gotta pay one of his corporate insurance firms a monthly amount which could range from $5 to $50 just to get some so-called discount (off-set by escalating Rx prices) ... and, that penalty business ... suppose one doesn't need an insurance pimp now but things change after May 2006?
one might end up paying more than one's monthly Rx cost by having to pay a monthly premium
I suspect the changes have had an impact on pharmacy and doctor's record/transaction systems ... the pharmacy system will have to keep track of yearly accumulative tabs for each customer and each customer's insurance plan
sample plan:
a deductible for the first, say, $250 of Rx costs.
Then, one pays 25% of the Rx costs up to $2250.
After that level is reached, one pays 100% for the next $2850 in Rx bills;
then, out of pocket reverts to 5% (or some co-payment) to year end.
and, then, there's something called Medicare Advantage Plans which as far I can surmise is outsourcing Medicare on the individual level ... systems have to be designed to accommodate them, too.
in this neck of the wood, there are something like 47 different options (some insurance companies had up to 3 options)
All that is needed is Medicare involved in working with Big Pharma and one's Medicare card to show the pharmacist.
edited to add:
Senate passes Medicare bill
Tuesday, November 25, 2003 Posted: 9:16 PM EST (0216 GMT)
WASHINGTON (CNN) -- After days of impassioned debate, the U.S. Senate Tuesday approved a $400 billion plan to overhaul Medicare. Supporters say it will give prescription drug coverage to 40 million older Americans, while critics warn that it could destroy the system.
The 54 to 44 vote was not along party lines --
11 Democrats voted in favor and nine Republicans voted no.
~snip~
Supporters of the bill -- including some Democrats who, like Sen. Dianne Feinstein of California, said it was better than no bill at all -- hailed the vote as a victory for senior citizens
~snip~
The House passed the bill in a controversial vote early Saturday after late-night phone calls from the president, a move credited with helping get the bill passed there. A three-hour vote was ended by GOP leaders at 6 a.m., after a 218 to 216 deficit flipped to a 220 to 215 victory.
http://www.cnn.com/2003/ALLPOLITICS/11/25/elec04.medicare/Senate Roll-call Vote:
http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=108&session=1&vote=00459voting for the Bu$h bill - it could have been defeated, especially with 9
Republicans voting against it!
Baucus (D-MT)
Breaux (D-LA)
Carper (D-DE)
Conrad (D-ND)
Dorgan (D-ND)
Feinstein (D-CA)
Landrieu (D-LA)
Lincoln (D-AR)
Miller (D-GA)
Nelson (D-NE)
Wyden (D-OR)
Not Voting - 2
Kerry (D-MA)
Lieberman (D-CT)
http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=108&session=1&vote=00459