Gearing up for a possible fall battle over comprehensive Medicare reforms, providers, insurers, drug manufacturers and employers are forging alliances to make sure their voices aren't lost.
The Healthcare Leadership Council, which represents hospitals, health plans and drug companies, said last week it is forming a Medicare-reform coalition that will focus on provider reimbursement and regulation issues.
The coalition, which probably will be called the Alliance to Improve Medicare, will argue in favor of comprehensive reform and against stopgap reforms to improve program solvency, such as cutting provider payments, said Mike Freeman, vice president of communications at the HLC.
Among the coalition's chief concerns, particularly for its employer members, will be whether providers begin to shift costs onto private-sector payers because of further Medicare payment cuts and whether HCFA is allowed to become a more aggressive purchaser, as President Clinton has proposed in his Medicare reform plan (July 5, p. 2).
That coalition also will be concerned with preserving Medicare beneficiaries' choice of prescription drug coverage and with reducing Medicare regulation.
"Simply layering a prescription drug benefit on a broken program won't work," Freeman said.
Taking a higher profile is the Citizens for Better Medicare, which began running an advertising campaign last week in Washington and the national media.
The coalition-whose prominent members include the Pharmaceutical Research and Manufacturers of America, the National Association of Manufacturers and the U.S. Chamber of Commerce-opposes federal interference in prescribing drugs.
The coalition's members want the government to design a program that provides prescription drugs for people who don't have such coverage now but doesn't displace the coverage that some seniors have now through Medigap or Medicare supplemental policies.
Right now, 65% of Medicare beneficiaries have prescription drug coverage-most through employer-sponsored retiree plans, HMOs or Medigap, but about 11% of Medicare beneficiaries receive coverage through Medicaid.
Clinton and the National Bipartisan Commission on the Future of Medicare have proposed plans to expand coverage. Clinton proposed a universal coverage plan managed by pharmacy benefit managers and financed by beneficiaries' premiums and coinsurance, federal surplus revenues and provider savings.
The commission proposed a system that would offer a government-subsidized drug benefit for only beneficiaries earning less than 135% of the federal poverty level.
The organization would not say how much it is spending on the advertising campaign. Its campaign focused on the Washington area.