The new Medicare bill is the largest entitlement expansion since the 1960s. Couple this with the Homeland Security Act, which created the largest bureaucracy in the history of the country, and Republicans are no longer behaving like true Republicans, more closely resembling Democratic principles that advocate more government, not less.
Equally frustrating is the insultingly small amount of time given to Congress to review the bill before voting. Most reports have the timeframe at four days before the actual vote was called. This means that many of the legislators had not even read the bill before they cast their votes, and those who did read it and who might have had questions or issues with its content had no opportunity for clarification.
The excuses that Democrats and Republicans, who now oppose the USA PATRIOT Act they so enthusiastically supported after the September 11 terrorist attacks, give is their lack of understanding of components of the bill before they cast their vote. Whose fault is that? The vote should not be called unless all parties have fully read and resolved any conflicts. Instead, they vote due to pressure, lobbying, and anything but responsible governing.
Meanwhile, the mainstream media is blustering about the "controversial bill passed" but cannot explain why it is controversial, or give specific examples of changes and the potential impact on consumers. My guess is most of the reporters have not read the bill, nor do they have the wherewithal to analyze it meaningfully, let alone articulate to audiences the real pros and cons.
That said, I credit the Wall Street Journal's November 18 story "A Guide to Who Wins & Loses in Medicare Bill" for at least giving a general explanation as to who does and doesn't benefit and why.
Briefly, pharmaceuticals and insurance companies benefit because there are controls in place with the new bill, including limiting competition outside U.S. borders, allowing drug companies to continue to prosper in the style they have grown accustomed to; subsidies are in place for insurance companies and hospitals for providing specific services and coverage; consumers can purchase discount cards that give them access to lower pricing for specific drugs tagged by "pharmacy benefit managers"; and employers will receive tax-advantaged subsidies for offering retiree insurance coverage.
The new bill will not take full effect until 2006 through 2010. So for now, the action on this bill is more about politics than economics. The cost of the new Medicare is in the trillions of dollars, and at the rate of spending currently, the likelihood of this bill becoming viable is suspect.