By Tom Curry National affairs writer
msnbc.com
updated 2/10/2005 12:03:57 PM ET 2005-02-10T17:03:57

The next time you see one of those ubiquitous television advertisements for erectile dysfunction drugs such as Cialis or Viagra, just remember your tax dollars will be helping pay for older Americans who want to use them.

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With Medicare spending soaring in the next several years, why, an Iowa congressman wants to know, is the taxpayer helping subsidize Viagra for older men?

The drugs are taxpayer-subsidized, thanks to the Medicare prescription drug program Congress created in 2003.

Rep. Steve King, R- Iowa, says the focus should be on providing life-saving drugs for truly needy seniors, not on subsidizing older men who want to enjoy the erectile function they had when they were younger.

King has introduced a bill that would stop Medicare from subsidizing Viagra and other impotence drugs.

Subsidizing 'recreational sex'
“We are telling young people you need to delay your sexual activity, hopefully until marriage, and we’re still taxing those young people, that have raging hormones, to subsidize Grandpa’s recreational sex,” he said.

It is bad enough for Congress to push government debt on to succeeding generations to pay for entitlements and other programs, King argued, “let alone identify something like this and say ‘It is coming right out of your pocket today.’ That’s a real insult to the younger generations and I think eventually they are going to revolt.”

The people who sign up for the Medicare prescription drug entitlement will pay a monthly premium (about $35 in 2006) and pay a share of the cost of their prescriptions, but much of the cost will be paid by the taxpayers, both young and old.

King’s bill, supported by eleven co-sponsors, both Democratic and Republican, landed in the House hopper on the very day that the Bush administration said the drug entitlement will cost $720 billion from 2006 to 2015, the first decade in which the program will be fully in effect.

The cost estimate in late 2003 when Congress passed the law creating the drug entitlement was $400 billion for the years 2004 to 2013.

Total Medicare spending will amount to 21 percent of all federal outlays by the year 2015, compared to 13 percent of outlays last year, according to an estimate released last month by the Congressional Budget Office.

King himself voted for the entitlement, but said Wednesday, “we had a $400 billion estimate on this prescription drug plan and it was stretching us to the limits. I had considerations at home that were part of that equation, Iowa being last in the nation in Medicare reimbursement rates.” He said he succeeded in getting a provision in the bill that helped redress Iowa’s last-place status.

“There was no one in this Congress that anticipated it would be providing for impotence drugs,” he said. “I don’t think anyone knew.”

Sticker shock
Like other members of Congress he said he is feeling sticker shock now that new estimates of the drug entitlement’s cost are emerging.

“I’m looking at this now and wondering: $400 billion up to $720 billion. If I had known that then, I would voted ‘no’ on the bill.” King told MSNBC.com. “How much of this new number is going for non-essential drugs? I’m convinced that the impotent drugs are all non-essential.”

He added that “if we decide to cap the money Medicare spends, instead of letting it be an open-ended entitlement,” the federal government would be forced to make trade-offs between paying for cholesterol lowering drugs for some elderly people and sexual performance drugs for others.

A spokesman for the Centers for Medicare and Medicaid Services said if a drug is approved by the Food and Drug Administration and if a Medicare beneficiary’s doctor decides that drug is medically necessary for him, Medicare will cover its cost.

When Congress wrote the law in 2003, it decided to exclude eight different classes of prescription drugs, including weight loss drugs and anorexia medications.

The spokesman also noted that Medicaid, the state-federal insurance program for low-income people, also covers Viagra and similar drugs. So it is not only the over-65 population that is benefiting.

“I have arguably one of the most senior districts n America,” King said. “Iowa has the highest percentage of its population over the age of 85 (of any state). Ten of the 12 most senior counties in Iowa are in my district. None of these people are pounding on my desk saying, ‘You need to get the younger generation to pay for my Viagra.’”

Imports from Canada
At a press conference Wednesday at which a bipartisan group of senators announced a new bill to allow the re-importation of pharmaceuticals from Canada and other countries, none of the senators would comment when asked about King’s legislation.

Instead, their focus was on forcing U.S. drug-makers to lower their prices by allowing re-import of drugs shipped to Canada and other nations where governments impose price controls.

One of those senators, Sen. Edward Kennedy, D- Mass., said “a huge portion” of the new drug entitlement “is a windfall profit for the drug companies and the HMO’s.”

The $720 billion Bush administration cost estimate “will add new pressure for us to pass this legislation” to allow drug re-imports, said Sen. John McCain, R- Ariz. He denounced what he called “the egregious and outrageous provision” in the 2003 bill that bars Medicare from negotiating price discounts with pharmaceutical manufacturers. He called it “a disgraceful example of the power of the drug companies.”

One senator who was willing to express support for the idea of not having Medicare pay for Viagra was Sen. Tom Coburn, R- Okla. King’s provision “will fly through” Congress, Coburn predicted.

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