half of the 13 million Medicare beneficiaries with no drug coverage. "It is a no-show," says Ron Pollack of Families USA, a consumer group.

All the proposals face industry resistance. Private insurers don't want to see low-income patients subsidized because they fear it will attract the least-healthy, and most costly, segment of the uninsured population. Pharmaceutical companies say that Gore's plan may be even more expensive than anticipated, leading to higher taxes and price controls. Drugmakers are spending heavily this election year, kicking in $4.7 million to the GOP and $1.8 million to the Democrats since early 1999. In Washington, it's the Rx for staving off unwelcome change.