Congressional Democrats:Fill Medicare Donut, Win Seniors Back This Fall!

[McCamy Taylor]

Someone is sure ticked off about the Medicare drug plan. We have a media blizt going on

http://www.washingtonpost.com/wp-dyn/content/article/2006/07/29/AR2006072900800.html

http://www.nytimes.com/2006/07/30/washington/30medicare.html?_r=1&oref=slogin

And the Republican Congress is nowhere in sight to apply a bandaid to correct the problem before the midterm elections. Even though experts have been warning that this problem was coming for years (literally). See this article from 2004

http://www.webmd.com/content/article/88/99741

"June 1, 2004 -- Medicare began its controversial prescription-drug discount plan today, although some analysts are already looking ahead to 2006 when the program's paid drug benefit begins. And some are warning that many seniors may find far lower benefits than they expect.A new report issued Tuesday warns that substantial numbers of elderly and disabled Medicare beneficiaries can expect high drug expenses even after the program begins in 19 months. ....The expected costs are due to peculiarities in the Medicare benefit law that cause a gap in available coverage. Medicare is set to pay 75% of initial drug costs up to $2,250 after a $250 deductible for most seniors. But then the program pays nothing until drug expenses reach $5,100, after which the government pays 95% of all costs."

<snip>

"Congress Not Finished Yet

"Gail Wilensky, PhD, a health analysts with Project HOPE and a former Medicare administrator, says she agrees that the structure Congress chose for the drug benefit is "bizarre." But she cautions that much of the dire warnings about the program may be election-year politics.

"She says it's "extremely unlikely" that Congress won't respond to voters and go back to reduce the donut hole's size.

'If you are caught in that donut hole you will be disappointed and start pressing your members of Congress to do something about it," says Wilensky, who advised President Bush during the 2000 presidential campaign."



Uh. Huh. Looks like the GOP Congress had more important things on its mind than the health and wellbeing of this nations elderly and disabled. Like gay marriage. And flag burning. And giving W. the right to spy on us without a court order. They just completely overlooked the fact that a lot of seniors who are not lucky enough to be on employer sponsored HMOs to supplement their Medicare (the ones who didnt need a Medicare drug plan in the first place) were going to run out of their drug benefit right about now, and that they would be faced with the choice of buying that anti-anginal medication---the one that has been making their life so much better these last six months now that they have been able to take it--or paying the electricity bill.

The GOP's lack of concern about the Donut shows how out of touch they are with reality. In their mind, every senior was able to read the brochure and understand what it meant and they all said to themselves "Hey, this means $2000 free money for me so I am happy. I'll go vote for the Republicans." The GOP thought this because they live in Neverneverland, DC where everyone is rich and has a tax accountant to do all their math and if they need a drug, they can just call their buddy at Pzifer or Dow and get it.

In the real world, when seniors who had never had drug coverage got it, they went to see their doctors and told them "Ok, I'll take that heart/cholesterol/arthritis drug you have been wanting me to take but which I could not afford." Their doctor said "Yippee!" The senior took the prescription to the pharmacy and started paying the $20 to $40 non-generic copayment each month with a little twinge but hey, it was better than $200 each month. Then there were a couple of rounds of antibiotics, $200 each (coypayments $40), and springs allergy and asthma medications, another $500 (coypaymemts much less). And before the senior knew it, summer was here, and when she went to the drugstore for that wonder drug that helped her chase the cat when it gets out in the garden, her pharmacist said "That will be $204.16, please".

But wait, it gets worse. Her neighbor has a Medicare Gap policy that he has been paying for years. It is a group policy that used to pay 100% of drugs after a $250 deductible. When Medicare started drug coverage, his medigap plan decided to rewrite their drug coverage to conform to medicare's drug plan. So, for a miniscule reduction in payments, he found himself paying $40 a prescription for drugs that used to be covered 100%. And when summer got here, he also found himself without coverage for the next four months. His insurance plan (Blue Cross Blue Shield) made out like a bandit thanks to the GOP Congress, and he has been left holding the bill.

What are these two people to do? If they have no money, they cant get their medicine. Doctors get samples of some drugs, but drug reps do not supply samples of everything and certainly not in adequate quantities to supply multiple patients for six months. Drug company programs to supply medications to the needy are not usually intended for those with insurance. Some people in this situation will say "I got along without it" and will stop taking their meds. However, now they are going to feel like crap, because they were used to feeling better. The man who had full drug coverage for so long may even die, because he has never been without his meds. Plus, if they stop taking the drugs , they will never fill their donuct holes and their insurance plans (Blue CRoss or Medicare) will never have to pay another cent of money for them for the rest of the year. Hurray says the federal government. Hurray says Blue Cross. Of course, if they stop taking heart drugs or asthma drugs, they may end up in the hospital, at which point, medicare and Blue Cross will be out a WHOLE LOT of money, boo hoo. But hey, no one ever said that the GOP run federal government was smart. If the GOP was smart, it would have done something about this crazy donut which is bad medicine, bad policy, bad politics.

Since health care is one of the Democrat's six issues in their "Six for 06" Campaign

http://democraticleader.house.gov/press/releases.cfm?pressReleaseID=1724

Here is an opportunity for them to do something. How about the Dems get together and draft some legislation to aid seniors who are caught between GOP indifference/incompetence and corporate greed? Bonus points for addressing the burning question of why drug companies raised prices across the board this year just as the Medicare, "if you charge it we will pay it" plan went into effect. Remember, seniors are paying these artificially inflated drug prices out of their own pockets this summer. It is not the limitless pockets of the federal government that are being raided by big drug companies. It is your grandparents' wallets.

[nam78_two]

1. K & r