Robert Novak

WASHINGTON -- Desperate to control the congressional embrace of prescription drug subsidies, the House Republican bill would apply means testing to catastrophic illnesses. That laudable effort, however, carries an unexpected consequence. The health insurance industry would have access to the income data of every senior citizen in America.

So much for supposed congressional concern about privacy. Ironically, this massive intrusion into secrets of older citizens results from Rep. Bill Thomas's attempt to prevent ideological disaster for the Republican Party flowing from its perceived political triumph of getting rid of the issue. The innovative Ways and Means Committee chairman's proposal for means testing is part of his drug subsidy plan, which provides reform elements missing from the Senate version.

Grumbling from the conservative base is rising as the Republican-controlled Congress and the Republican administration agree to subsidies without real reform. That fits the long-range agenda of Sen. Edward M. Kennedy, the Senate's liberal lion who has become a fox in moving inexorably toward government control of health care. Supposed carping from his left should not be taken seriously. Kennedy is happy with the administration-blessed Senate bill, which threatens future private participation in prescription drug programs.

What Kennedy does not want is Thomas's bill, which at least makes an effort to give seniors a private sector option. Its intrusiveness, however, shows what can happen when market-oriented Republican legislators institute a new entitlement.

The Thomas bill's provisions dealing with catastrophic illness provide federal payments once a senior citizen's annual out-of-pocket drug expenses exceed $3,700. However, for persons with an adjusted gross income over $60,000, the amount of the senior's expenses needed to qualify for aid would gradually rise under a formula until the person's income reached $200,000.

But how could this be administered? The bill spells it out. The Health and Human Services (HHS) department would give the Treasury the taxpayer identification number of everybody participating in the prescription drug program. Treasury would then inform HHS of each citizen's income. HHS next would compute who qualifies for how much aid, informing health insurance companies and pharmacy benefit management firms. These private companies could then easily calculate the income of every participant in the drug program.

Robert Novak

Robert Novak (1931-2009) was a syndicated columnist and editor of the Evans-Novak Political Report.

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