ABSTRACT
Passed by the U. S. Congress in 1965, the original Medicare program did not include coverage for prescription drugs. Although this omission did not initially generate much political attention, rapid growth in spending on pharmaceuticals during subsequent decades fostered political pressure to include prescription drug coverage under the umbrella of Medicare. The discussions became especially heated in the early 2000s as drug spending, as a percentage of total medical spending, increased from 8.6% in 1993 to almost 13% by 2003 (OECD Health Data, 2005). In response, the Bush Administration signed the Medicare Modernization Act (MMA) in 2003, representing the largest overhaul in Medicare’s 38-year history.
