The after-effects of Medicare D(isaster) are nearing or at a crisis point. Medicare D(isaster) is failing those who need it most and there is more confusion on the horizon re: the fact that the “donut hole”/gap in coverage is coming up quickly for many.
Waiting until the after the mid-terms will be too late for many!
Instead it is time to act, so can we please be a voice for those who are or will be caught in this nightmare of not being able to get much-needed rx’s? LTE’s, contacting congresscritters, the whole bit! A large number of people have to speak up about this horror. And, the blogosphere has the ability to do so.
Specifics are listed below.
More Medicare D(isaster) Limitations gives an explanation of the denial of rx’s to those who need them. Also incuded is a link (and an excerpt) of a report released by Henry Waxman that describes the hidden restrictions one must face in obtaining a rx. The use of step therapy (an insurance company policy that makes one take a rx that does NOT work, before approving on that does) is fully explained in a comment. Having had to go through step therapy when I had pneumonia a few months back, I can say from firsthand experience that it does pose a danger, and can be life-threatening.
Medicare D(isaster): Angry Opinions contains some opinions of those who are forced to participate in the program and their frustrations w/it. Aslo, an email from Robert Hayes, of Medicare Rights to the WaPo is included:
“The HMO industry and its Washington lobbyists may be the least trusted sources of honest data in the country…The HMO industry will spend millions to protect this cash cow that the Bush Administration and Congressional leadership gave it.”
Medicare D(isaster): More Money… includes the following information:
Prior to Medicare D(isaster) taking effect, health insurance, health services and pharmaceutical companies contributed $96,370,907 to candidates w/71% going to Republicans.
[Billy] Tauzin got $274,500; Rep. Bill Thomas, R-Bakersfield, got more than $432,000; Sen. Orrin Hatch, R-Utah, took almost $427,000; Rep. Nancy Johnson, R-Conn., took $731,517; Sen. Max Baucus, D-Mont., received $271,649; and Sen. Charles Grassley, R-Iowa, took $296,429.
Examples of the cost savings, had Medicare D(isaster) been run by the government, as opposed to private inurance carriers are also included.
This $80 billion price-tag is based on two specific provisions where Republicans sold out seniors for their industry contributors. First, they created a confusing web of competing and inefficient private plans run by private insurers – who receive huge subsidies from the federal government – that beneficiaries must choose from, rather than a simple stand-alone benefit run by Medicare. The low overhead costs of a single administrating agency could save $4.8 billion annually.
Second, they made it illegal for the federal government to negotiate the price of drugs with manufacturers, despite the fact every other industrialized nation negotiates these prices. When the government does negotiate lower prices for bulk drug purchases, as does the Veterans Administration, it saves more than 40 percent compared to the market cost. Applied to Medicare, this would save about $560 billion over the first eight years of the program. The cost of the disastrous Medicare plan is even greater when the subsidies given to insurance companies are factored in.
Also included in the comments are links to earlier diaries re: sinlge payer health care and specific examples of people being denied their rx’s.
Medicare D(isaster): Choice Time Again describes the problems that some dual eligibles are having w/Medicare D(isaster), as they are discovering that they are enrolled in 2 plans, and are having 2 premiums deducted from their Social Security checks. In additon, confirmation letters of a plan change/choice are being sent by private insurance carriers on government letterhead.
Medicare D(isaster) and Career Change$ states and links to the actions of Billy Tauzin, John Scully, and John Breaux after Medicare D(isaster) was passed.
Medicare D(isaster): John Breaux and Tom Delay’s Influence? includes info re: lobbying and campaign contributions.
Cost of Cancer Rxs Skyrocket!! links to a diary by nyceve that describes how one insurance carrier is cancelling coverage for those who need expensive care. (Litigation pending.) Also,
And, an article in the NYT claims that the price of nitrogen mustard, used in treating some types of lymphoma, increased from $77.50 to $548.01 in a two week period.
Medicare D(isaster): Transition Ends–Here We Go Again!!! Despite the wishes of those are are being forced to participate in Medicare D(isaster) the transition period is officially over. No more 30, 60, 90, day supplies of much needed rx’s. Instead, it appears that, as the prices of some rx’s have increased dramatically, the donut hole will be kicking in earlier than most expected. And the whole cycle of people not being able to get their rx’s will start all over again.
Medicare D(isaster): PR Won’t Hide Coverage Changes details more of the PR and sales that Leavitt is now doing. Also, lists of drugs that were formerly covered and now are not are described in the comments.
Medicare D(iaster): Some Harmful Side Effects Of Generics links to a column in the WSJ that describes, from a doctor’s point of view, generic alternatives that are required under Medicare D(isaster) that may cause harmful side effects to a patient. An additional discussion of generics is in the comments.
Medicare D(isaster) : Appeals, Computers, Changes… includes some of the hidden obstacles one must face and an unresponsive bureaucracy. Also, a claim that Medicare D(isaster) working is challenged.
