I have been told by people who know such things that the Dems are looking at ways to allow Medicare to negotiate prices with the drug industry, without offering its own plan, that actually would be meaningful. For example, it could negotiate a set of prices that would apply to all the insurance plans included under Part D. This seems unduly complex, but it could lead to lower drug prices. Whether they end up going this route and designing something that actually reduces drug prices, or whether they do something that is purely symbolic, remains to be seen. The moral of the story is that everything will depend on the details of how any reform measure is structured. If the public is not informed of these details, it will not be able to distinguish between a substantive measure and a purely symbolic one until it is time to pay the bills.
--Dean Baker