[caption id="" align="alignleft" width="200" caption="Rep. Chris Gibson, R-Kinderhook"][/caption]Wondering just how much the new Republican Congress is valuing idealism over pragmatism? They're willing to allow greater costs for seniors by sacrificing the closing of the so-called “doughnut hole” that costs some senior citizens hundreds of dollars a year in prescriptions that Medicare will not cover so they can claim defeat of the health care legislation approved last year at this time, at least according to freshman Congressman Chris Gibson, R-Kinderhook, A story in this morning's Register Star on Gibson's views points out that he "may not especially like the coverage gap - but he’s willing to bring it back in order to undo the much bigger health care reform package enacted by Democrats last year." In a telephone interview, Gibson could not say how or if the Republican majority in the House would avoid letting the “doughnut hole” return if the health care reform is repealed. "That’ll be a part of the discussions,” Gibson said. “I’m not going to support a policy that’s not paid for.” Gibson, who defeated Democrat Scott Murphy in November, did however express support for a number of elements of the health care laws within his statements, albeit with caveats that the whole kit and kaboodle be handled fresh, no matter any costs to citizens caught up in the great national debate of the day.

The doughnut hole refers to the gap in coverage beginning at prescription costs of $2,800. Up to that point, the Medicare prescription drug plan pays for medications. But people are on their own until costs reach $6,154, when catastrophic coverage kicks in.

The closing of the gap began to take effect Jan. 1, and beneficiaries should notice the difference immediately in prescription prices, Sen. Charles E. Schumer, D-N.Y., reported. By 2020, he said, the gap will be closed.

Columbia County is home to 1,047 people affected by the coverage gap, who will save $9.4 million during the next 10 years, Schumer’s office estimated.

Gibson acknowledged that the issue is not simply whether Congress pays for a doughnut hole fix - the Democratic-passed law does that -- but how. The health care reform law covers the cost by compelling drug companies to give Medicare Part D beneficiaries a 50 percent discount on brand-name drugs.

Critics say that’s a flawed approach, however, because drug companies would be able to simply raise prices, while offering the discount, meaning seniors could end up paying more for drugs anyhow.

The new Republican majority has declared that new spending on programs must be paid for with cuts in other programs - but not cuts in other parts of Medicare, for instance, as the Democratic-passed law does and which the GOP attacked during the debate over the legislation.

Democrats note that Republicans enacted the Medicare Part D program under President Bush through borrowing, adding to the budget deficit.

Repeal is unlikely to go any farther than the House, as long as Democrats control the Senate and the White House.

The Republican leadership had scheduled a vote on repeal this week but delayed it because of the shooting of Rep. Gabrielle Giffords, D-Ariz. The earliest votes would be next week.

If the leadership follows the script it laid out last week, the House will vote on repeal before considering an alternative reform plan still being crafted by Republicans. Gibson has been critical of that approach, saying they should be considered together.

Generally, Gibson said, he supports a reform package based on free-market principals which cuts down on the cost of medical liability lawsuits and allows access to insurance policies across state lines, in order to contain health care costs.

More competition will reduce premiums, he said.

In addition, Gibson said he favors increasing the number of people with insurance - not over the current law, which greatly expanded coverage, but over the conditions before the law was passed. And he supports giving states more flexibility in administering Medicare.

And although he has been critical of the law, he said he agrees with some aspects, such as prohibiting insurance companies from dropping beneficiaries if they become sick.

“If it’s insurance, you shouldn’t be dropped,” Gibson said.