Medicate Part D - Part Disaster
A Eugene, OR Register-Guard Editorial
Published: Sunday, January 22, 2006
For many of Lane County's 54,000 Medicare beneficiaries and the beleaguered pharmacists trying to serve them, the new Part D prescription drug plan has been a disaster from Day One.
Frail senior citizens waited in lines for hours trying to fill prescriptions for vital medications only to be told their names weren't in the computer, or they were going to have to pay more out-of-pocket than they ever had before, or their medications weren't covered under the plans in which they had been automatically enrolled.
Many begged their pharmacists for help. They asked if they could borrow the unexpected cash deductibles they were now being charged. Others left in tears after failing to get through on jammed phone lines to anyone who could confirm their coverage.
And the pharmacists did help. They gave people drugs without verification of coverage or payment of deductibles. But then a hundred problems turned into a thousand problems, and before long, 10,000 Oregonians were engulfed in a health care crisis because they couldn't get their prescriptions filled.
Gov. Ted Kulongoski had to intervene with an emergency plan. He ordered the state to reimburse pharmacies for providing up to 30 days' worth of medications to patients who weren't showing up on computer records as being enrolled in the new drug plan or as qualifying for low-income discounts.
Kulongoski joined governors from at least 25 other states who've asked for federal reimbursement of the emergency drug funding. They shouldn't have to ask. This is entirely a federal fiasco, and states should be held harmless.
Remember, Mark McClellan promised a "seamless transition" to the new program. McClellan, chief of the Center for Medicare and Medicaid Services, has done a heckuva job managing that transition.
The meltdown is so serious nationwide that the Bush administration had to order the private Medicare drug plan carriers to cover an emergency 30-day refill of prescriptions and cap co-pays for low-income seniors at $5. These are the same insurance companies that joined the pharmaceutical industry in showering Congress with cash to make sure their interests were protected when the prescription drug program was being created. Looks like the only losers are the low-income seniors the program was designed to help.
Don't forget the ugly history of this deeply flawed legislation. It never would have passed if the White House hadn't deliberately deceived Congress in 2003 about the true cost of the drug plan, insisting it wouldn't exceed $400 billion over 10 years. Key Republicans balked at anything that would cost more than that.
Then an armada of lobbyists spent a combined $141 million to ensure that the new drug benefit would primarily benefit private companies. The record number of pharmaceutical, HMO and managed care industry lobbyists - almost 1,000 all told - made sure the language of the new law would expressly prohibit the government from using its bargaining clout to negotiate lower prices and would also ban the reimportation of cheaper drugs from Canada.
Comptroller General David Walker called the drug plan "one of the largest unfunded liabilities ever undertaken by the U.S. government." It's expected to cost the federal government about $728 billion over the next 10 years, a total that is higher than the annual gross domestic products of Sweden, Egypt and Portugal - combined.
In addition to fixing the problems that led to its horrendous debut, Congress needs to revisit the entire prescription drug program. It's hopelessly complex and utterly unaffordable in its present form.
A no-brainer first step would be to immediately pass the bill co-authored by Sens. Ron Wyden, D-Ore., and Olympia Snowe, R-Maine, that gives Health and Human Services Secretary Mike Leavitt authority to negotiate lower prices for drug purchases through Medicare.
Published: Sunday, January 22, 2006
For many of Lane County's 54,000 Medicare beneficiaries and the beleaguered pharmacists trying to serve them, the new Part D prescription drug plan has been a disaster from Day One.
Frail senior citizens waited in lines for hours trying to fill prescriptions for vital medications only to be told their names weren't in the computer, or they were going to have to pay more out-of-pocket than they ever had before, or their medications weren't covered under the plans in which they had been automatically enrolled.
Many begged their pharmacists for help. They asked if they could borrow the unexpected cash deductibles they were now being charged. Others left in tears after failing to get through on jammed phone lines to anyone who could confirm their coverage.
And the pharmacists did help. They gave people drugs without verification of coverage or payment of deductibles. But then a hundred problems turned into a thousand problems, and before long, 10,000 Oregonians were engulfed in a health care crisis because they couldn't get their prescriptions filled.
Gov. Ted Kulongoski had to intervene with an emergency plan. He ordered the state to reimburse pharmacies for providing up to 30 days' worth of medications to patients who weren't showing up on computer records as being enrolled in the new drug plan or as qualifying for low-income discounts.
Kulongoski joined governors from at least 25 other states who've asked for federal reimbursement of the emergency drug funding. They shouldn't have to ask. This is entirely a federal fiasco, and states should be held harmless.
Remember, Mark McClellan promised a "seamless transition" to the new program. McClellan, chief of the Center for Medicare and Medicaid Services, has done a heckuva job managing that transition.
The meltdown is so serious nationwide that the Bush administration had to order the private Medicare drug plan carriers to cover an emergency 30-day refill of prescriptions and cap co-pays for low-income seniors at $5. These are the same insurance companies that joined the pharmaceutical industry in showering Congress with cash to make sure their interests were protected when the prescription drug program was being created. Looks like the only losers are the low-income seniors the program was designed to help.
Don't forget the ugly history of this deeply flawed legislation. It never would have passed if the White House hadn't deliberately deceived Congress in 2003 about the true cost of the drug plan, insisting it wouldn't exceed $400 billion over 10 years. Key Republicans balked at anything that would cost more than that.
Then an armada of lobbyists spent a combined $141 million to ensure that the new drug benefit would primarily benefit private companies. The record number of pharmaceutical, HMO and managed care industry lobbyists - almost 1,000 all told - made sure the language of the new law would expressly prohibit the government from using its bargaining clout to negotiate lower prices and would also ban the reimportation of cheaper drugs from Canada.
Comptroller General David Walker called the drug plan "one of the largest unfunded liabilities ever undertaken by the U.S. government." It's expected to cost the federal government about $728 billion over the next 10 years, a total that is higher than the annual gross domestic products of Sweden, Egypt and Portugal - combined.
In addition to fixing the problems that led to its horrendous debut, Congress needs to revisit the entire prescription drug program. It's hopelessly complex and utterly unaffordable in its present form.
A no-brainer first step would be to immediately pass the bill co-authored by Sens. Ron Wyden, D-Ore., and Olympia Snowe, R-Maine, that gives Health and Human Services Secretary Mike Leavitt authority to negotiate lower prices for drug purchases through Medicare.
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