According to a recent study by the National Institute for Health Care Management Foundation, spending on prescription drugs increased by nearly 19% last year, following a similar increase in 1998. That means a rise of about 40% over two years, due largely to aging patients being prescribed expensive medications for chronic ailments. In turn, health insurance premiums for individuals and employers have risen.

These trends will likely increase pressure on Washington to design a comprehensive Medicare drug coverage benefit. But with drug costs increasing at such wild rates, any solution will require tough decisions and will likely fuel controversy such as that surrounding President Bush's "Helping Hand" proposal to spend $153 billion on a Medicare drug benefit. Democrats in Congress rejected it, saying it was inadequate.

But another recent study offers some good news. The National Academy of Sciences found that the chances that American seniors will face chronic disabilities like dementia or stroke are rapidly declining due to greater knowledge of the benefits of diet and exercise, a decrease in smoking, and, ironically, increased use of advanced prescription drugs. In other words, though a Medicare drug benefit may be expensive, it may pay for itself through decreased costs in other parts of the program.