Friday, December 30, 2005

Boston Globe Identifies Problems in Medicare Drug Plans

The Boston Globe has an excellent summary of the problems we are seeing so far with the Medicare prescription drug plan. The problem stems from the initial political goals:

It was clear back in 2003, when the Bush administration rammed this bill through the Republican Congress, that the purpose was not to devise an affordable prescription drug program for seniors. Rather the administration wanted to help two friendly industries, the pharmaceutical companies and the HMOs, and to get bragging rights for the 2004 election that President Bush had helped seniors. Few voters would grasp just how bad the law was, since its effective date was deliberately put off until 2006.

They provide more information on how the plan both provides inadequate benefits for beneficiaries and increases profits for pharmaceutical companies. It should be added that, while the plan is very poorly designed, many who qualify should still strongly consider signing up. The plan is better than nothing for most, and the penalties for signing up after May make it a better deal to sign up by then.

The column has a number of recommendations for improving the plan:

First, get rid of the costly crazy-quilt of private programs and bring the ‘’Medicare” drug program back into public Medicare.

Second, allow Medicare to negotiate bulk discounts the way the VA does.

Third, get rid of the doughnut hole, and design a simplified benefit structure with modest copays and then 100 percent coverage after a set annual cap on out-of-pocket costs.

Finally, if the savings from the bulk price discounts are not quite sufficient to cover the costs of filling in the doughnut hole, take back a little of Bush’s tax cuts to the richest 1 percent.

I have already encountered a number of problems while assisting patients in signing up for the plan. I’ll wait until January, when the plan is actually in operation, to discuss this in more detail.


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