More on the fiasco of the Medicare Drug program

[salin]

Yesterday I posted a thread to encourage DUers to recall some of the funky circumstances surrounding the passage of the Medicare Prescription Drug program. I continue to believe that the coverage of the problems with the program will be hot and heavy for awhile – and looping that back to the *how* this was passed in the first place – especially in light of the pay-to-play/slush fund scandals enveloping the congressional GOP – has the potential to be exceptionally powerful in the coming election cycle.

Today I searched for more stories – and found confirmation of one of the areas that I suggested yesterday was going to be a future show-down. Those states offering emergency assistance in the short run for failures/flaws in the program leaving people who had coverage with no coverage and no ability to pay for their prescriptions – are going to be in fight with the feds for reimbursement.

The key Medicare spokesperson has now said that the fed govt will NOT reimburse – that they will refer states to the insurance companies – as where to get reimbursement. Think about that – the feds say to the state – sort out the claims on the 68 different plans and the thousands of people who were fell through the cracks – assume the costs of that and then the costs of battling each company offering the plans – to get reimbursement. Now that is going to be a fight.

Meanwhile this opens the door for more tragedy in the here and now. The following item is from Tennessee – in short – a number of states in the southeast are not going to offer any assistance – not because there are no problems, but because the state doesn’t have the money to do so and the feds have said they won’t pay the states back. This means there are very, very likely to be some tragic results in the near future – if there haven’t been already. This story makes me both want to weep, and scream at the top of my lungs at the same time. More evidence that right to life only is only before birth. The thing is without the cynical maneuverings to get this program passed for bush in time for his reelection – the people now at greatest risk of serious health problems or death, due to lack of medications, would have their medications and not be at risk.

http://www.tricities.com/servlet/Satellite?pagename=TRI%2FMGArticle%2FTRI_BasicArticle&c=MGArticle&cid=1128769322488

Serious flaws emerge in Medicare's new drug program
BY SEAN MUSSENDEN
MEDIA GENERAL NEWS SERVICE
Jan 15, 12:00 AM EST

WASHINGTON - More than a dozen states stepped in last week to make sure millions of poor senior citizens receive their medications after serious flaws emerged in Medicare's new prescription drug program.
While similar problems have surfaced in the Southeast, health officials in most Southeastern states have not put up emergency cash to help seniors temporarily with their medical bills.
"We ran the numbers, and I'm not sure how the other states are doing it," said Carol Herrmann, head of Alabama's Medicaid agency.
She estimated it would cost Alabama $60 million this month to provide drugs to poor seniors who have run into problems with the new federal program.
------------- more at link

Another story from the Southeast –
http://www.shreveporttimes.com/apps/pbcs.dll/article?AID=/20060113/NEWS01/601130330/1002/NEWS

Medicare drug program causing problems
January 13, 2006
By Mike Hasten
[e-mail]

BATON ROUGE -- Thousands of low-income and elderly Louisianans accustomed to getting their prescriptions filled with no problem are having trouble now that a Medicare prescription program is in place.

The problem, health-care officials say, is many-faceted. And although officials of the Centers for Medicare and Medicaid Services are working on a solution, it's a slow process.
Many of the state's 93,500 people who are eligible for both Medicaid and Medicare aren't getting prescriptions filled without a major struggle.

--- snip ---

For years, Medicaid recipients received a card that got them free or inexpensive prescriptions. The Centers for Medicare and Medicaid Services combined the Medicaid prescription program with a new Medicare plan that gives a discount after patients meet a deductible.

A combination of factors comes into play, said Jerry Phillips, state Medicaid officer. Many Medicaid recipients didn't sign up for a Medicare plan and were assigned to one that doesn't include the drugs they need.

Or they signed up but chose the wrong plan, their new Medicare cards were lost in the mail during the storms or they threw away their new cards because they were accustomed to using the Medicaid card.

--- more at link ---

Please add any other related stories you run across – both news items and personal experiences. Of particular interest is how widely problems are being reported – are most people reading the Sunday news becoming aware that this is a growing CRISIS not a ‘glitch’ or ‘snag’?

