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Medicare Drug Muddle

Many of the Medicare Recipients Who Would Benefit Most from Using Discount Drug Cards Think They're too Much Trouble 
to Be Worthwhile


A Times Editorial

August 20, 2004


The Medicare drug benefit passed with fanfare last year has proven to be a disappointment - both to retirees and the Bush administration. Assistance with the rising cost of prescription drugs was at the top of the wish list for Medicare recipients, yet now that such help is available, few have signed up. As for the political boost from older voters that President Bush expected for shepherding the drug law through Congress, forget about it.

A recent nationwide survey showed that a majority of older Americans think the discount drug cards being offered through Medicare aren't worth the trouble. Typical is the assessment of Barbara Fletcher, a 72-year-old Largo resident. "The whole thing is a big fat joke," she said.

As a result, instead of running on the issue Bush is ignoring it on the campaign trail. And John Kerry's advisers think the direction of Medicare reform is one of the issues that will help Democrats win over older voters, who went for Bush by a small margin in 2000.

It is a shame the program has been so politicized - by Republicans and Democrats - because for many retirees the help being offered can really make a difference. Yet Bush has only himself to blame for the reversal of fortune. The benefits fall short on two key considerations: Medicare is forbidden from negotiating lower prices with drugmakers, and Americans are not legally allowed (though the law is currently ignored) to import cheaper drugs from Canada and other countries. In the survey done by the Kaiser Family Foundation and Harvard School of Public Health, 80 percent of retirees favor lifting those two restrictions.

The program is also unnecessarily confusing, which is a key reason seniors have been slow to adopt the discount drug cards. The cards became available in June and can be used until 2006, when broader drug benefits will be available. For a $30 fee, retirees can get double-digit discounts on drugs, but Medicare complicated things by allowing more than 70 different cards to be offered without uniform coverage or discounts.

As a result, only about one in 10 Medicare recipients has enrolled in the drug program. Many don't need the help because they have private drug insurance or access to other discount programs. Of the 7-million low-income recipients who would see significant benefits from the program - they get a free $600 drug credit this year and next - only about 1-million have signed up. (The income limits for free drugs are $12,569 for a single person and $16,862 for a couple.)

In 2006, a more comprehensive benefit will replace the drug cards. Unfortunately, that plan will be even more complex, involving a monthly premium, annual deductible and a large gap in coverage. Once again, low-income retirees and those with catastrophic drug costs will benefit most under the plan, while other recipients may not see a clear advantage. Yet it is not clear that those who need it most will have the information needed to make the right choice.

The biggest challenge for Medicare, once again, will be explaining the program. "It's going to be a big job to help people work through this stuff," said John Rother, a policy expert with AARP.

As the recent survey points out, the federal government is better at creating programs than it is at making them comprehensible.

 



 

 


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