When George Bush signed a controversial bill that reformed Medicare, the government health plan for the elderly, into law back in 2003 he declared it would be "the greatest advance in health-care coverage for America's seniors since the founding of Medicare." The reform's central provision, known as Part d, subsidises the supply of prescription drugs by private insurers. Critics mocked the chaotic launch of that scheme, and feared its huge cost would end up wrecking the budget.
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