How do we encourage media coverage, and or political activity that ties the problems with the program – back to the DC Pay-to-Play politics that led to the passage of this program. The public has to begin to see that Pay to Play isn’t just about giving political donors some pork or contracts – it is about crafting public policy that when tilted to corporate interests over the balance of good public policy – can have a devastating impact upon the lives of millions of Americans. This fiasco is directly related to how the DeLay/Rove operate – both in terms of policy being used as political advantage (get a program for bush to help him get elected – if it is flawed – who cares about policy… whatever just get it done so we get reelected) and in terms of Pay to Play (the provisions of this bill were NOT written to keep costs down, nor to benefit seniors or the disabled, it is documented (I believe) that portions of this bill were written by corporate lobbyists for their benefit.)

See the Post/thread from yesterday for some background on the funky politics that were at play when this bill was passed.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=364&topic_id=139524&mesg_id=139524

[ayeshahaqqiqa]

1. Call the 700 Club

and ask Pat Robertson if stepping in and helping these people instead of asking them to part with their pennies and giving it to him might not be a good idea.

[salin]

3. or perhaps ask him

what their sins are for which they are being smited?

[Indykatie]

2. CMS is Culprit

The government spokespersons are quick to say that the problems are multi-faceted but that's a lie. The biggest and most prevalent issue stems from CMS's inability to approve and enroll 100% of the Medicare beneficiaries for activation of coverage by the insurance companies. Companies have to submit electronic files to CMS with all the enrolled people and wait for CMS to approve each enrollee. Given that all Medicare recipients are eligible for the coverage insueres should have been allowed to activate everyone coverage without this step. I have first hand knowledge of this. The only silver lining here is that the botched roll out will doom the program as a failure even for that small segment that supported the program.

[salin]

4. Sadly, a heck of a lot of folks are going to be hurt

many people, my mother included, have had their prescription drug benefits programs yanked out of their retiree benefits - and told they HAVE to enroll.

I would love to understand more about this process.

Have to go offline for a couple of hours but will check back in as soon as I can. Thanks.

[napi21]

5. I was listening to KGO radio overnight and their news said

Arnold was going to demand reimbursement from the Feds ("but was going to help the Californians that are being hurt NOW!").

Your post doesn't say who the "key medicare" spokesperson was who said there will be NO reimbursement, but it sounds like a whole lot of States for the Pubs to be pi**ing off all at one tie, and in an election year too!

[salin]

6. Mark McCleland

Medicare will not reimburse states -- CMS
By OLGA PIERCE

WASHINGTON, Jan. 13 (UPI) -- Medicare will not reimburse states that paid for prescriptions because of glitches in the new federal drug benefit, Centers for Medicare and Medicaid Services Administrator Mark McClellan said Thursday.

Instead, they should seek reimbursement from insurance companies.

---- snip ----

"People are in Medicare drug plans, and it's the plans that are supposed to pay for people's prescriptions.

"What we're doing with states using their state systems is getting them in touch with the drug plans that are providing coverage so that the drug plans can reimburse them."


More at link.

http://www.upi.com/HealthBusiness/view.php?StoryID=20060113-041453-6462r

There is going to be one heck of a showdown. If bushco gives in and pays states - fiscal conservatives who are already displeased will go bonkers; If bushco doesn't give in watch for more scattering from party line on a state by state breakdown.

[Hidden Stillness]

7. Angle: They "Privatized" It, + Never Even Had to Make the Announcement

I agree that connecting the pseudo-"Medicare" Part D prescription drug bill disaster to corrupt Republicans and their now-total ties to corporate lobbyists is a powerful and effective approach. It should be tied to Abramoff/DeLay and lobbying, to neo-cons and their all-corporate background, and to price- and bill- gouging, especially natural gas, heating oil, and gas for vehicles at the pump; this would tie it, yet again, to Cheney's Halliburton and the "Energy Bill," and the Bush oil family fortunes (and multi-generational ties to the oil-rich bin Laden family, "curiously" still not caught).

This does not have to be a muddled, convoluted thing to explain, because you would not overload it with details except where necessary--especially now that people are becoming more and more aware of some of these connections, and now that Bush is being exposed, spying on Americans who haven't done anything, as a total, power-mad criminal. The middle class and poor people of this country are simultaneously being beaten to death by price-gouging, flat and not rising wages, this Part D scam that makes everything more expensive, and the cutting of any and all government programs that used to help them. Besides that, the entire Federal governmant seems bizarrely to be no longer even connected to this country. This total situation, of things that have been uncovered by investigations, and things that people are suffering in their own lives and getting no help on, should be put together and unified in people's minds, and blamed on Republicans.

