The open enrollment period for the first year of Medicare Part D drug benefit ends Monday. This drug benefit was supposed to be a help for seniors and the disabled. For too many people, especially the poor on Medicaid and Medicare, it has turned into a headache. 

If the drug benefit had been designed with the interests of its beneficiaries in mind, it would look a lot like the New York state Elderly Pharmaceutical Insurance Coverage program with the addition of the disabled who are currently not eligible. EPIC has a very high satisfaction rate among those who are enrolled because it has standard fees and co-payments, with a broad formulary covering most drugs and with most pharmacies in the state participating. 

If those in Congress who designed Medicare Part D believed in real competition among plans, they would have included a government-run drug plan with standard fees and benefits as an option. That simplified option would have proven very popular with seniors. Now, there is a chance to enact that option with the Medicare-Guaranteed Prescription Drug Act of 2006, introduced by Sen. Debbie Stabenow, D-Mich., and Sen. Edward Kennedy, D-Mass. 

This bill would establish a Medicare-run drug plan that would offer prescription drug coverage and access to negotiated prices with a monthly premium that is uniform nationally. The bill also would lower out-of-pocket costs contained in the current Medicare drug law. 

Why standard coverage is important was illustrated by a study released in April by the Kaiser Family Foundation. The study found there are 1,429 stand-alone drug plans offered under Medicare Part D (as well as 1,314 Medicare Advantage plans.) 

In its survey of stand-alone plans, the study compiled a sample list of 152 drugs and looked at how many of those drugs were covered by each plan. The number varied from 64 percent to 97 percent of the drugs on the sample list. The cost of the drugs paid by enrollees also varied from plan to plan. For Norvasc, a high blood pressure medication, it ranged from $15 to $62; for Fosamax, prescribed for osteoporosis, it ranged from $15 to $66. 

Instead of a universal, comprehensive, standardized national drug benefit designed for seniors and the disabled, the Medicare drug benefit was designed as an affirmative action program for insurance companies and a cash cow to increase the profits of the pharmaceutical companies. There is no standard premium among the various plans, the drugs covered are different and the pharmacies used may vary. And plans are free to drop out in January if they didn't make enough money, dumping all their enrollees and forcing them to start over to pick a new drug plan. 

Those running the program say it's all about competition to keep prices down. If Congress had really wanted to keep prices down, it would have authorized the federal government to negotiate drug prices on behalf of all Medicare beneficiaries just as Canada's provinces do. Instead, the Medicaid drug law has specific language against doing that, showing its bias to protect the pharmaceutical companies. 

The Stabenow-Kennedy bill would require the secretary of health and human services, whose agency runs Medicare, to "implement strategies similar to those used by other federal purchasers of prescription drugs and other strategies to reduce the purchase cost of part D drugs." The savings could be used to subsidize the "doughnut hole," the gap between $2,250 to $5,100 of annual drug costs when no coverage is provided. 

Medicare may not be a perfect program, but a government-run program option with standard benefits and negotiated prices is a far better option than the confusing program passed by Congress and signed into law by President Bush. The Stabenow-Kennedy bill offers a way for constituents to press their lawmakers to fix Part D in 2006 before the second open enrollment period begins on Nov. 15. 

Michael Burgess is executive director of the New York State Alliance for Retired Americans, based in Latham.