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Most measures, the Department of Veterans Affairs has solved the puzzle, that medicines sold at an affordable price, at least one large group of Americans without wrecking the federal budget.

Likewise, his great power as one of the largest purchasers of medicines to the USA, bringing VA, for millions of veterans to pay only $ 7 for a maximum of 30 days a prescription. Thousands are registering for the program each month.

But of all the success, the legislature has infringed the VA models - and others like that employed by the Government of the immense power to negotiate lower prices - as they try to Americans aged Liberation rising costs of cannabis during processing, the elderly receive medical benefits.

Instead, Congress is deeply divided by ideology, from birth until the legislation would add that, for the coverage of Medicare prescription medication, but many experts say that behind the needs of elderly . The benefits cost $ 400 billion over 10 years, are too complex and too limited and that the law is partly based on mechanisms for cost control, unfounded or not.

Indeed, the Congress to release the pharmaceutical industry on the nature and cost controls in the village for virtually all other major providers of Medicare services.

“The legislation before Congress represents more than distort the reform of Medicare,” said Dr. Paul M. Ellwood, a famous political analyst of health, was one of the first proponents of Managed Care. “Instead of setting up a system easily understandable decisions on the basis of cost and quality, Congress is writing legislation, the increased complexity of the disease, it is difficult to navigate for seniors. ”

The efforts for a final agreement on Capitol Hill, distinct mixture of Representatives and Senate measures, was at the top of the agenda, as Labour Congress this week. Lobbyists of health policy and experts say that the probability that a bill comprehensive drug is in force this year seems no better than 50-50. But Thomas A. Scully, administrator of the Confederation Centers for Medicare and Medicaid Services, said yesterday that he was “95 percent that we received a Medicare bill out of Congress.”

Politics, legislation is a reason of convenience, combining the benefits of medicines, long sought by Democrats, with a Republican approach to the management of sickness and private insurance companies. To ensure the votes, the Senate was the bill with the help festooned various interest groups. It is the language which, for examples, aid chiropractors, marriage and family therapists, doctors, Alaska, in hospitals Iredell County, NC, operators of air ambulance services and many other groups.

The needs care bipartie “has resulted in a number of compromises, a hodgepodge of a bill,” said Senator James M. Inhofe, Republican of Oklahoma, against the Senate.

Michael Valentino, a manager of VA’s Drug Benefit Program, welcomed the Congress to try to help patients suffering from disease buy prescription drugs. But he added that the report could be extended if Medicare, to take full advantage of their purchasing power.

C. John Rother, AARP Director of Policy, the pressure group Americans for the elderly, said the legislation was a “real stroke of luck” for people with low incomes or high drug expenses.

“But for many others,” he said, “benefits are deemed inadequate.”

Premiums and benefits under the drug could plan, plan, state to state and year to year. The Senate and House bills once default drug coverage costs of investment and catastrophic coverage for high costs. But the beneficiary would pay all drug costs in the middle, until their Out-of-sac cost reaches a certain level - $ 3700 per year under the Senate account and $ 3500 in connection with the establishment .

Robert D. Reischauer, former director of the Congressional Budget Office, said the gap in coverage “reasonable despite political analysis and trade was not in insurance. Congress-engineered away, the drug plan costs under the limit of $ 400 billion.