The larger subsidy has the salutary effect of encouraging more Medicare beneficiaries not to forego the benefit, even if they have no immediate need for it. But, of course, a larger subsidy, such as Proposal B, will likely cost Medicare more money. This does not mean that beneficiaries should forego necessary hypertension medication because of their cost. It does mean that beneficiaries would be encouraged to purchase more drugs of only limited value. The answer to this question largely depends upon which side of the economic fence one sits.
Conflict also arises over the administration of a prescription drug benefit.
One approach is to leave the job to an independent supervisory board to determine benefits and manage the competitive process. The other approach is to allow the existing Medicare administrative authority, the Health Care Financing Administration, to have primary responsibility for managing the Medicare drug benefit. The decisions to be made in the coming months are partly budgetary, philosophical, and political. Meeting the challenge will not be easy, and is by no means assured. The easiest course to take, after all, may be to do nothing at all.