
Katie Coombes on the
Failures of Medicare Part D
September
15, 2006
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Katie Coombes is the lead organizer
of the Medicare Task Force. The Champaign County Health
Care Consumers' Medicare Task Force is comprised of
affected consumers, senior advocates, and concerned
citizens working to support legislative improvements to
Part D.
Medicare Part D is the new prescription drug coverage
option for Medicare beneficiaries. The Part D program is
markedly different from traditional Medicare. Part D
lacks the central principle of Medicare, described by
Winston Churchill as, "bringing the magic of averages to
the rescue of millions."
The only way for people to participate in Part D is to
purchase a private insurance plan. This design divides
the total risk pool of forty three million Americans
with Medicare into small sub-groups. There are nearly 80
companies offering over 1,400 Part D plans each charging
different monthly premiums and covering different
medications, and each taking their own cut in profits
and administrative costs.
The Part D program's design is not only inefficient and
wasteful, it is also harmful to those it is intended to
benefit. The most harmful failing of the Part D program
is the coverage gap known as the Donut Hole. During this
gap, Medicare beneficiaries pay one hundred percent of
their prescription drug costs and continue to pay their
monthly insurance premiums. For many, this is simply
more than they can afford forcing them to go without
their medication. The Donut Hole does not reign in costs
as proponents argue, it merely shifts costs to Medicare
beneficiaries and often results in poor health and
increased trips to the emergency room, the costs of
which are covered under traditional Medicare.
Medicare beneficiaries live on fixed incomes and have
changing prescription drug needs. Insurance is supposed
to provide protection from debt and guarantee access;
Part D does neither. The unpredictable out of pocket
costs and absence of guaranteed coverage for needed
medicines make it clear Part D is not a real benefit for
Medicare beneficiaries.
However, the insurance and pharmaceutical companies have
benefited from Part D. As Part D is only available
through private insurance plans, the insurance industry
has seen an increase in business. The Part D legislation
forbids Medicare from negotiating discounted drug prices
allowing the pharmaceutical companies to continue
charging the highest prescription drug prices in the
world.
Part D must be redesigned so that it benefits the people
with Medicare rather than the powerful interests of the
insurance and pharmaceutical industries. A real Medicare
prescription drug benefit would be administered by
Medicare with the authority to negotiate discounts and
without a Donut Hole.
Congress passed the Part D program legislation, so only
Congress can fix it. It should be a non-partisan
priority to improve the Part D program and make it the
most efficient and cost-effective way to deliver
affordable medicines to people with Medicare. I urge
everyone to contact their Congressional Representative
and ask them to make improving Part D a legislative
priority.
People who are interested in learning more about
Medicare Part D and how they can take action to support
legislation that would fix Part D can attend a community
meeting next Thursday, September twenty first from ten
to noon at the Urbana Civic Center. An educational video
narrated by Walter Cronkite will be shown and speakers
will include Dean Baker from the Center for Economic
Policy Research as well as William McNary from Citizen
Action Illinois. For more information call 352-6533. |
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