Perfect time to hone health care questions

With but a handful of presidential primaries before the Feb. 5 multistate votefest that includes Illinois, voters are likely to hear a lot of rhetoric on the issues of health care and health insurance in coming days.

Luckily for them, the release of the first big report on the impact of the Medicare Part D prescription drug program gives them some hard results to compare with the rhetoric of candidates touting the government as health care savior.

The study, published on the Web site of the Annals of Internal Medicine, show the controversial program that got off to a chaotic start did indeed save enrollees a small amount of money. But it also showed it cost taxpayers a whole lot of money.

The study covered 2006 enrollment, the first full year of the program. And despite some suggestions to the contrary, it saved enrollees $9 per month in out-of-pocket expenses. That's $108 per year, and the report indicated it covered about 14 additional days of medicine. Not a lot, but probably more significant to those on fixed incomes than not.

Those savings did not come cheaply, however.

According to the agency that administers the program, Medicare spending rose from $338 billion in 2005 to $401 billion in 2006, a stunning 19 percent increase. That increase was double the increase of the prior year and the fastest increase since 1981.

Voters also might want to include, in their health care issue analyses, questions on how much insurance and pharmaceutical companies are profiting from offering Part D programs.

And also ask candidates what savings can be achieved by allowing the federal government to negotiate prescription drug prices on behalf of Medicare beneficiaries.

The Part D program has been almost consistently changing since its inception. And it is still in its early days. Thus, it would be unwise to make hard assumptions about its overall effectiveness or its overall costs, which were projected from the get-go to rise dramatically over time.

But the initial numbers would certainly suggest voters ought to be asking candidates some hard questions about their health care proposals.

And they might want to remind themselves to be careful what they wish for as well.

The health care issue, which carries huge costs and numerous long-term implications for future generations, is certainly worth serious debate. But adding further obligations to a Medicare program already nearly insolvent and not yet dealing with the massive baby boom generation without serious discussion of who will pay for it and how is downright irresponsible.

Wanting something is not at all the same thing as being able to pay for it, a very good reason to apply those who/how questions to the rhetoric of presidential aspirants in upcoming days.