AFP/ANP/Evert-Jan Daniels

Song in my head:
Step up and forfeit
your frontal lobe
Ani diFranco

Medicareless

eRobin, over at The American Street made me aware of an amendment to the minimum wage/estate tax bill, introduced by Frank Lautenburg (D-NJ).

Senator Lautenberg’s amendment would prevent Medicare Part D providers from offering plans with a coverage gap and require plans to offer only uninterrupted drug coverage. (no link provided)

The Medicare Part D drug coverage is a boon to health insurance and drug companies, and speaking from personal experience, needs a lot of improvement. Most insurance plan formularies do not cover all your prescriptions. The coverage gap is extensive and there is a penalty for signing up late. Not only is calculating the late penalty fee confusing, the whole plan is confusing, costly, and if you already had a supplemental medicare policy before Part D took effect, you were obligated to use that policy's drug program, regardless if you're medicines were on the formulary or not. Basically, it was anti-choice for senior and alter-abled consumers. A recent survey from the National Institute of Aging found that 70% of seniors (and the alter-abled) said that the design of the bill was poorly designed. Newsday Link

The same Newsday article is a poorly written analysis of the drug consumer's perspective. The audience of the article should be the drug consumer but it whitewashes the real story. Here's my analysis of the article in red......

The less medicine they take, the less likely the elderly were to enroll in a new Medicare drug plan, a signal that many senior citizens still don't view the program as insurance in case their health deteriorates.
It's impossible to pick a plan if you don't know what drugs you will need in the future. If you pick a plan that doesn't cover a drug you might need in the future you are screwed. Perhaps consult a clairvoyant.....

Researchers say the trend was particularly noticeable among the poor and those without a college education. About 40 percent of these seniors did not have drug coverage -- and were not taking medication.
Financially challenged consumers are not likely to pay a Medicare Part D drug program monthly premium if they are not currently taking medications. They can't afford it and it seems like an unnecessary expense on a fixed income.

"We speculate that this arises because of constraints or perceptions that make it difficult for people in these groups to account for future benefits," said the authors of an article, published Tuesday in the journal Health Affairs.
Yes, financial constraints and it is impossible to make a smart choice if you have no idea what medications you might need down the road. Perhaps these people would rather pay the late penalty fee then sign up and pay an insurance company money for coverage that they do not need.

The authors concluded that healthy people with low education should be targeted with counseling on the future benefits of coverage, and that waiving a penalty for late enrollment could help bring more into the program.
No, the bill needs to be rewritten to be more consumer-friendly. States are already strapped with cash for providing services. Who will provide this counseling on future benefits? Who will fund such a program? Once again...consult a clairvoyant.

As incomes rose, the elderly were more likely to have drug insurance, even if they were taking no medications. For those with more than $20,000 in income annually, the percentage without drug coverage dropped to 11.3 percent.
Money is the bottom line. Folks on a fixed income make hard choices between food, utilty bills, or medicine.

Seniors taking three or more medications were far more likely to have drug coverage, even among the poor. Only 5.2 percent of these people did not have prescription drug coverage, the authors wrote.
It's not being poor that is the qualifier. It's how many drugs are you taking.

The researchers based their conclusions on a survey of 2,137 seniors who were interviewed just before enrollment into the program began and again once enrollment ended.

"The Part D program has performed better than some people feared, but it has also left a significant chunk of people uncovered," said Daniel McFadden, a lead study author and a professor of economics at the University of California, Berkeley. "Many are people that any system would have difficulty reaching and helping make informed choices."
The bill is hard to understand and has confusing loopholes.

Other authors were Florian Heiss and Joachim Winter of the University of Munich in Germany. The study was funded through the National Institute on Aging and the E. Morris Cox Fund at the University of California at Berkeley.

Seniors seemed conflicted in how they view the program. While 57 percent of respondents described the program as a major benefit, only 30 percent said it was well designed.
In other words 70% said the program is poorly designed.

When Medicare was passed in 1965, it was also hotly contested and debated," said Leslie Norwalk, deputy administrator for the Centers for Medicare and Medicaid Services. "Over time, people have grown to love their Medicare program, and I suspect people will grow to love their drug benefit. It just may take a while for the political waters to calm."
Whatever. Lets see if that message will stand in the polls in November.

Judith Stein, executive director of the Center for Medicare Advocacy Inc., an advocacy group, said seniors don't like the design of the program because it leads to confusion rather than maximum value.
Seniors and the alter-abled don't need anymore confusion or stress.

"Part D should be revisited and redesigned to offer a standardized prescription drug program through the traditional Medicare program," Stein said. "Such a program would be more valuable to more people with Medicare and less expensive for taxpayers."
Democrats...Run with this message. Seniors are a big voting block.