One angle that I have not heard people making specifically, that I think would really resonate as it is already an outrage and a worry, is that the "Medicare" Part D, aside from being a scam and an impossible mess to try to figure, was actually the commercialization (or "privatization," although I don't like the word--this is all PUBLIC), of a part of the Medicare/Medicaid/Social Security system, which they have been completely unable to do, whenever it has been straightforwardly proposed. This pseudo-"Medicare" thing, if you read it carefully, is not actually a guaranteed benefit, as any real program would be spelled out as, and never addresses itself to the individual on the program--all benefits, etc., actually go to the insurance and drug corporations. The drug "benefit" is not even the main part of the bill; most of it will be as-yet unexplained "reforms," God help us. This complete betrayal, exposed as it already has been, as yet another Karl Rove scam, should be emphasized, over and over, as the commercialization/"privatization" of a Medicare service, as all contracts for individuals will be with commercial corporations, not with the Medicare agency--"odd," if this is supposedly a government program--and it is up to each person, as an individual, to pay for premiums, drugs where not covered, deductibles, etc., etc. How is this not the complete commercialization of a Federal program? They could not do it with Social Security, with anything else they have tried to fight us on, because we don't want it; so they lied, called it a "benefit," got their corporate media to lie and cover up for them, and they killed a government program and made it an unprotected commercial profit-maker for themselves, anyway. Hammer away at it like that for a while, and notice the increasing anger--not to mention the fact that this is yet another example of secretive people who were never elected, controlling policy in the Bush White House.

There is a great list of reasons why not to support this horrible thing, at http://www.retiredamericans.org/index.php?tg=articles&idx=More&topics=72&article=130 .

Just to show how things might be connected as an argument, I had a really great conversation today at a store with a cashier I talk to whenever she is working. She is a very non-radical, non-political, friendly middle-aged lady, very pleasant to make small talk with. After we talked about the weather--it had been warm for this time of year, and is now cold again--she said she wondered if this would make a difference on our heating bills this Winter. I said I hoped so, that it would help things, but you usually don't get anything off on a bill, even when there should be, and before I knew it, it was a very political conversation. She mentioned that a friend of hers just got a natural gas heating bill of over $350, which genuinely shocked me, and I asked, "How are people supposed to come up with the money?" She said she didn't know, and added, "They don't care." Before I knew it the conversation had jumped to corporations gouging the life out of us, and what are the working people supposed to do, and that no one believed the price hikes had anything to do with the hurricanes and damage, etc., and she suddenly said, "I think George Bush is getting kind of power-mad," and I said, "It's like they are some totally different kind of people running the country now, like they aren't even Americans anymore"--and she agreed, and said I was right about that! Around that point when we had been discussing getting the life squeezed out of us with these bill hikes, getting now unable to pay them all, I seized a chance to say something, and to know how it would go over. "Well, that's what you get for voting for Republicans"--implying after that part of the conversation, that this is what they would eventually do to all of us middle class people--and she said, "I have never in my life voted for a Republican," and I added, for myself, "Never...Never." It was a wonderful conversation, and then she mentioned how Republicans are always just attacking Democrats all the time, for anything and everything they can make up. This was, both of us, just the most ordinary kind of middle class person, and as the conversation ended and I was leaving, we smiled at each other as if we now both knew that the secret was out, and that the people really know, and can say it now. I have had, all day, an excited, exciting feeling that we are coming back, and that this wave will soon go our way again, Democrats are the people--and it will be the real-world force of an issue like this that will do it, where they tried to kill the middle class and old people...and FAILED.

[gizmo1979]

8. Who's in charge of the medicare

fiasco?Did Bush hire a Dog show judge to oversee medicare?This is a big story.You mess with old people they do not forget.We have to place the blame firmly at the feet of the Repugs,they didn't even let dems in on the meetings.This will lead to their downfall faster than wiretap,Abramoff and Plame put together.They pissed off the old people lookout!

[justabob]

9. Mark McClellan, scotty's brother