Medi-mess

As most of you know, seniors could begin signing up for Medicare Part D yesterday. I have to admit, being young and writing a column targeted towards college students has let this slip under my radar. That is until I was listening to NPR yesterday and Talk of the Nation had two guests discussing the new benefit. It's a scary state of affairs, for both seniors and their kids/grandkids alike who help them decide on a course of action.

My grandparent's six children currently split their pharmaceutical bills every month (which can be no small chunk of change -- $450 last month according to my mom). My mom and I were running some errands when the program came on, and she was insistent (not that I would complain!) on listening to the program so we can figure out what my grandparents should do.

I came away from that program even more confused. And if I'm confused, you know seniors are drowning under the information flood. There are many details essential for consideration that news articles don't discuss. I'll be blogging on them the next few days, so here's to hoping we can understand this better!

For today, it's important to realize the donut-hole nature of these plans. Graham of Over My Med Body! does a great job explaining this:

For the first $2,250, you and Medicare split the drug bill (Medicare pays 75%). After that, for the next $2,850 of drug costs, you, the patient, have to pick up the entire tab. Once $5,100 is reached ($2,250 + $2,850), Medicare kicks back in, paying 95%. People call this donut coverage; you get to eat a bite until you get to the middle, then you get nothing, but then you get donut again once (if) you get to the other side.

So if seniors have exhorbitant prescription bills, they will still have to pay past a certain amount of expenditure. What makes these plans even more frustrating is that insurers can pick and choose what prescriptions are covered. Seniors want to figure out if their plan covers all the drugs they currently take, or they could end up paying out of pocket before the "hole" in the plan kicks in. This is no small task for many couples, especially those with serious medical problems. It's also important for seniors to make sure their plan covers their pharmacy, or if not, that their plan covers another convenient pharmacy.

Am I the only one who feels like it's just plain cruel to do this to people who've lived through the last 65 years? Now that they've finally reached "golden years" we say, "Hey! You want prescriptions! Come here!" and then whack them in the back of the head with a bat. This benefit is a total disaster.

Comments

[Mark]

Warren Olney's To the Point did a good job on this too - the reason for all the confusion is the same reason our health care system in toto is a mess - too much bureacracy and greed. Private insurors now devote as much as 40% of the premium dollar to overhead. For the 'D' benefits, they inserted two provisions (hell - they wrote the whole bill!) - one that Medicare not be able to negotiate prices, another that the program be turned over the a myriad of insurors, each of whom will try to game the system. It is our health care system in microcosm - Medicare D simply extended what we already have in the private sector into the public sector.

[Adrock]

First off, this is the first time I've heard that a plan only covers certain pharmacies. If thats fo' real, I'm both amazed and apalled.

Secondly, there is simply no way Democrats shouldn't be benefitting from this politically. The only people who think this is a good program are brainwashed Republican hacks. Not one elder person I've talked to is really gung ho about this. And that includes a majority swath of my grandmother's friends in a Florida retirement community. Mmmmmm, Florida, you know you want to turn blue baby.

[Hellmut Lotz]

It also means that there may not be much competition. Goods are defined at a time and a place. If the plans do not offer the same drugs then they are not competitors. If the plans are not available at the same pharmacies then they are not really competing.

When Bush has to choose between markets and big business, he always picks big business. Thus he manages to privatize the profits, socialize the costs, and confuse the seniors.

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