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CNN SUNDAY MORNING

Interview With Julie Rovner

Aired November 30, 2003 - 07:43   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SEAN CALLEBS, CNN ANCHOR: We want to talk more about what Medicare reform will mean for the 41 million Americans who now use it. And here to help us sort it all out is Julie Rovner. She is the health policy correspondent for NPR.
Julie, thanks very much for joining us morning.

JULIE ROVNER, HEALTH CORRESPONDENT, NPR: Good morning.

CALLEBS: I'm struck by three things. Now there was reform in '88. There was reform in '97. And when the House voted on this measure in a roll call that usually takes 15 to 20 minutes, it took what? 2.5 to 3 hours?

ROVNER: Almost just short of three hours.

CALLEBS: So and listen to what Representative Sherrod Brown of Ohio, he is the senior Democrat on the House Energy Commerce Committee's Health Panel. He said it is better than nothing, but barely. Is that fair?

ROVNER: I think that's certainly the view of a lot of people. This is a very difficult vote for a lot of members. It was a true compromise, if you will. There were a lot of things that Republicans liked and hated in the bill, a lot of things that Democrats liked and hated in the bill. And those tended to be opposite things.

CALLEBS: Let's talk about some of those. Now this is something President Bush fought for very strongly. And he is very eager to sign this.

ROVNER: Yes, absolutely. This is something that Republicans made a priority when they took over the House and Senate last year after the elections. They said we're going to do Medicare now.

Everybody talks about this as a Medicare prescription drug bill. The Republicans always thought of it as a Medicare reform bill, with the prescription drugs kind of the sweetener to get people to swallow some of the reforms.

CALLEBS: Well, talk about that, because so many people are concerned about the escalated cost of prescription drugs. And so many, 41 million Americans are on this. It's an annual budget of $270 billion. We quickly went through it there. There will be breaks for people who are saddled with extremely high payments for drugs, but what about the elderly people who depend on Medicare? Is this going to be a big setback for them?

ROVNER: Well, it depends And obviously, this is a Medicare drug benefit. Again, if you have low income, you'll probably do very well. If you have up to about 150 percent of poverty, about $20,000 a year. You get a very good benefit, assuming you don't have a lot of assets.

This is very complicated, I have to say. Someone last week described reading the bill is like reading the owner's manual to the space shuttle.

The other people who will be helped are people with very high drug costs, regardless of incomes. If you have more than $6,000 or $7,000 worth of drug bills every year, you will get substantial help.

For people in the middle, it's going to be a very mixed bag. It depends. If you already have coverage, you might end up worse off than you are now, because it -- you might lose the coverage that you now have if it's provided by an employer. So there really are going to be winners and losers, even within those 41 million Medicare beneficiaries.

CALLEBS: Well, Julie, let's talk about so many people who depend on this, because we talked about the reform that was out there in '97. And many people say that was simply a failure.

This time, there was an effort to bring the health care providers on board and work things out with them, so there wouldn't be any surprises down the road. How is that going to play out?

ROVNER: Well, in 1997, the Medicare changes were part of the balanced budget act. So they were largely cuts to Medicare. There were reductions. In some cases, reductions and increases.

This bill is actually trying to entice private plans and the health providers to get on board, by giving them more money.

Now the money for the doctors and the hospitals was really a side from the reform element to this bill. That was just something to kind of cement their support for the entire enterprise.

What we're really talking about are these private -- and these new private plans that they hope will serve seniors. They hope that there would be more private plans in 1997. In fact, a lot of the private plans they're anticipating now were the same types of plans that were first allowed in 1997. They didn't show up. This is a big gamble in kind of three ways. They're hoping that these plans show up to offer the coverage.

CALLEBS: Right.

ROVNER: They're hoping that the seniors show up to join the plans if the plans show up to offer the coverage. And finally, they're hoping that if that happens, these plans can control Medicare costs. And all three of those questions remain to be answered.

CALLEBS: Well, Julie, a big gamble. And let's hope that people don't need a Rosetta stone to decipher this, once all the information does come out. Julie, thanks very much for coming in this morning.

ROVNER: Sure.

CALLEBS: Julie Rovner, health policy correspondent, NPR. We appreciate it.

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