Jonathan Cohn has penned a smart piece examining the difference between Medicare's official beginning in 1966 and Medicare Part D's voyage into the world.
Another difference between the two administrations is their willingness to take initiative. Last year, experts repeatedly warned the Bush administration that it had inadequate contingency plans in place, culminating in a December Government Accountability Office report that predicted with eerie accuracy exactly what has happened at pharmacies around the country these past two weeks. LBJ's team was far more cautious. Although confident that hospitals could handle any potential surges, it still drew up plans for transferring patients to overflow facilities, even lining up helicopters in Texas to provide speedy transport.
There were helicopters ready for the opening of Medicare. Nevermind a category 5 hurricane predicted to come ashore for a few days. It's painfully sad to draw this comparison.
Truly, LBJ was a different species than Bush, but there's a powerful meme in connecting these events. This mess isn't Government's fault, it's the Bush Government's fault. Just like the war, just like the hurricane -- planning is inadequate, unqualified individuals are put in positions of great influence and power, and the public suffers.
I joked about it yesterday, but CMS officials decided that 150 phone operators would be sufficient for pharmacies' questions. There's more than 150 insurance plans! Yesterday they corrected that mistake and upped the number to 4500. Any idiot could have told you that 150 operators for something as major as the drug benefit was grossly inadquate.
It didn't have to be this way. But with every road it laid on the way to the the benefit, the Administration made sure it left a little bomb.
First, over a dozen plans could be offered in every state, and those plans can cover whichever drugs and pharmacies they see fit -- boom!
The government can't negotiate with drug companies, ensuring high prices and billions in wasted money for tax payers -- boom!
Pass a benefit, thereby ensuring all efforts to reimport drugs from Canada will be deemed unnecessary -- boom!
Decide 150 operators are sufficient to deal with the first two weeks of enrollment -- boom!
Let states become responsible for picking up the slack when thousands of people can't get their medications, and refuse to reimburse them for doing so -- boom!
It's no wonder this road is in shambles.
In the end, we all suffer. Because our taxes are paying for this -- our money is being wasted. Cohn points to who's actually suffering here:
Worse yet, the majority of these people are so-called "dual eligibles," meaning that they are not only old and sick but also poor--in other words, exactly the kind of people who are most dependent on drugs and least able to afford them on their own.
Whether it's in the military without enough body armor, dying of dehydration and lack of medical care in the super dome, or being denied medications because of completely preventable glitches, it's the same people who are paying for these mistakes, over and over.