Medicare D is has not lived up to all of the hype that proceeded it.  People have been denied their rx’s, and as a result, more have had to be admitted into the hospital. In Wisconsin,

a mentally ill man gave up trying to get his medications at the pharmacy and had to be hospitalized…and…a low-income woman with heart problems was unable to afford a $70 co-payment for her medications and wound up in the emergency room with chest pain two weeks later.

Aimee McCutcheon, a lawyer for an advocacy group stated,

“We’re seeing more hospitalizations than at the beginning of the year.”

Consumer protection organizations have urged that Medicare D be strenghtened by requiring that those who have been overcharged receive reimbursements promplty.  Aslo, a  standarized appeal process for when a rx is denied by the insurer is being requested.  
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Kirsten Beronio of the National Mental Health Association said,

“We are very unhappy with how things are turning out…In general, (Medicare) has been addressing problems on a case-by-case basis, instead of treating them as the systematic problems that they are.”

This further causes a delay in rememdying the problems, due to the time element involved.  And, Hillary Rodham Clinton is also attempting to solve the problems caused by Medicare D.

Senator Clinton’s advocated expanding federal health coverage and suggested balancing that by making the existing systems more efficient and less costly by linking government dollars to results, paying for performance and utilizing health information technology to reduce mistakes.  According to Senator Clinton,

the government is simply not getting its money’s worth for its health care investment and should focus more on prevention.

Senator Clinton is also attempting to call for a bipartisan approach, as she is  the new Medicare drug sponsoring with key Republicans, specifically Bill Frist.  That bill would improve the information technology sector of health care. She also is working on a different bill with Sen. Charles E. Grassley on ways to expand and improve long-term care options.  

Once again, the bills described focus strictly on the needs of senior citizens, while ignoring the difficulties that people with disabities are having with Medicare D.  This further demonstrates how the concerns people with disabilities are ignored as the Epilepsy Foundation, Paralyzed Veterans of America and United Cerebral Palsy Association (to name a few) are calling for an immediate reform to Medicare D.

Another example of the lack of concern for people with disabilities is shown by U.S. Rep. Jerry Moran today.  He  announced a proposal that would extend the May 15 deadline to enroll in a Medicare D plan by approximately 7 months.

“Kansas seniors are struggling greatly,”

Moran said.  No mention of the fact that those with disabilities are, in many instances, struggling too.  Also, no mention of the fact that similar legislation was already defeated.  So, now it appears to be that senior citizens are also seeing the carrot-and-stick approach by Republicans.

In contrast, Rep. Nancy Pelosi appears to be listening to the concerns of those with disabilities.

“Democrats are holding town hall meetings across the country to talk to the Americans directly affected by the Republican culture of corruption, and work for a complete overhaul of this disastrous plan,”

according to a press release on her website.

After reading an earlier article, the above could be taken with a grain of salt.  Democratic lawmakers say the No. 1 issue that they are hearing about from their constituents is Medicare D.
Democrats have introduced about 20 bills to Medicare D. The objective is to keep the program front-and-center,  reminding voters that the Bush administration and most Republican members of Congress refuse to fix it.

Democratic pollster Mark Mellman said,

“This is an issue that should be raised often because it is a central preoccupation of very large numbers of Americans and because people now look at the Republican program, the Bush program, as being a disaster.”

And,

“If the Democrats are smart, they will play this thing until it’s completely overhauled,” said Celinda Lake.

Which is what the Lansing State Journal claimed on January 18, 2006.

There should be no confusion over a solution, however. Rewrite the Medicare program now…

And now the dems have just realized it?  

And now, MarK McClellan is saying that legislation is unnecessary.  

“Our first focus is on solving the problems that exist right now…We think we can do that administratively.”

Oh, and here’s what is just being done by the 2006 Governmental Accounting Standards Board (GASB) in describing how a subsidsy to an employer re:  Medicare D should be reported.  It asked questions!

  1. How should an employer account for and report a Medicare Part D payment from the federal government to the employer?
  2. How does a Medicare Part D payment from the federal government to an employer affect the accounting for the transaction and financial reporting by a defined benefit OPEB plan?
  3. How should an employer account for and report a Medicare Part D payment from the federal government to the plan?
  4. How should a defined benefit OPEB plan account for and report a Medicare Part D payment from the federal government to the plan?

As Medicare D was enacted in 2003, why weren’t these administrative details taken care of earlier?  And, since they were not, we are supposed to believe that Medicare D can be fixed administratively?

And, there is also more from Dr. Jeff Kelman, chief medical officer for the Medicare division that handles the drug benefit, as he said the agency was responding to the concerns of people with disabilities.

“We have made a lot of effort to work with the disability groups and the mental health groups because they represent a very vulnerable and important population to bring into the benefit.”

Despite that statement, Medicare’s directives to the private insurers are ignored sometimes, since they are issued only as guidelines and thus lack the force of federal regulations. These are just two of the many examples of administrative oversight of Medicare D.  

Here is a a third:

Robert Hayes, president of the Medicare Rights Center, states that he had a discussion with Mark McClellan, (Administrator of the federal Centers for Medicare and Medicaid Services) EARLY LAST YEAR:
“I was sitting in McClellan’s office and I said, ‘Look, even if you get this transition 99 percent right for the people losing Medicaid coverage, you’re still going to have 64,000 people without drug coverage come Jan. 1.’ And [McClellan] said ‘No, we have everything under control.’

Am I missing something???