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Daschle acknowledged that senators of neighboring states voted for the bill, figuring it was "better than nothing."
"I don't believe it was better than nothing," Daschle said, who pointed out what he perceives to be deep flaws with the bill.
That isn't to say there aren't some positives, Daschle said, noting four good points with the Medicare Reform Act:
* Begins to correct Medicare payment deficiencies to rural physicians and hospitals, bringing them closer to parity with urban health providers. "The problem is that it lasts for only two years and then the disparity begins again," warned the three-term senator.
* Provides a prescription drug benefit for low-income, non-Medicaid seniors.
* Increases access to generic drugs, to save money for seniors.
* Provides a discount card for low-income seniors, which the senator said "may be marginally helpful."
Daschle said that in his view, the fact that the Medicare Reform Act doesn't kick in until 2006 is another good point. "It gives us time to fix it," he said.
What's wrong with the bill? Plenty, according to Daschle.
"It doesn't do anything to control the cost of drugs," he said, noting that prescription drug costs rose 15 percent last year and have been rising 15 percent a year for several years running.
The bill will close the door on using the Internet to buy cheaper drugs in Canada. "It does allow you to travel to Canada and buy a 90 days supply," he said. "That's good for South Dakotans because we're relatively close to Canada, but it doesn't do anything for seniors who live farther away."
Shaking his head in bemusement, Daschle said the bill actually prohibits the Medicare program from negotiating with the drug companies for lower prices in bulk purchases. Yet that's a tool used by the Veterans Administration to control costs for veterans. "We wanted that power of negotiation, but it was defeated," he said. The drug companies won at the expense of seniors, he added.
Daschle warned that the new law may lead to retirees losing their retirement medical coverage from private businesses, as business seeks to reduce costs and dump former employees into a more expensive Medicare system.
"The U.S. Congressional Budget Office study estimates that 5,000 South Dakota retirees may lose their private plans, which are often better than Medicare," Daschle said. Further, 16,000 South Dakota seniors may see dramatic increases in Medicare costs, he said, according to the same study.
"My greatest concern is that benefits will erode over time," Daschle said. The monthly premium will rise from $35 per month in 2006 to $58 by 2013, he warned.
Spearfish seniors struggled to understand gaps in coverage, what some critics have called "the doughnut." As Daschle explained it, a Medicare-covered senior would pay $250 before Medicare started covering 75 percent of the costs up to $2,850. From that point to $5,100 in annual expenses is the hole of the doughnut, where there is zero coverage, Daschle explained. Anything above $5,100 in expenses would be covered 95 percent by Medicare, he said.
"This is pretty complicated and I worry about 80- and 90-year-olds figuring it out," he said.
Daschle has introduced legislation to fix the problems with the Medicare Reform Act.
In a question and answer session, Spearfish's Maury Etem said he orders his drugs from Canada, via the Internet. "Are the prescription cops going to come after me?" he asked. Daschle said Internet sales will be phased out over the next two years.
Jerry Shrader said he was wondering about the Bush Administration's priorities, racking up huge deficits and planning a mission to Mars when so many families are struggling with health care.
Republican Bill Trent rose in defense of the Medicare Reform Act, saying there were many good things in the bill, such as the fact that medical tests are now covered. He also praised the fact that South Dakota is getting $133 million for rural health care.
Clare Armstrong told Daschle that if his former employer (Qwest) canceled his medical plan, "I'll have to go back to work."
