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MAY 2006
Welcome
(at the point of a gun) to Medicare's drug disaster!
by Rick S. Bender, President of
the Washington State Labor Council, AFL-CIO
Earlier this year, I helped -- or tried to
help -- my mother enroll in one of the Medicare Part D prescription drug
plans. It involved making a
list of the medications and dosages she currently uses, trying to
anticipate what her prescription needs could be in the future, and then
choosing from one of more than 40 private plans with different premiums
and ever-changing lists of covered drugs.
And then, there was the paperwork.
Choosing the plan that best suited her was
confusing enough, even before the bureaucratic mistakes involving lost
applications, and eventually, re-enrollment.
It was a frustrating experience, and not
just because it was difficult, complicated and ended up taking months
instead of weeks. It was
frustrating because we were doing it at the point of the federal
government’s gun -- an arbitrary, punitive enrollment deadline.
And it was infuriating because Congress and the Bush administration
didn’t bother to fix the Medicare drug program before they imposed that
threat.
At this writing, barring unexpected congressional intervention, seniors and people with disabilities who fail to enroll by May 15 will have to pay a minimum of 7 percent higher monthly premiums for the rest of their lives. Happy Mothers Day!
Congressional Democrats
(including all of
Organized labor, the Alliance for Retired Americans, consumer and health care advocacy groups have all asked this question, and so far the only answer we’re received is to “get with the program.” Well, here’s a look at what’s wrong with the program:
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Written and backed by the pharmaceutical companies, it blocks access to the free market – the same one they insist we not subvert with drug price controls. It explicitly prevents Medicare from negotiating lower drug prices for buying in bulk. The result is that Part D prices are often 50% higher than those negotiated by the Veterans Administration.
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The so-called “donut hole” provision denies coverage between $2,250 and $5,100, even while enrollees continue to pay premiums. As an aside, the Washington State Labor Council has gotten calls from retirees who thought they don’t reach the donut hole until they have paid $2,250 out of pocket. Wrong. Their coverage gets denied when their costs and the insurance companies’ cost adds up to $2,250. That point will arrive very quickly for many seniors.
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It forces seniors to join private plans, denying them the choice of a benefit plan directly from Medicare. Why are these private insurance companies afraid to compete with Medicare? Because if you take profit margins out of the equation, it would be cheaper to choose a direct Medicare benefit. Plus, why use a government-run bureaucracy -- you know, like Medicare’s -- when private industry can create a brand new state-of-the-art bureaucracy?
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Insurance companies are allowed to bait-and-switch. They can yank drugs off of their coverage list in the middle of the year, but Medicare Part D enrollees are locked in and cannot switch plans until the next year.
There’s more wrong with Medicare Part D, not the least of which is that taxpayers are forking over more than $700 billion for this mess, despite the fact that many low-income seniors now will be denied Medicaid coverage and end up worse off than before.
It should come as no surprise
that the architects of this program were the pharmaceutical and insurance
industries, and members of Congress like Sen. John Breaux of
It may be too much to ask this Congress to fix this Part D Disaster. As The (Vancouver) Columbian recently pointed out, “four-day weekends for campaigning make it tough to buckle down to gnarly matters of public policy.”
So maybe we’ll have to start fixing it ourselves, on Election Day.
Rick Bender is President of the
Washington State Labor Council, AFL-CIO,
the largest labor organization in the state.
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Copyright © 2006 Washington State Labor Council, AFL-CIO