Highlights Of Medicare Plan


^Highlights of President Clinton's proposal

^Eds: Also moved on general news lines

^With AM-Medicare-Drugs, Bjt

^By The Associated Press=

President Clinton's proposed Medicare changes include:

A new prescription drug benefit, available as an option starting in 2002. Medicare does not currently cover drugs not administered in hospitals or doctors' offices.

Coverage would start with the first dollar of prescription costs, with no deductible. The government would pay half the first $2,000 of drug costs in a year. Costs above $2,000 would have to be paid by the beneficiary. The monthly premium would rise gradually, reaching $44 in 2008 and the $2,000 cap would rise to $5,000. Estimated cost: $118 billion over the next 10 years.

Elimination of all copayments and deductibles for preventive medical care including mammograms, prostate cancer screenings and diabetes management. Estimated cost: $3 billion over 10 years.

A new 20 percent copayment for lab tests for which beneficiaries currently pay no out-of-pocket fees, and inflation indexing of the $100 annual Medicare deductible for doctor's office visits and other outpatient treatments. The inflation indexing would likely result in deductible increases of $2 to $3 a year. Estimated savings: $11 billion over 10 years.

Beneficiaries who opt to join private managed care health plans that participate in Medicare would share in any savings if the plans were more efficient than average or extra expense if they were less efficient. Monthly Medicare premiums would be lower for those who chose plans that were less expensive. Those who chose more expensive plans would pay the difference. Estimated savings: $8 billion over 10 years.

Most curbs on payments to health care providers that were set in motion by Congress in 1997 as part of a plan to balance the federal budget would be extended for another decade in order to achieve an additional $39 billion in savings. However, a $7.5 billion fund would be established so that adjustments would be made if it was determined that some cuts were hurting patient care.

Medicare administrators would get new authority to replace some government price formulas now used in purchasing goods and services, such as medical equipment, with competitive contracting. Estimated savings: $25 billion over 10 years.

$794 billion in expected government surpluses would be dedicated to Medicare over the next 15 years.