Again, I'm stealing my information from folks like Louise M. Slaughter, M.P.H., of The New England Journal of Medicine.
Also, a number of folks are inclined to believe that the economic shakiness of the entire Medicare program is due to the costliness of Medicare Part D, that the Medicare Part D is essentially a "bait and switch" scheme.
Louise M. Slaughter, Master of Public Health:
.... The current problems with Medicare Part D are largely the direct result of the undemocratic way in which the plan was authored and passed. The final legislation, heavily influenced by drug-company and health insurance lobbyists, focused mainly on the needs of those industries instead of those of the seniors it should serve.
The political process used to pass Part D was the worst abuse of the legislative process I have seen during my 20 years in Congress. In the months before its passage, a few powerful Republican leaders worked to undermine conscientious reform proposals. In early 2003, while the House bill was being drafted, Democrats and Republicans authored 59 sensible amendments to it. At the behest of the Republican leadership, however, the House Committee on Rules rejected all but one, preventing them from being debated by Congress. Many of those amendments — among them, one requiring the administration to use beneficiaries' collective purchasing power to negotiate lower prices and one allowing Americans to import cheaper drugs from Canada — would have made the legislation far more effective and probably would have received bipartisan support, had they been allowed onto the floor.
Next, the conference process, whereby the House and Senate versions of legislation are reconciled, was fundamentally corrupted and kept almost entirely secret by senior Republicans. Democrats on the conference committee were excluded from deliberations, to the point of being physically barred from the conference room on one occasion. The pharmaceutical industry, however, was invited in.
Serious conflicts of interest on the part of the bill's primary authors were common. The chairman of the Commerce Committee, Representative Billy Tauzin (R-La.), coauthored the bill while negotiating a $2-million-per-year job as a lobbyist for the Pharmaceutical Research and Manufacturers of America (PhRMA), the drug industry's trade organization. The top Republican aide on a subcommittee involved in writing the legislation also left his position soon afterward to lobby for PhRMA. Thomas Scully, the administration's top Medicare official, deliberately understated the program's projected cost by $134 billion, and when the chief actuary of the Centers for Medicare and Medicaid Services (CMS) objected, Scully reportedly threatened to fire him if he shared his true estimate with Congress. Soon after the legislation passed, Scully resumed his career as a health care–industry lobbyist.
http://content.nejm.org/...
Under the nefariously criminal leadership of legendary Tom DeLay
When the conference report was brought to the House for a vote, members were given less than one day to read the 850-page bill, a violation of House rules. When the vote was called at almost 3 a.m., voting Democrats stood unanimously with 22 Republicans in opposing the legislation. Had the vote been gaveled down in the customary 15 minutes, the bill would not have passed.
The infamous 3 a.m. vote. Remember that?
DeLay also attempted to bribe Michigan Congressman Nick Smith with political favors in order to get him to change his vote.