Quick review. Medicare was enacted in 1965 to provide health insurance to people age 65+ regardless of income or medical history. Prescription drugs were EXCLUDED from the bill. The Center for Medicare and Medicaid Services (CMS) administers it, and CMS is a department within HHS.
George W Bush came along in 2000 with a Hope and Change matra. A segment of the voting population wanted change to Medicare. He gave it to them.
In 2003, the Drug and Health Industry industry spent a combined $141M on lobbying for the new bill (a record at the time). They deployed ~1,000 lobbyists to push industry interests in the GWB reform. 431 of those lobbyists previously worked for the Federal government. And 30 of those were former Senators and Reps.
The new law was passed with a trick and in violation of House Rules, giving members less than 24 hours to read the 850-page document. A final vote was called ~ 3 am. Rep. Louise Slaughter (D-NY) said at the time that the “Medicare Prescription Drug, Improvement, and Modernization Act” was the "worst abuse of the legislative process I have seen during my 20 years in Congress.”
The big winners were the lobbyists. They STOPPED the Govt from using all of its Medicare enrollees as brute force to negotiate for Rx pricing. And they STOPPED the re-importation of drugs made in the US by US companies, and then sold to countries that do negotiate. In other words, the same drugs, but cheaper.
So, whatever you think of Obamacare and the way it was passed, dont forget about what changes W Bush made to Medicare.