CMS spokesman Peter Ashkenaz stated that the government has been
“working with the plans and providers and pharmacists on a standardized, and hopefully simpler, form to request these exceptions and make appeals.”
Second, Ashkenaz claimed that Medicare has been reminding insurers that they should provide coverage for drugs not on their formularies until appeals from doctors have time to get reviewed.
Medicare D(isaster): Numbers, PR, Reality, Irony! links to other info that states health care costs continue will to increase. MSM is now hard at work, attempting to convince those who are eligible to enroll in Medicare D(isaster) policies, despite the fact that people do not trust the program. More from Robert Hayes:
In this springtime of national discontent, the nation’s prescription drug program resembles the rebuilding of New Orleans and the war in Iraq. They each serve as a human tragedy, an administrative fiasco and a predictable consequence of politicians willing to squander the national treasury so long as it goes into the pockets of their mercenary supporters.
Had the drug benefit been administered directly by Medicare, doctors, rather than profiteering insurers, would decide what drugs are needed, and Medicare would use its substantial purchasing power to bring U.S. drug prices in line with the rest of the world. (Americans, on average, pay double the price of other developed countries for the same medicine.)
Also,
Michael Leavitt, who was “unaware” of the problems with Medicare D(isaster), is now running around the country to sign people up for Medicare D(isaster) policies. But be warned: Michael Leavitt assisted his parents in choosing a Medicare D(isaster) plan that put their own retiree health insurance coverage in doubt.
And this is the height of irony: Levitt’s father made a fortune in the insurance business!!!
(Now I am wondering why Leavitt’s father even needs Medicare D(isaster). Anyone else thinking along those lines?)
Medicare D(isaster): PR Machine and $$$$! links to ealier diaries re: the sales pitch and Max Baucus’ campaign contributions. Coincidentally, Baucus was the one of two democrats “allowed” in the final negotiations of Medicare D(isaster). As stated earlier, the other was John Breux.
True Medicare D(isaster) For Cancer Patients!!! A cancer patient is unable to get her rx’s due to Medicare D(isaster) and is not receiving any medication. At one time, she was getting her rx’s through a charity program by one of the rx cos but now the rx cos are claiming that
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.
Medicare D(isaster): Collateral Damage? contains a statement from Congressman Elijah E. Cummings of Maryland.
…this President refuses to listen to the concerns of the 42 million Americans who are Medicare beneficiaries”…”
Assuring that our most vulnerable Americans have convenient access to a high-quality, affordable prescription drug plan should be our number one priority. This President and the Republican majority seem more concerned about benefiting special interests.
“The Medicare Part D program was not set up to provide a meaningful benefit to seniors. It was set up first to benefit the pharmaceutical industry and then to benefit the insurance industry.”
In addition, an
amendment to allow Medicare D(isaster) beneficiaries to change plans once a year w/o penalty and extend the enrollment deadline to December 31 was defeated when Sen. Kay Bailey Hutchison (R-Texas) — changed her vote to “no”.
Her campaign contributions from big pharma and insurance carriers are also linked to in the last paragraph.
Medicare D(isaster): Immigration/ID/Interpretation was written to illustrate the possibility of denial of medical treatment to immigrants as ID is now required, according to the Defecit Reduction Act.
Born out of ongoing efforts in Washington to clamp down on illegal immigration, the new federal requirement compels anyone seeking Medicaid coverage to provide a birth certificate, a passport, or another form of identification in order to sign up for benefits or renew them.
In addition, there is specific information re: the lack of translation of insurance carrier services also included.
According to Peter Ashkenaz, Medicare must accommodate non-English-speaking callers. When calling Medicare directly, one can request a translator through the toll-free line. However, than pressing two for Spanish, the menu of options is in English, with nothing to suggest that interpreters are available.
However, despite many who speak another language, a request for a translator must be made in English. Aslo, a few of the insurance carriers have not had translators and have been hanging up on those who request one. (Although they do say thank you for calling.) This puts many at a severe disadvantate, and, depending on their medical condition, could be life-threatening for some.
However, now the Medicare D(isaster) Sales Pitch Is Now Interpreted. It appeats that the administration belatedly realized that those who do not speak English are also eligible for Medicare D(isaster). The administration and the NAACP have formed an arrangement to market Medicare D(isaster) to minorities as a means of increasing enrollment in the program, despite that the official stance of the NAACP is that Medicare D(isaster) “needs improvement.”
Also, Adolph Falcon, of the National Alliance for Hispanic Health, said the organization is helping the administration with its outreach to the Hispanic communities.
CMS claims that Medicare D(isaster) is the beginning of closing the health disparities gap among people. And, bush follows up with
“I’m trying to show that our government is reaching out to people from all walks of life in all neighborhoods.”
But, are the speeches that are now being translated fully explain the implications of the “donut whole”/gap in coverage, and, in some instances, has already begun?
