American seniors are still travelling to Canada via car, bus and the Internet to beat high prescription drug costs (see CMAJ 2001;164[2]:244-5). Despite promises by both political parties that Congress would deliver meaningful health care reform, including some drug coverage, voters in next month's mid-term elections say that little, if anything, has changed since they voted in 2000.
Capitalizing on this frustration, one congressional candidate in South Florida has bought TV ads inviting Medicare beneficiaries — disabled people and those 65 and older — to use her hotline to get information about ordering prescription drugs from Canada. “Our neighbours in Canada can buy the very same FDA- approved drugs for 2 to 3 times less than we pay,” says Carol Roberts.
The frustration of seniors is palpable this election year because of unkept promises. There was supposed to be a patient's bill of rights to make it more difficult for HMOs or insurers to deny needed coverage. Patients were also promised new privacy regulations and access to cheaper US-made drugs from Canada, plus the right to sue HMOs. None of these measures were approved, but it was the political gridlock over adding a prescription drug benefit to Medicare that caused the most despair and anger. (Most of the 40 million people covered by Medicare do not have drug coverage.)
Democrat Senator Edward Kennedy noted that Washington already pays 75% of prescription drug costs for members of Congress. “How many of us are willing to face our constituents … knowing that we have secure coverage … but we reject proposals that do even less for our fellow citizens?”
Why is prescription drug coverage such a huge issue in the US? When retired steelworkers in Pittsburgh lost their health benefits earlier this year after their company filed for bankruptcy, one former employee learned he would have to start paying US$975 a month for the medication needed by his wife, who has multiple sclerosis.
The American Association of Retired Persons says 26% of the retirees it polled recently would vote against any senator who continues to let partisan differences prevent passage of legislation mandating a prescription drug benefit.
Politicians already know that results like this can't bode well: half of voters in the mid-term elections 4 years ago were over age 50, a percentage that will probably rise again this year. — Milan Korcok, Florida