Center for Medicare and Medicaid spokesman Gary Karr is sticking to the Administration's talking points:
"It is disappointing to see this level of partisan politics enter the equation." He said, "The expression we are hearing from nursing homes is generally very positive, but that doesn't mean people aren't having problems. Some have prepared very early for the transition, and they are having even fewer problems."
Not than we can expect anything different, but to suggest nursing homes didn't prepare enough ahead of time, and that's the problem, is flat out lying. That's because most of the people struggling with getting their medications are so-called "dual eligibles", or people who are enrolled in both Medicare and Medicaid. Unlike standard Medicare enrollees, dual eligbiles were randomly and automatically assigned to prescription plans. 70% of nursing home residents are enrolled in Medicaid (and the vast majority of those are elderly, and thus enrolled in Medicare). As this New York Times article reports, all the preparation in the world won't help when the government keeps changing its mind, doesn't enroll the people it's supposed to, and allows private companies to decided which drugs should be covered:
Lights burn way past business hours at Sarah Neuman, where six months of preparation, including a new computer system, has proven all but useless. Clarifications arrive from the federal government faster than even a team of professionals can keep up with them.
''Nobody at the moment understands what they're doing, and not for lack of trying,'' said Elaine Healy, the medical director at Sarah Neuman, the smallest of three campuses of the Jewish Home and Hospital Lifecare System.
The first priority for the beleaguered staff at Sarah Neuman is figuring out what happened to a group of residents, now whittled down to 26, who should have been assigned a plan but fell through the cracks. Next they must assess the random assignments of residents to plans, decide whether to appeal the drugs not covered, prescribe different ones or switch plans.
This isn't bad government, this is bad plan design. Refer again to Jon Cohn's article on the unbelievably smooth roll out of Medicare in 1966. Remember, as well, that Medicare was the first time everyone over 65 had government-guaranteed access to doctors and hospitals -- substantially more complex than adding a prescription benefit. Legislators have made every aspect of this bill, from its choice (52 plans in some areas for Medicare enrollees) to its non-choice (dual eligibles being randomly assigned plans), a labyrinth.