[Drug politics in the USA]

About 40 million Americans over 65 years of age are enrolled in the Medicare programme. However, this programme (with some exceptions approved by the Congress) does not provide prescription drug coverage for the outpatients. Furthermore, the recent rate of drug expenditure increase has been twice higher compared to overall health care expenditures. Even though the Medicare beneficiaries are offered various forms of supplemental prescription drug coverage, there exist attempts to reform this national programme. Several such proposals, however, failed during the last 15 years (US Congress). A recent two-stage strategy for a comprehensive Medicare reform was proposed by president Bush jr. It would solve the prescription drug coverage (even without the Medicare beneficiary enrollment in supplemental private programmes) through direct support to federal states in the first stage; in the second stage, a comprehensive Medicare reform would take place and the prescription drug coverage would be subsidized in proportion to the annual income of the beneficiaries. The required cost of this reform would be about 160 thousand million $ over a decade. This plan brought about opposing proposals both from the Democrats and Republicans in the Congress. The fate of the reform will depend on the representation of the two political parties both in the House of Representatives and the Senate as well as on the political power of influential groups.