Background on the Prescription Drug Issue
Prescription drugs are the second-fastest growing health care cost in the United States. Americans pay the highest prices in the world for brand-name drugs—often more than twice what Canadians and Europeans pay for the same prescriptions. The high cost of prescription drugs is especially hard on seniors, low-income people, working families, and people with chronic illnesses who require regular medication.
To help you understand Obama vs.


McCain on key prescription drug issues, here's a comparison between the two presidential candidates.

• McCain on Prescription Drugs
  During his long Senate career, McCain has supported legislation intended to advance patients’ rights and to give seniors better access to prescription drugs, although he voted against creating the Medicare prescription drug benefit when it was first proposed. Later, McCain voted against expanding it.
  
  As part of his 2008 presidential campaign, McCain has proposed lowering the cost of prescription drugs by increasing competition among U.S. pharmaceutical companies through the safe re-importation of drugs from Canada and other developed countries, and through faster introduction of cheaper generic drugs.
  
  McCain on the Medicare Prescription Drug Benefit
  McCain also has proposed a change in the Medicare prescription drug benefit (Medicare Part D) that would require some seniors to pay more than others for prescription drug coverage, depending on their incomes.
  
  Under the McCain proposal, Medicare beneficiaries with annual incomes of more than $82,000 for an individual or $164,000 for a couple would pay higher premiums for prescription drug coverage. Seniors at about those income levels already pay more for physician services under Medicare Part B, thanks to the 2003 Medicare bill championed by President Bush, and McCain argues that it’s only fair and logical to expect them to pay more for prescription drug coverage as well.
  
  "People like Bill Gates and Warren Buffett don't need their prescriptions underwritten by taxpayers," McCain said. "Those who can afford to buy their own prescription drugs should be expected to do so."
  
  Ironically, in 1997 McCain voted against “means testing” for Medicare, the very thing he is now proposing for Medicare Part D.
  
  Arguments ForMcCain's Prescription Drug Plan
  The biggest argument for adopting McCain’s “means testing” approach to prescription drug coverage under Medicare is that it would help reduce the cost of the Medicare system.
  
  Douglas Holtz-Eakin, McCain's chief economic advisor and a former director of the Congressional Budget Office, says McCain's proposal would affect only the richest 5 percent of Medicare beneficiaries and save the system about $2 billion a year.
  
  Arguments Against McCain's Prescription Drug Plan
  Those who oppose McCain’s proposal to link Medicare prescription drug coverage to a beneficiary’s income argue that while billionaires like Bill Gates and Warren Buffett may not need help paying for their prescriptions, many middle-class people do.
  
  Critics of McCain’s plan fear that the income levels McCain has proposed could eventually end up much lower, possibly as low as $40,000 for individuals, which would force many more people to shoulder additional costs for Medicare prescription drug coverage.
  
  Making Medicare beneficiaries pay more for coverage could make them decide to opt out of the program and eventually turn Medicare into a welfare program instead of a social contract with America’s seniors.
  

• Obama on Prescription Drugs
  Obama has proposed several steps to help lower the cost of prescription drugs and to improve access to generic drugs that cost less. Those steps include:
  
  • Lifting the ban that currently prevents the federal government from negotiating with drug companies to get lower prices on drugs for the Medicare program, just as it does to lower drug prices for veterans. Annual savings from this measure alone could be as high as $30 billion.
  • Allowing seniors and other Americans to buy safe prescription drugs from other developed countries where prices are lower.
  • Increasing the use of generic drugs in Medicare, Medicaid and the Federal Employees Health Benefits Plan, and preventing pharmaceutical companies from blocking safe, low-cost generic drugs from entering the market.
  • Closing the so-called “doughnut hole” in Medicare Part D prescription drug program. The doughnut hole is the gap in coverage that happens when an individual reaches an initial spending limit and must pay for all drug costs until a second, higher amount is reached. The doughnut hole costs many individual seniors thousands of dollars every year.
  • Making Medicare coverage easier to understand by requiring insurance companies to send Medicare beneficiaries a full list of the drugs they use and the fees they pay every year. The idea is to help seniors determine which Medicare prescription drug plans so they can choose a plan that will reduce their expenses while helping them maintain or improve their health.

Final Words on the Prescription Drug Issue
Both McCain and Obama have made increasing the availability of low-cost prescription drugs a priority of their proposed health care plans. Obama has offered more specific strategies for accomplishing that goal, but neither presidential candidate has explained how he would achieve the various steps he has outlined, or how the government would pay for the cost of the changes he has proposed.

Vague rhetoric is the common language of all political campaigns, and we’ve learned to expect campaign promises without much substance. On life-or-death issues such as health care and prescription drugs, however, voters deserve more than a list of good intentions from Obama vs. McCain, who are vying to become the next U.S. president.