Fwd: The Eleventh Step to Improving Medicare Prescription Drug Coverage

[Guest guest]

Asclepios

Your Weekly Medicare Consumer Advocacy Update

ACT NOW: The Eleventh Step to Improving Medicare Prescription Drug Coverage

September 8, 2005 • Volume 5, Issue 36

Remember the “managed care revolution”? In the 1990s Medicare opened its arms to private Medicare HMOs expecting to rein in Medicare spending while providing a wider range of benefits to people with Medicare. Generous government funding allowed Medicare HMO plans to spread across much of the country and Medicare HMO enrollment followed suit—rising to a high of 17 percent of people with Medicare in 1999.

Do you remember what happened next? Promised savings were not realized from the Medicare HMO’s, and in the Balanced Budget Act of 1997 Congress cut back on its large overpayments to the private Medicare plans. The result: nearly one-third of Medicare HMOs, their profit margins cut, pulled out of Medicare, leaving millions of people with Medicare confused and angry. The plans acted as any profit-making venture would in the market place: they looked to greener pastures to maximize profits. In a sense, that is just what they are supposed to do. A corporation owes a duty to its shareholders to maximize profits. It is the government regulation of those corporations that must serve the public interest.

When millions of men and women were abandoned by their private Medicare HMO plans, they were able to fall back on Original Medicare to provide them with continuous health care coverage.

Despite the history of private plans’ failure to provide cost-effective and reliable coverage, the Bush Administration and Congressional leaders pushed through the 2006 Medicare drug benefit completely dependent on private plan participation.

There is neither reliability nor stability in the private, for-profit Medicare marketplace, as hard experience has taught people with Medicare. Regrettably, this is a lesson ignored by the framers of the 2006 prescription drug benefit.

Medicare drug plans do not have to continue in the Part D program or even offer the same plan year to year. Premiums, deductibles, copayments, and drug formularies will fluctuate. Consumers will be forced annually to gamble with their wallets and with their health.

And, history is likely to repeat itself. The time will come when even our current federal leaders will look to curb plan profits. Then, companies will abandon their Medicare drug plans and people with Medicare but this time, there’s no Original Medicare fallback.. There needs to be one Gibraltar-like product that will withstand the inevitable private drug plan pullout—and that rock should be a national, standardized Medicare Drug plan offered under Original Medicare.

Here’s the final step for improving the Medicare prescription drug benefit:

11. Establish a nationwide, Medicare administered prescription drug plan that people with Medicare could choose as private Medicare drug plans atrophy.

Click here to send an e-mail message or letter to your representatives in Congress asking them to establish a nationwide, Medicare administered prescription drug plan.

Sign up here to help build a national campaign to give people with Medicare the drug program they deserve.

Medical Record

Multiple sources of health care coverage increase administrative costs for people with Medicare, providers and Medicare. In 2001, 90 percent of people with Medicare had more than one source of coverage including retiree (32.6 percent), Medigap (28.1 percent), and Medicaid (12.2 percent) (“Medicare: Making It a Force for Innovation and Efficiency,” Commonwealth Fund, July 2005).

People with Medicare will pay more and more every year—at a rate much higher than the rate of inflation. As drug costs continue to climb, the prices Medicare drug plans and consumer pay for drugs will also go up, and the benefit will change to make up for these increased costs. From 2006 to 2013, people with Medicare can expect:

The annual deductible to rise from $250 to $445;

The initial coverage limit—between the annual deductible and the doughnut hole where people will have to pay 100 percent of drug costs—to grow from $2,250 to $4,000. Participants will get more coverage before they fall into the doughnut hole.

The doughnut hole itself will be bigger. The out-of-pocket expenses participants will incur while in the doughnut hole will increase from $3,600 to $6,400.

(“Prescription Drug Pricing: Untying Medicare's Hands,” Families USA, April 2004).

People with Medicare have resoundingly indicated their desire for a drug benefit offered by Medicare, not private insurers (“National Survey of the Public’s Views on Medicare,” Kaiser Family Foundation/Harvard School of Public Health, 2003).

Fast Relief: What You Can Do

Let everyone—your colleagues, friends, families—know how we can improve the Medicare prescription drug benefit for people with Medicare and American taxpayers. Help us build a national network of concerned citizens who want to create the Medicare prescription drug benefit Americans deserve.

Click hereto help build a national campaign for a real Medicare prescription drug benefit!

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Don’t Let Your Suffering Go Unnoticed

Are you struggling to pay for your prescriptions drugs or get the health care you need? Work with the Medicare Rights Center to bring your story to the ears of policymakers, the press and the public in an effort to expose the shortcomings of the American health care system. To learn more about how to make your voice heard in the national Medicare debate, visit www.medicarerights.org/maincontenthiddenlives.html

The Louder Our Voice, the Stronger Our Message

Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly action alert designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.

Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare. A national nonprofit founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.

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