11/08/05: Poor Medicare Drug Program Will Confuse Seniors And Cost Them More - Peggy Baime Madison

Poor Medicare Drug Program Will Confuse Seniors And Cost Them More

Dear Editor: More a gift to the drug industry than to us, the drug benefit law prohibits Medicare from using its potential power to force down drug prices, yet it forces most seniors and disabled to pay out of pocket for each year's first $250 in purchases and "doughnut hole" purchases from $2,250 to $5,100 even though they still pay the premiums.

Money spent out of pocket is credited for the first $250 for "doughnut hole" spending only if it is to buy drugs the company covers. Companies can change the drugs they cover every week, but most users are locked into their plan for a year.

To compound the confusion, the above specifications are government "guidelines" and companies will be allowed to add here, subtract there, as long as their overall plan is "actuarially equivalent" to the government guidelines.

Moreover, starting in May 2006, if a person is eligible for a drug plan and does not have equivalent coverage, there will be a 1 percent surcharge to a plan's premium for each month a person delays signing up for a plan for the rest of that person's life.

Other serious concerns are drug coverage for poor participants will be transferred from previous plans (Wisconsin plans) to Medicare's less regulated and more expensive coverage; there is no plan for nursing homes; there is an incentive for employers to drop drug coverage; and finally, the law's future provisions will drive people to HMOs, and will cap federal payments to Medicare.

If you can't understand the plan, it's not a good plan.