Medicare D: Today’s Responses and Reality

Both Sentors Dick  Dubrin and Carl Levin now offer “solutions” to the Medicare D(isaster).

From Senator Dick Durbin:

The Medicare bill was drafted with the most powerful Republican donors in mind: pharmaceutical and insurance companies…Republicans followed an ideological belief…by forbidding Medicare from negotiating with pharmaceutical companies and handing the program over to private companies offering hundreds of plans…Americans expect us to put their interests ahead of special interests. Republicans should join Democrats in their plan to extend the enrollment period and in efforts to allow Medicare to offer drug coverage directly and to negotiate prices much as the Department of Veterans Affairs does

continued
Senator Carl Levin intends to ask Congress to:

  •  Prohibit the clause that allows Medicare drug plans to change the list of prescription drugs they will pay for during a calendar year.
  •  …propose that insurance companies be allowed to change their list of covered drugs, called formularies, only once each year during the patient open-enrollment period.
  •  Eliminate prescription-drug co-pays for patients who used to receive their prescription drugs for free through Medicaid.
  •  Offer relief to those seniors who used to pay a fraction of their drug costs through pharmaceutical company plans designed to help low-income Americans. Many seniors and disabled people who qualified for that help now aren’t eligible for low-income assistance…and must pay more for their medications.
  •  Eliminate the segment of Medicare drug coverage called the doughnut hole…for most Medicare beneficiaries it begins when their total drug costs reach $2,500 — during which beneficiaries must continue paying a monthly premium for their Medicare prescription drug plans, but they receive no help with their drug costs.

And here is what some rx-makers are doing:

ending programs that provided free or discounted prescriptions to elderly Americans now that pharmaceutical benefits are widely available under the Medicare program–saying government rules are forcing them to back away…companies say certain of their assistance programs could be interpreted as a kickback to win loyalty to their prescriptions.

Reality is that there are many people in life-threatening situations as they are not able to afford their rx’s under Medicare D.  An example of this is Crystal Bell, who received a kidney transplant in 2003.  Her rx costs were supposed to paid by Medicare D, however, the cost  s have now doubled, as Medicare D, doesn’t pay 50-percent for the drugs she’s taken after her kidney transplant.

According to Ms. Bell

“…its either rent or medicine…and I choose medicine…I could have been the person next door to you, or your daughter’s friend in high school, and now look at me, I’m just trying to get by…I’m not going to give up, you can’t kill me.”

After calling Medicare, Ms. Bell was told that the problem should be fixed in 30-60 days.  Her response?

“I don’t have thirty to sixty days.”