Suppose the Federal government has created a program that saves taxpayers money, promotes individual freedom, and gets a 90% satisfaction rating from the people who use it.  Should it:

(a) Bury the evidence and let nobody speak of it again;

(b) Effectively dismantle the program by adding lots of new bureaucracy and interfering with what made it work; or

(c) Learn from the success and try to duplicate it in other places?

If you chose answer (c), you’re probably a reasonable tax-paying citizen. But that won’t get you very far in Washington. All too often, what matters there isn’t results — it’s grabbing power wherever you can. You and I can see a clear case of this misdirected bureaucratic energy in the push to have the government micro-manage the lives of people who use Medicare Part D.

Part D is an endangered species: A government-sponsored program that works really well. Since it went into effect in 2006, Part D has done some remarkable things.

First, it has given patients a great deal of choice. Most states have between 20 and 30 different program plans available. Those choices give patients the wide-ranging benefits of competition for their business. It’s hard to think of any business where the quality of customer service doesn’t rise when there is more competition to serve the same customers.

The competitive forces driving private providers to serve these patients also means that Part D has consistently delivered budget savings, costing the government much less than initial expectations and keeping costs to patients well in line, too.

But the most important feature of all is that Part D puts individuals and their doctors in the lead to determine what will lead to the best health and quality-of-life outcomes for patients. It’s easy to overlook the fact that many prescription drugs are used to prevent pain, suffering, and discomfort down the road.

Whether it’s a therapeutic prescription for a condition like high blood pressure or high cholesterol, an anti-anxiety medication being used to enhance a patient’s mental health, or an antibiotic or anti-rejection drug used to help someone recover quickly and successfully from surgery, most prescriptions are used to keep bad things from happening. That saves money, which is good — but it also prevents a great deal of suffering.

For this to work, however, patients and their doctors need to be in control — not bureaucrats. The threat of growing interference by office-holders and power-seekers in Washington could topple all of the benefits that come from today’s well-functioning Medicare Part D. We have heard politicians call for government to set price controls and establish firm ceilings on how much can be spent on patient care. But the big picture is that bureaucratic manipulation of prescription prices is nothing but window dressing. Proposals to force Pharmaceutical companies to pay a ‘rebate’ of up to 40% of their drug sales to Medicare is nothing more than a tax that will drive up the cost of prescriptions and insurance for seniors.

Part D works because of competition, not Washington pencil-pushing. The more government seeks to manipulate and take command over the program, the less patients will benefit from the power of competition. The cure to health-care costs isn’t to drive more decision-making to government, but to stay out of the way of patients and their doctors so they can use whatever therapies make the most sense to prevent illness and disease. Today’s Medicare Part D does that. It should continue to do so tomorrow.


Nansen Malin is a political activist living in SW Washington State. She is the former Americans for Prosperity WA State Director and is active in social media.


[photo credit: alexraths,]