Medicare 'doughnut hole' eating seniors' cash

[Omaha Steve]

Full story: http://www.bergen.com/page.php?qstr=eXJpcnk3ZjczN2Y3dnFlZUVFeXk2MTAmZmdiZWw3Zjd2cWVlRUV5eTY5NjA1ODkmeXJpcnk3ZjcxN2Y3dnFlZUVFeXk1

Medicare 'doughnut hole' eating seniors' cash

Thursday, July 13, 2006

By MARY JO LAYTON
STAFF WRITER


Seven million Americans enrolled in the new Medicare drug plan are facing a massive gap in benefits that will force them to pay out of pocket for pricey prescriptions, a state advocacy group said Wednesday.

Old Tappan retiree Melba Heck has already fallen into the so-called "doughnut hole" in her Medicare Part D coverage. Just this month, she had to pay $400 for medication even though she's paid $50 a month all year for drug coverage.

"This is highway robbery," said Heck, a retired nurse. "We're not extravagant people. For the first time in 10 years, I've had to cut back on my church pledge."

The report, released by New Jersey Citizen Action and Americans United, calls on Congress to offer more generous drug benefits. They also want Medicare to use its free-market muscle to negotiate with drug companies for cheaper medicine.

[BlueEyedSon]

1. Im just shocked that this bill created more revenue for big pharma

just shocked

[Telly Savalas]

5. The donut hole isn't good for big pharma

Big pharma does best when more people are using their expensive branded medicines. As the article in the original posts states, when there are restrictions on coverage, seniors are apt to skip doses and die sooner. Also, as the article states some plans cover generics to keep seniors from falling in the donut hole.

In short, when coverage is limited, there is less spending on pharmaceutical products.

Where the Medicare Act threw a bone to Big Pharma was the provision that prevents the federal and state governments from negotiating prices for pharma products. That's why drug prices are inflated in the U.S. versus other places.

[napi21]

2. A cousin of mine did NOT sign up for Part D because of this hole!

He is on an awful lot of different meds, but when his wife checked on all the different plans available, even though they are paying $1,300 a month for their insurance coverage, Medicare with Part D would have cost MORE!

Many of his mes are not part of any formulary, and there are $20-$35 copays on a lot of the tests.

I guess it's a good plan if you are healthy, but anyone with serious health problems, forgt it!

[Cleita]

8. I didn't either.

It's not a good plan any way you take it apart. Any insurance that you have to pay a premium for and then make deductibles and co-payments on is a windfall for the insurance company and bad news for the patient. Prescription drugs should have been covered without a part D premium and it could have been if Medicare could have bargained for cheaper drugs in bulk.

I have prescription coverage with my medigap policy. It costs me almost $200 a month, and I do have co-pays but I don't have the donut hole and I don't have to pay the extra $50 unless congress gives the PHARMA industry another big break in their favor. If they had done it right Medicare would have paid 80% of the approved price of the meds and your medigap insurance should have kicked in the other 20%. For me that would have taken care of the co-pay.

Then I could rest easily that my medical problems would be taken care of for $200 a month. For all those who whine about paying for my medical care remember that I spent my young and healthy years with my medical insurance and Medicare paying for somebody else. That's the way the program is supposed to work when the conservatives aren't effing it up.

[pooja]

3. The plan to save social security... deny drugs to elderly.

:evilfrown:

[The_Casual_Observer]

4. This wasn't done by accident. Contracts like that are written

specifically to screw the insured. There are highly paid staffs of people who work 10 hours a day working out every last detail so that they will be be able to deliver the absolute minimum amount of service for the absolute maximum payment.

[Cleita]

11. We need a law that takes medical care and drugs out of the

stock market. In other words, they should not be publically traded on the stock exchange. For one thing I don't buy the premise that the drug companies need all this money to develop new drugs. Grants could be given to universities to do the same. Then the patents could be sold to the manufacturers who could be allowed a modest profit, however, I believe these companies should be kept from trading on the stock exchange and should be regulated by Medicare and the Health dept.

I think health care should be delivered the same way. The small medical practice and other medical deliverers could be allowed a small profit, but the price of their services regulated by the government in a universal, single-payer program.

[nosmokes]

6. yeah it's a scam alright. we're in thedoughnut hole until i spend$5k

and that's on top of what's already been spent. and since my wife is unemployed and can't get insurance thanks to a pre-existing condition, we hafta pay for her meds outta pocket as well. is this a great country or what?

[LibDemAlways]

7. This is one of the worst examples of "screw the little people"

I've ever seen. Millions of seniors scrape by on social security and whatever they've managed to save over a lifetime. Where the hell is the money supposed to come from to cover this gap in coverage? Meantime, they still have to pay the monthly premium.

There is no low too low for a repuke with a scheme to reward big business. Why the Dems didn't scream bloody murder about this at the time is beyond me.

[Cleita]

9. Also, it's screwing them at a time of their lives that they will

be needing more and more medical care as they grow older. Also, remember that those seniors paid into the system all their lives that was used for health care for the seniors that came before them. Now they are trying to cheat them out of what they need at the time of their lives that they need it the most.

[Skidmore]

10. If congress insists on letting pharma take profits in the market like

this, then government underwriting of R&D should be no longer an option for the drug companies.