This is alarming to me, that this many seniors already had drug coverage through Medicaid or through employers or retiree programs. The article from the New England Journal of Medicine further states that only 12% got coverage they did not already have.
This was obviously not to benefit seniors, since 20 million of the 25 million already had previous drug coverage. I see a lot of propagandizing of this issue right now, and I would love to see some Democrats talking about it out loud.
The article from the NEJM below.
Part “D” for “Defective” — The Medicare Drug-Benefit Chaos
True, the program provides drug benefits for some Americans who previously had none. But because of its strange design, enrollment is falling far short of expectations. Officials in the Bush administration boasted that 25 million people are receiving benefits through Medicare Part D. But the government’s data reveal that about 20 million of them already had adequate drug coverage through Medicaid, their employers or unions, or health maintenance organizations; as of late February, the new benefit was providing only 12 percent of the elderly with coverage they did not already have.
In many cases, the program worsened patients’ situations, with a particularly heavy burden falling on indigent Medicaid enrollees. Before the new entitlement, most had virtually all their medications covered fully by the states. But on January 1, 6.2 million of these vulnerable elderly were reassigned to one of the private insurance companies designated by Medicare to run its program. Word of these arrangements didn’t always reach the patients, insurers, or pharmacies accurately, and tens of thousands of indigent patients were told to get prior authorization, pay a large initial deductible, or make substantial copayments for regularly used medicines they previously received at no cost. Thousands discovered that the drugs they had been taking for years were not covered by their new insurers. Clinical crises ensued, and 37 states had to provide emergency payments for frail citizens.
And it takes the power from the hands of doctors to prescribe what they consider proper medicine. The author calls this a stinging indictment of his profession, to allow this.
In Medicare Part D, decisions about which drug in a class to use are made by each insurance company, often requiring prescriptions to be rewritten. The concept abandons the expectation that a doctor will choose the most appropriate and cost-effective drug and reassigns that decision to an insurance company that has its own agenda. The current infatuation with this solution is a stinging indictment of our profession; the encroachment on our prerogatives flows from our failure to address these responsibilities ourselves.
And this paragraph addresses the dreaded doughnut hole part of the plan. It points out that many seniors will be approaching or in that hole by November.
Medicare Part D lives on, responding semiappropriately to noxious stimuli by flailing its limbs as best it can. It even shows some limited capacity for learning, and one important learning opportunity is just seven months away. Elderly citizens vote in droves, and many of them will have hit their “doughnut hole” by early November. At that point, they will let their legislators know how they feel about the program.
Someone needs to be speaking out on this issue. Even those who were able to retain their present plans for now realize that it was only because some incentive was given for their former employers to do this. And they wait for the next shoe to drop, after it is too late to sign up for coverage and drug prices are higher than ever.
