Total Chaos: Medicare Drug Plans

By Pat Zimmerman of Scapoose, Oregon. Pat is retired and a volunteer for the State Health Insurance Benefits Assistance program.

I'm a volunteer trained by the State of Oregon to help seniors evaluate and select Medicare insurance programs. I've worked in health care and have a Ph.D. in Information Science. Recently, I've been spending 20-30 hours a week working with seniors who are attempting to decipher the new Medicare drug program. Despite all these advantages, and after dozens of hours of internet research, I still preface my advice to seniors with 'It seems like', or 'I think' or 'Damned if I know'.

Medicare Part D is an incredibly complex, confusing and misleading program. Rather than the federal government offering two or three understandable options, the Bush administration insisted on 'privatizing' prescription drug coverage. The result: chaos.

In my county (Columbia) there are 45 'standalone' and around 15 'Advantage' drug insurance plans -- this week. Each offers different premiums, coverage, drugs, co-payments, deductibles, exclusions, enrollment requirements and total drug costs. Medicare has a web site that supposedly helps seniors compare these plans. Perhaps understandably, the website is confusing, sometimes wrong and frequently freezes or kicks you off after you've spent hours painstakingly entering all your prescriptions and dosages. And getting even this help pre-supposes access to the internet, an advantage that many Columbia County seniors don't have.

If your income is low, the situation is much worse. Taxpayer funded 'feel good' ads have flooded the media proclaiming that low income seniors will have help to pay for drugs. Medicare has advertised that people with low incomes will 'automatically' be sent a letter announcing that they qualify for assistance and describing how to apply. Out of about 12 people I've worked with so far who do qualify, exactly one has received this letter. The rest don't know that help is available, much less how to apply for it. Many of them have drug discount cards that will be cancelled Jan. 1, and are desperate because their drug costs are as much as half their income. Unless they happen to talk with someone who knows the system, they are facing choices between food and heat or drugs needed to stay alive.

This is a disaster. In the last seven years, drug manufacturers spent $675 million lobbying the Bush White House and Congress -- more than any other industry. The Medicare 'reform' law that instituted the drug program specifically prohibited the government from negotiating with pharmaceutical companies to reduce drug costs for 45,000,000 Medicare recipients. Drug company stocks skyrocketed after the adoption of these 'reforms'. Bush and his cronies rewarded the pharmaceutical companies by dumping 45 million seniors into 'free market' chaos.

It looks to me like Bush has designed an insanely complex program that promise much to seniors, while in fact enriching drug companies, while cynically culling the poorest and most disadvantaged.

  • Varner (unverified)

    This is a good piece on an important issue. A question comes up for me reading this, did the Bush administration design a program intended to fail?

    It seems like to get program this complex and non-functioning one would have to try to fail. Is this the case?

  • BlueNote (unverified)

    I am an attorney and my wife is a physician and it still took the two of us a dozen hours to assist our respective mothers in selecting a plan. Who but a pandering politician would design an insurance plan with a "donut hole" in the middle. Try finding car insurance where you have a 250 deductible, followed by 80% coverage up to 2500, and then no insurance at all until your losses hit 5000 or so. Do you think your bank (or the guy you hit in the crosswalk) would consider that as adequate "car insurance"? Probably not. We can have a legitimate debate about whether it is an appropriate use of our national resources to provide further benfits to senior citizens while taking benefits away from the indigent and the working poor, but this "insurance plan" is mostly hype and false promises that do little but cause pain and confusion to the elderly and infirm.

  • Skip from Gresham (unverified)

    The drug companies owned Clinton and after 8 years we received NOTHING in the way of relief of high prescription costs. Those same drug companies own Bush and we get a complicated mess....that provides some relief with a doughnut that protects the drug industry profits.

    Looks like the drug companies spend their lobbying money VERY wisely.

  • (Show?)

    The drug companies owned Clinton?! Are you kidding?

    They - along with the health insurance industry - destroyed the Clinton health care plan, and helped create the political momentum that led to the 1994 GOP takeover.

    They 'owned' him only in the sense that the Baltimore Ravens 'owned' the Green Bay Packers 48-3 tonight.

  • JTT (unverified)

    Don't forget Big Tobacco & Grover Norquist's role in taking down Clinton's Health Care plan.

  • geno (unverified)

    This is my personal experience with the "privatization" element of the pharmaceutical enrichment, medicare destruction prescription bill: A private insurer called to advise she needed to schedule an in-home appointment to assist me with selecting the appropriate option. How nice. On further inquiry, she said it is likely her company can offer the same coverage at a slightly lower premium than medicare. Great! Upon delving deeper I asked why I could not just provide her a list of prescripts over the phone, receive a quote and projected savings, receive the app. in the mail and return it? No, she needed to meet with me in my home while on a swing through my neighborhood to sign up other medicare eligible folk. Hmmmm? Why the high pressure tactics? In exploring a bit further, I learned that the insurer would need my signature to authorize an automatic deduction of the premium from social security benefits. How convenient. Premiums paid directly to the private insurer from social security benefits. What a sweet deal for the insurer. Oh yeah, and after the hook is set, and benefits start flowing to the insurer, what will prevent them from increasing future premiums to eventually exceed the medicare premium?? This is a gravy train for private insurers who are preying on the elderly and infirm. While this rep. was not invited to my house, I am sure she has a number of contracts in hand from my neighbors. Could it be that the plan was designed to be confusing to enable private insurers to "help" the elderly direct a portion of social security benefits to the insurer? This administration just doesnt get it. We may be easily confused, but were not stupid.

  • claudia Grimm (unverified)

    geno: If you have the name and contact information of the agent who contacted you, I would encourage you to report the person to the Oregon Insurance Division. You can call toll free in Oregon at 888-877-4894.

  • Tomas (unverified)

    You have a beautiful soul ! I enjoy your page very much.

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