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The Medicare Prescription Drug Program: A Model for Broader Health Care Reform


In 2003, conservatives, utilizing principles of competition and choice, created a prescription drug benefit program that has simultaneously given millions of seniors access to life-prolonging medicines, controlled costs, come in under budget, and proven wildly popular. These same principles can be applied to reforming the overall health insurance system and replacing Obamacare. A wider understanding of how Part D functions and what it has achieved, can help conservatives advance the cause of market-oriented health care reform.


In 2010, a jubilant President Obama signed the Affordable Care Act into law. Liberals had finally achieved their long-sought policy goal of a national health care system established and controlled by the federal government. Almost six years later, the American people have registered their verdict: polling consistently demonstrates that more people disapprove of the law than approve – by 8 points according to an average of recent public polls.1  Yet, when asked whom they think would do a better job handling the issue of health care, Americans say they trust Democrats over Republicans by an average of eight points.2

What is going on here? Logically, one would think that we tried it the liberals’ way and the American people didn’t like it; so shouldn’t they turn to conservatives for a better alternative? The problem is that, while conservatives have succeeded in pointing out Obamacare’s many problems, we have failed to convince the American people that we can be trusted to enact better reforms. This is a particularly disturbing failure when you consider that the last major health care reform enacted prior to Obamacare was pushed by conservatives, is overwhelmingly popular, has made medical treatment accessible for millions, and has come in under budget.

As the debate over replacing Obamacare heats up, policymakers would be well served by understanding why the Medicare prescription drug program has worked so well and how that success can be replicated for the larger health care system.

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