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Schumer Calls for Expanding Medicare to Include Prescription Drug Coverage

Underscoring the need to expand Medicare to include prescription drug coverage, US Senator Charles E. Schumer today revealed that up to one third of New York City and Long Island seniors may not have prescription drug coverage and that nationally the average senior without prescription coverage spends $800 out of pocket each year filling critical prescriptions.

"With so many seniors on fixed incomes, this is the kind of medicine that is hurting people," said Schumer.

Schumer surveyed area health insurance companies, Medicaid and several other smaller health programs and found that of the nearly 1.2 million Medicare beneficiaries in the five boroughs and Suffolk and Nassau counties,


  1. 782,282   (62.5% of area seniors) receive some form of prescription drug coverage usually very modest.
  2. Of this total, 473,260   of the area's Medicare beneficiaries have purchased supplemental policies to cover prescription drugs.
  3. 273,987 of low income area seniors have access to a prescription drug benefit under Medicaid
  4. 35,035 are covered under a New York State program that helps seniors slightly above the poverty line afford drugs.
  5. Nearly all of the remaining 382,484 (37.5%) seniors have no prescription drug benefit whatsoever. Which is in line with national statistics which show that 34% of all seniors lack a prescription drug benefit.

Even those seniors with a prescription benefit typically spend $570 per year in copayments and premiums related specifically to prescription drugs, according to the American Association of Retired People.

"Supplemental insurance policies that have a prescription drug benefit are not very generous," said Schumer. "Whether you are fortunate enough to be able to afford supplemental insurance or not, the prospect of growing old and needing prescription medication is a frightening one."

Over the past five years the price of a prescription has increased 40 percent, from $26.61 to $37.38 per prescription. At the same time, an average of 18 prescriptions are filled per year for elderly Americans. Total US spending on prescription drugs between 1995 and 1997 increased by 26%, and the number of prescriptions filled grew by nine percent.

According to the New York State Office for the Aging, 60% of Medicare beneficiaries in New York City and Long Island earn less than $15,000 annually, and Social Security is the only form of income for 27% of them. Eleven percent live under the poverty line and one fifth suffer from some kind of chronic physical or other limitation.

Schumer surveyed area pharmacies and compared the cost of the ten most popular prescription drugs among senior citizens. The amount of money that seniors pay for prescriptions varies widely depending on their health. Schumer noted that a senior taking Prilosec to treat ulcers must pay between $1,439 and $1,800 for a year's supply of medication, depending on which New York City area pharmacy fills the prescription. The most expensive supply of Prilosec in New York City costs over $500 more than the cheapest Prilosec in Rochester, according to a December survey by Schumer's office.  

A year's supply of Zoloft, the leading depression medication for seniors, would cost $876 at CVS in Manhattan, $923 at Robins in Queens, $935 at CVS in Islip and $986 at S&N pharmacy in Brooklyn. A year's supply of Norvasc, the leading hypertension and angina medication, would cost $540 at Hunts Point Drug Company in the Bronx, $600 at Ride Aid in Manhattan and $504 at Hugenot in Staten Island.

"That is an enormous sum of money for anyone to pay, but especially for those who rely on Social Security and a pension," said Schumer. "Medical care has changed a great deal since Medicare was created in 1965. Today, prescription medication has taken the place of surgical procedures and hospital stays as a way to treat most illnesses, but Medicare has not caught up with the modern world. Seniors who want to live an active and healthy life cannot afford the drugs that can make that possible. They are faced with the false choice of financial health versus physical health."

According to medical and pharmaceutical experts, a typical heart patient might take three medications each day: Lanoxin to prevent congestive heart failure, Vasotec to stabilize and reduce blood pressure, and Lasix, which is a diuretic. A Long Island senior would pay over $600 per year for these three medications. A Brooklyn senior could pay as much as $800 per year for the same medications.

Prescription drugs are the fastestgrowing major cost component of both private insurance and Medicaid. According to the Special Investigations Division of the House Committee on Government Reform, while managed care and other measures slowed overall growth in national health care spending to about five percent annual growth between 1992 and 1997, spending for drugs increased by twice that rate at 11% per year.

Standing with New York City seniors, Schumer said that the rising cost and increased use of prescription drugs has made the adoption of a Medicare Prescription Drug Benefit essential. A plan proposed last year by the Administration would add a new, voluntary Medicare drug benefit beginning in the year 2002. Seniors who pay a $24 monthly fee would have Medicare pick up 50% of prescription drug costs up to a limit of $5,000 ($2,500 Medicare share). Low income seniors would have a smaller copayment and monthly fee. Schumer said he would fight to ensure the plan's passage in Congress during the next session.

"This plan would make a real difference in the lives of people who deserve better than to weigh the cost of drugs against the cost of food or other essentials. I am encouraged that the pharmaceutical industry has now said that it will support this new benefit, but the proof as they say, is in the pudding," said Schumer.

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